The Butterfly Shaped Gland: Your Thyroid and How it Affects Your Health
In case this has never come up in your day-to-day conversations, January is Thyroid Awareness Month! And as we close out the month we thought we’d take a minute to ask the question - how much do you know about the thyroid and how yours is functioning?
When people experience issues with weight gain and can’t pinpoint the cause, they start to wonder “could something be wrong with my thyroid?”. Beyond that well-known aspect, the thyroid plays a much bigger part in our overall health.
What Does The Thyroid Do?
The thyroid gland is a small, butterfly-shaped gland located at the base of the neck just below the Adam's apple. Although small, the thyroid gland plays a major role in our body, influencing the function of many of the body’s most important organs, including the heart, brain, liver, kidneys and skin. Making sure that the thyroid gland is healthy and functioning properly is crucial to the body's overall well-being.
Thyroid disease is one of the most common conditions in Americans and it’s estimated that in the United States, about 20 million people have thyroid disease.
Ana Maria Kausel, MD, a leading endocrinologist in New York City gave us insight on thyroid problems, thyroid medication, what you can do to maintain optimal thyroid health and more. Dr. Kausel is board-certified in endocrinology, diabetes, and metabolism by the American Board of Internal Medicine. She's also a member of the American Association of Clinical Endocrinologists and the Endocrine Society. Dr. Kausel uses her extensive medical knowledge to offer highly personalized care. Check out her Instagram and blog here to learn all about her practice and thyroid health!
What are usually the underlying causes of thyroid disorders?
Autoimmune
Viral/bacteria
Medications (Checkpoint inhibitors now broadly used for cancer, amiodarone for the heart, lithium for bipolar.)
Iodine deficiency or excess
Pregnancy
Do you see a certain age of people that start to develop thyroid problems or is it a wide range?
It’s a wide range. It can really present at any age. They’re are times in life where it’s more important to diagnose it, like women seeking fertility and children and adolescents so there’s more screening and more diagnosis but technically it can come at any age.
Do you primarily see females with thyroid problems?
It’s more prevalent in women. High serum antithyroid peroxidase antibody (TPO antibodies for Hashimoto’s thyroiditis) concentrations are found in approximately 5% of all adults and approximately 15% of older women .Hypothyroidism is much (five to eight times) more common in women than men. For Hyperthyroidism (Graves Disease) the female to male ratio is 4:1
What symptoms do you see most that indicate there is a thyroid problem?
For hypothyroidism (underactive thyroid) it is changes in the menstrual cycle, fatigue, hair loss, miscarriages, slight weight gain, cold intolerance
For hyperthyroidism (overactive thyroid) it is unexplained weight loss, fatigue, anxiety, palpitations, frequent bowel movements.
What do you see more of overproduction or underproduction of thyroid hormone?
Underproduction is more common.
Could you have a thyroid problem and not know it?
Yes, specifically hypothyroidism.
How do people know if they have a thyroid problem? What kind of testing is the most popular? Is this always accurate? What do you recommend people do to find out if they have a thyroid issue?
The gold standard tests to diagnose any thyroid disease are TSH and Free T4 levels. Some doctors order T3 levels, although it’s not standardized. Some integrative medicine practitioners order Reverse T3 which should not be used as an indication to treat thyroid disease. Then based on whether the patient is hypo or hyper we send the necessary antibodies and additional tests.
Are treatment plans for thyroid disorders very specific based on the person?
Yes, based on age, whether the patient is pregnant or wants to get pregnant and most importantly based on the disease.
What are your thoughts on thyroid medication?
I would like to raise awareness about the use of thyroid medication. It is the most prescribed medication in the US and often used to treat weight gain and fatigue. It’s a medication that can have serious health consequences if not used correctly like bone loss, arrhythmias and even stroke.
What foods, supplements or lifestyle changes do you recommend for a healthy thyroid?
In regards to food, despite all the internet information available, there are no clinical studies that support that foods cause or cure thyroid disease. I find that most of my patients want to follow a gluten-free diet when they get diagnosed, yet the gluten study was very small and not clinically significant. More research is needed. Also there is a misconception about certain cruciferous vegetables that might cause thyroid enlargement (goiter) but again, this claim is still yet to be clinically proven and has to be consumed in HUGE AMOUNTS. Certain patients, like patients with thyroid cancer that will be treated with radioactive iodine benefit from a low iodine diet, but otherwise I never tell my patients to change their habits unless they’re very unhealthy.
I recommend less processed, more real foods and low sugar.
Regarding supplements, selenium has been clinically studied in patients who have eye disease due to Graves. I also usually tell patients seeking pregnancy to make sure their vitamins have the required amount of iodine (150 mcg of potassium iodine) and also to use ionized salt to cook since fancy salts do not have iodine. Otherwise I don’t recommend thyroid supplements. Some supplements in the market have animal thyroid tissue that can have bad health consequences.
What are the best things you can do to maintain optimal thyroid health?
Eating a balanced diet with good iodine and selenium. Basically nuts, shellfish and cook with ionized salt. Also stress management since it is often a trigger to develop thyroid disease, specifically autoimmune.
How to be proactive when it comes to thyroid health
An at-home self-exam known as the "neck check" can help you find thyroid lumps or enlargements on your own thyroid gland. If you want to visit a doctor and learn about your thyroid, find an endrocrinoligst near you!
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