What is the thyroid gland? Signs and Symptoms of Disease

The thyroid gland is a small, butterfly-shaped gland located in the base of the neck just below the Adam's apple. 

Although relatively small, the thyroid gland influences the function of many of the body’s most important organs, including the heart, brain, liver, kidneys and skin. Ensuring that the thyroid gland is healthy and functioning properly is important to the body's overall well- being.

Common Signs and Symptoms of Thyroid Disease

Hyperthyroidism:  When hyperthyroidism develops, a goiter (enlargement of the thyroid) is usually present and may be associated with some or many of the following features:

• Fast heart rate, often more than 100 beats per minute
• Becoming anxious, irritable, argumentative
• Trembling hands
• Weight loss, despite eating the same amount or even more than usual
• Intolerance of warm temperatures and increased likelihood to perspire
• Loss of scalp hair
• Tendency of fingernails to separate from the nail bed
• Muscle weakness, especially of the upper arms and thighs
• Loose and frequent bowel movements
• Smooth skin
• Change in menstrual pattern
• Increased likelihood for miscarriage
• Prominent "stare" of the eyes
• Protrusion of the eyes, with or without double vision (in patients with Graves’ disease)
• Irregular heart rhythm, especially in patients older than 60 years of age
• Accelerated loss of calcium from bones, which increases the risk of osteoporosis and fractures

Hypothyroidism:  In its earliest stage, hypothyroidism may cause few symptoms, since the body has the ability to partially compensate for a failing thyroid gland by increasing the stimulation to it, much like pressing down on the accelerator when climbing a hill to keep the car going the same speed. As thyroid hormone production decreases and the body’s metabolism slows, a variety of features may result.

• Pervasive fatigue
• Drowsiness
• Forgetfulness
• Difficulty with learning
• Dry, brittle hair and nails
• Dry, itchy skin
• Puffy face
• Constipation
• Sore muscles
• Weight gain and fluid retention
• Heavy and/or irregular menstrual flow
• Increased frequency of miscarriages
• Increased sensitivity to many medications

Hashimoto’s Thyroiditis:  Hashimoto’s thyroiditis may not cause symptoms for many years and remain undiagnosed until an enlarged thyroid gland or abnormal blood tests are discovered as part of a routine examination. When symptoms do develop, they are either related to local pressure effects in the neck caused by the goiter itself, or to the low levels of thyroid hormone.

The first sign of this disease may be painless swelling in the lower front of the neck. This enlargement may eventually become easily visible. It may be associated with an uncomfortable pressure sensation in the lower neck. This pressure on surrounding structures may cause additional symptoms, including difficulty swallowing.

Although many of the features associated with thyroid hormone deficiency occur commonly in patients without thyroid disease, patients with Hashimoto’s thyroiditis who develop hypothyroidism are more likely to experience the following:

• Fatigue
• Drowsiness
• Forgetfulness
• Difficulty with learning
• Dry, brittle hair and nails
• Dry, itchy skin
• Puffy face
• Constipation
• Sore muscles
• Weight gain
• Heavy menstrual flow
• Increased frequency of miscarriages
• Increased sensitivity to many medications

The thyroid enlargement and/or hypothyroidism caused by Hashimoto’s thyroiditis progresses in many patients, causing a slow worsening of symptoms. Therefore, patients with either of these findings should be recognized and adequately treated with thyroid hormone. Optimal treatment with thyroid hormone will eliminate any symptoms due to thyroid hormone deficiency, usually prevent further thyroid enlargement, and may sometimes cause shrinkage of an enlarged thyroid gland.

Thyroid Nodule:  Most patients with thyroid nodules have no symptoms whatsoever. Many are found by chance to have a lump in the thyroid gland on a routine physical exam or an imaging study of the neck done for unrelated reasons (CT or MRI scan of spine or chest, carotid ultrasound, etc.).

In addition, a substantial number are first noticed by patients or those they know who see a lump in the front portion of the neck, which may or may not cause symptoms, such as a vague pressure sensation or discomfort when swallowing. Obviously, finding a lump in the neck should be brought to the attention of your physician, even in the absence of symptoms.

Family History:  A familiar place to look for thyroid disorder signs and symptoms is your family tree. If you have a first degree relative (a parent, sibling, or child) with thyroid disease, you would benefit from thyroid evaluation. Women are more prominent thyroid patients than men; however, the gene pool runs through both. According to a national survey by the American Association of Clinical Endocrinologists (AACE), more than three-fourths (76%) of the population do not know that thyroid disease runs in families.

Other Reasons to Consider a Thyroid Evaluation

• Prescription Medications: If you are taking Lithium, Amiodarone, Antithyroid drugs (either PTU or Tapazole), or Levothyroxine, you should consider a thyroid evaluation.

• Radiation Therapy to the Head or Neck: If you have had any of the following radiation therapies, you should consider a thyroid evaluation: radiation therapy for tonsils, radiation therapy for an enlarged thymus, or radiation therapy for acne.

• Chernobyl: If you have leaved near Chernobyl at the time (1986) of the nuclear accident, you should consider a thyroid evaluation.