When you think of the body parts central to who you are, the brain and heart probably come to mind, maybe even the gut. But let me nominate another candidate: the thyroid.
A butterfly-shaped gland at the front of your neck, the thyroid is the conductor of the orchestra that is your endocrine system. It supports or regulates literally every function in your body, including your metabolism, yet most people give more thought to their pet’s thyroid (thanks to persistent nagging at the vet’s office) than to their own.
That is seriously short shrift for what’s been called the great regulator of body and mind.
Thyroids Create and Distribute Hormones
The thyroid triggers a symphony’s worth of metabolic processes by creating and distributing hormones. The ones you hear about most are T3 (triiodothyronine) and T4 (thyroxine), which play big roles in regulating the speed of your metabolism–particularly how fast your body produces energy from nutrients.
By triggering the release of these two, a third compound called TSH (thyroid stimulating hormone, made in the pituitary gland) helps lay the foundation for a boggling number of other hormonal functions.
T3, T4 and TSH collaborate to determine how much cholesterol is converted into pregnenolone, progesterone, and DHEA, which in turn result in the production of testosterone, estrogen and cortisol.
But the thyroid’s influences run throughout. Every cell in the human body has receptors for hormones produced in the gland, making a healthy thyroid essential to reproduction, growth, clear thinking and cardiovascular health.
Unfortunately, things do go wrong.
An estimated 20 million Americans have some form of thyroid disease, according to the American Thyroid Association, and an estimated 5 percent of women and 3 percent of men in the U.S. have undiagnosed dysfunction of the gland.
Problems can occur when things get out of whack between the thyroid and supporting players like the pituitary gland and hypothalamus. Commonly the thyroid gets a misguided signal to produce too much or too little T3 and T4, or is unable to answer the call at all.
Causes of Thyroid Disease
Genetics, tumors, environmental toxins and radiation, autoimmune disease, and certain types of poisoning can all be culprits. When the thyroid goes into errant overdrive, it’s called hyperthyroidism. When it’s dragging and doing too little work it’s known as hypothyroidism. The latter is more common, but both can wreak havoc on a person trying to stay fit. You can even have both at once.
Diagnosing Thyroid Disease is Difficult
Symptoms of thyroid problems can be all over the map. People with hypothyroidism may be chronically tired and cold, hoarse, experience hair loss, put on extra weight despite dieting, have memory problems and generally feel blah.
Hyperthyroidism can also leave you exhausted and losing your hair, but may include nervousness and irritability, more frequent bowel movement, feeling too hot, having a racing heart, and unexplained weight loss. Symptoms typically come on slowly and build over time.
Most of these problems can be managed. The bad news is that until the conditions are diagnosed and treated, otherwise healthy aspects of diet and exercise can actually make matters worse.
“For someone who has significant clinical hyperthyroidism, it’s as if they are already running a treadmill every day, even in their sleep,” Cleveland Clinic endocrinologist Christian Nasr, MD said on the clinic website. “Excessive exercise can cause a patient to go into heart failure if their thyroid hormones are not under control.”
Challenges of Underactive Thyroid
People with hypothyroidism should also be careful, Nasr said. When underactive, the gland causes slowing of the pulse, and exercise can put a big strain on the languid heart. Even in healthy people, intense aerobic exercise has a big impact on circulating levels of thyroid hormones. Read how Alyson overcame hypothyroidism to lose 77 pounds.
Some raw veggies contain natural pesticides that can also harm an ailing thyroid. So-called goitrogens disrupt the production of T3 and T4 by interfering with iodine uptake in the gland (lack of iodine is globally the leading cause of goiter, a pronounced enlargement of the thyroid.)
Plants heavy in goitrogens include cruciferous vegetables like broccoli, cabbage, kale, and cauliflower. Cooking these vegetables removes much of the threat.
Test and Treatment
So what to do if you think your thyroid may be on the fritz?
“If you’re feeling fine and your weight is stable, there’s no need to get checked,” Tiffany Hor, MD, an endocrinologist at Rush University Medical Center, said on the university website. “But if you notice one or more of these symptoms, or if you have a family history of thyroid dysfunction, ask your primary care doctor whether you should be tested.”
The standard test for either hypo- or hyperthyroidism is to measure TSH levels in the blood. If the thyroid is underactive, the pituitary gland will pump out more TSH, instructing it to work harder. The higher your TSH level, the greater your chance of having hypothyroidism. With hyperthyroidism, your doctor may also test for levels of T3 and T4 directly.
The goal of any treatment will be to restore hormone levels to their normal range, which fluctuate over time.
Don’t Go It Alone
While the Internet is full of diets and workouts aimed at fixing what’s broken, most genuine disorders require treatment beyond what you can do on your own. And medical treatment is often very straightforward.
Hypothyroidism is usually treated with a synthetic hormone that you take as a pill. Oral medication is also a common treatment for hyperthyroidism as are radiation and surgery, both of which require a lifetime course of synthetic hormones.
Once your condition is under control, your ability to lose weight should return. But because thyroid hormone levels fluctuate in even healthy people due to stress and other factors, those starting new fitness routines should check with their doctor to see if their medication dosage needs adjusting.
The thyroid influences and controls many functions in the body, so if these symptoms sound familiar be sure to see your medical provider and maintain your good health.