It’s estimated that 59 million Americans have a thyroid problem, but the majority don’t even know it yet. The thyroid, a butterfly-shaped gland located in the neck, is the master gland of metabolism. When your thyroid doesn’t function, it can affect every aspect of your health, and in particular, weight, depression and energy levels.
Since undiagnosed thyroid problems can dramatically increase your risk of obesity, heart disease, depression, anxiety, hair loss, sexual dysfunction, infertility and a host of other symptoms and health problems, it’s important that you don’t go undiagnosed.
You don’t need to have all of these symptoms in order to have a thyroid problem, but here are some of the most common signs that you may have a thyroid condition:
- Muscle and Joint Pains, Carpal Tunnel/Tendonitis Problems.
Aches and pains in your muscles and joints, weakness in the arms and a tendency to develop carpal tunnel in the arms/hands and tarsal tunnel in the legs, can all be symptoms of undiagnosed thyroid problems.
- Neck Discomfort/Enlargement.
A feeling of swelling in the neck, discomfort with turtlenecks or neckties, a hoarse voice or a visibly enlarged thyroid can all be symptoms of thyroid disease.
To help find out if your thyroid may be enlarged, try a simple “Thyroid Neck Check” test at home.
- Hair/Skin Changes.
Hair and skin are particularly vulnerable to thyroid conditions, and in particular, hair loss is frequently associated with thyroid problems. With hypothyroidism, hair frequently becomes brittle, coarse and dry, while breaking off and falling out easily. Skin can become coarse, thick, dry,and scaly. In hypothyroidism, there is often an unusual loss of hair in the outer edge of the eyebrow. With hyperthyroidism, severe hair loss can also occur, and skin can become fragile and thin.
- Bowel Problems.
Severe or long-term constipation is frequently associated with hypothyroidism, while diarrhea or irritable bowel syndrome (IBS) is associated with hyperthyroidism.
- Menstrual Irregularities and Fertility Problems.
Heavier, more frequent and more painful periods are frequently associated with hypothyroidism, and shorter, lighter or infrequent menstruation can be associated with hyperthyroidism. Infertility can also be associated with undiagnosed thyroid conditions.
It’s estimated that 59 million Americans have a thyroid problem, but the majority don’t even know it yet. The thyroid, a butterfly-shaped gland located in the neck, is the master gland of metabolism. When your thyroid doesn’t function, it can affect every aspect of your health, and in particular, weight, depression and energy levels.
Since undiagnosed thyroid problems can dramatically increase your risk of obesity, heart disease, depression, anxiety, hair loss, sexual dysfunction, infertility and a host of other symptoms and health problems, it’s important that you don’t go undiagnosed.
You don’t need to have all of these symptoms in order to have a thyroid problem, but here are some of the most common signs that you may have a thyroid condition:
- Muscle and Joint Pains, Carpal Tunnel/Tendonitis Problems.
Aches and pains in your muscles and joints, weakness in the arms and a tendency to develop carpal tunnel in the arms/hands and tarsal tunnel in the legs, can all be symptoms of undiagnosed thyroid problems. (For more information)
- Neck Discomfort/Enlargement.
A feeling of swelling in the neck, discomfort with turtlenecks or neckties, a hoarse voice or a visibly enlarged thyroid can all be symptoms of thyroid disease.
To help find out if your thyroid may be enlarged, try a simple “Thyroid Neck Check” test at home.
- Hair/Skin Changes.
Hair and skin are particularly vulnerable to thyroid conditions, and in particular, hair loss is frequently associated with thyroid problems. With hypothyroidism, hair frequently becomes brittle, coarse and dry, while breaking off and falling out easily. Skin can become coarse, thick, dry,and scaly. In hypothyroidism, there is often an unusual loss of hair in the outer edge of the eyebrow. With hyperthyroidism, severe hair loss can also occur, and skin can become fragile and thin.
- Bowel Problems.
Severe or long-term constipation is frequently associated with hypothyroidism, while diarrhea or irritable bowel syndrome (IBS) is associated with hyperthyroidism.
- Menstrual Irregularities and Fertility Problems.
Heavier, more frequent and more painful periods are frequently associated with hypothyroidism, and shorter, lighter or infrequent menstruation can be associated with hyperthyroidism. Infertility can also be associated with undiagnosed thyroid conditions.
- Family History.
If you have a family history of thyroid problems, you are at a higher risk of having a thyroid condition yourself. You may not always be aware of thyroid problems in your family, though, because among older people, it is often referred to as “gland trouble” or “goiter.” So pay attention to any discussions of glandular conditions or goiter or weight gain due to “a glandular problem,” as these may be indirect ways of referring to thyroid conditions.
- Cholesterol Issues
High cholesterol, especially when it is not responsive to diet, exercise or cholesterol-lowering medication, can be a sign of undiagnosed hypothyroidism. Unusually low cholesterol levels may be a sign of hyperthyroidism.
- Depression and Anxiety.
Depression or anxiety — including sudden onset of panic disorder — can be symptoms of thyroid disease. Hypothyroidism is most typically associated with depression, while hyperthyroidism is more commonly associated with anxiety or panic attacks. Depression that does not respond to antidepressants may also be a sign of an undiagnosed thyroid disorder.
- Weight Changes.
You may be on a low-fat, low-calorie diet with a rigorous exercise program, but are failing to lose or gain any weight. Or you may have joined a diet program or support group, such as Weight Watchers, and you are the only one who isn’t losing any weight. Difficulty losing weight can be a sign of hypothyroidism. You may be losing weight while eating the same amount of food as usual — or even losing while eating more than normal. Unexplained weight changes and issues can be signs of both hypothyroidism or hyperthyroidism.
- Fatigue.
Feeling exhausted when you wake up, feeling as if 8 or 10 hours of sleep a night is insufficient or being unable to function all day without a nap can all be signs of thyroid problems. (With hyperthyroidism, you may also have nighttime insomnia that leaves you exhausted during the day.)
Diagnosing thyroid disease is a process that can incorporate numerous factors, including clinical evaluation, blood tests, imaging tests, biopsies, and other tests.
CLINICAL EVALUATION
A critical part of detecting and diagnosing thyroid disease is the clinical evaluation conducted by a trained practitioner. As part of a thorough clinical evaluation, your practitioner typically should do the following:
- Feel (also known as “palpating”) your neck.
- Listen to your thyroid using a stethoscope.
- Test your reflexes.
- Check your heart rate, rhythm and blood pressure.
- Measure your weight.
- Measure body temperature.
- Examine your face.
- Examine your eyes.
- Observe the general quantity and quality of your hair.
- Examine your skin.
- Examine your nails and hands.
- Review other clinical signs
Find out more about the specifics of the clinical evaluation for thyroid disease in this article.
THYROID BLOOD TESTS
The blood tests that may be done as part of a thyroid diagnosis include the following:
- Thyroid Stimulating Hormone (TSH) Test
- Total T4/ Total Thyroxine
- Free T4 / Free Thyroxine
- Total T3 / Total Triiodothyronine
- Free T3 / Free Triiodothyronine
- Thyroglobulin/Thyroid Binding Globulin/TBG
- T3 Resin Uptake (T3RU)
- Reverse T3
- Thyroid Peroxidase Antibodies (TPOAb) / Antithyroid Peroxidase Antibodies
- Antithyroid Microsomal Antibodies / Antimicrosomal Antibodies
- Thyroglobulin Antibodies / Antithyroglobulin Antibodies
- Thyroid Receptor Antibodies (TRAb)
- Thyroid-Stimulating Immunoglobulins (TSI)
Find out more about these blood tests for thyroid disease in this article.
THYROID IMAGING TESTS
A number of imaging tests are performed for diagnosis of various thyroid conditions. These tests include:
- Nuclear Scan / Radioactive Iodine Uptake (RAI-U) – which can tell whether a person has Graves’ disease, toxic multinodular goiter, or thyroiditis.
- CT Scan – to help detect and diagnose a goiter, or larger thyroid nodules.
- MRI / Magnetic Resonance Imaging – to evaluate the size and shape of the thyroid
- Thyroid Ultrasound – to evaluate nodules, lumps and enlargement of your gland. Ultrasound can tell whether a nodule is a fluid-filled cyst, or a mass of solid tissue.
Find out more about these imaging tests for thyroid disease in this article.
THYROID BIOPSY/ASPIRATION
A needle biopsy, also known as fine needle aspiration (FNA) is used to help evaluate lumps or cold nodules. In a needle biopsy, a thin needle is inserted directly into the lump, some cells are withdrawn and they are evaluated for cancer. (Some practitioners use ultrasound while conducting a biopsy in order to ensure that the needle goes into the right position.) Cancer can be definitively diagnosed about 75 percent of the time from FNA. Evaluation of biopsy results can also show cells indicative of Hashimoto’s thyroiditis.
Find out more about fine needle aspiration (FNA) biopsy of the thyroid in this Q&A article.
OTHER DIAGNOSTIC TESTS AND PROCEDURES
Practitioners sometimes use other diagnostic tests and procedures to identify thyroid dysfunction. The use of these tests is considered controversial to mainstream practitioners, but many of these tests are well-accepted and in use among alternative, integrative and holistic physicians. These tests include:
- Iodine Patch Tests
- Saliva Testing
- Urinary Testing
- Basal Body Temperature Testing
Find out more about unconventional diagnostic tests in this article.
THYROID SELF-TESTS / ORDERING YOUR OWN TESTS
Some patients need to be highly involved in their thyroid diagnosis and care, which is where self-tests and the ability to order your own tests can be a critical tool for an empowered patient. Among the options for patients include:
- The Thyroid Neck Check – A check you can perform yourself.
- MyMedLab.com Blood Tests, including Anti-Thyroid Antibodies (Thyroglobulin Antibodies and Thyroid Peroxidase Antibodies), Free T4, Free T3, Reverse T3, and more
- ZRT Laboratory’s Saliva and Bloodspot Testing, including TSH, Free T4, Free T3, and Thyroid Peroxidase (TPO) Antibody.
- Diagnostechs Saliva Testing, including TSH, Free T4, Free T3, and antimicrosomal antibodies.
Find out more about self-tests, and how to order your own thyroid tests in this article.
BEING INFORMED AND EMPOWERED
Being informed and knowledgeable about thyroid disease signs, symptoms and risks can be an important part of getting properly diagnosed.
Interactive thyroid quizzes are important tools to help you identify risks and symptoms in particular areas.
Other tools that can be helpful in preparing for a visit with your physician, or during the actual examination, are checklists of risks and symptoms.
DIAGNOSING THYROID CONDITIONS
Diagnosis of various thyroid disease and conditions involves clinical examination, blood tests, and in some cases, imaging tests and/or biopsy. There are different tests and procedures used to diagnose the following thyroid problems:
- Hypothyroidism
- Hashimoto’s Disease
- Hyperthyroidism
- Graves’ Disease
- Goiter
- Nodules
- Thyroid Cancer
