Between managing the kids, the house, work and other commitments, it’s not uncommon to feel like every bit of energy has been sapped out of you. But if that exhaustion is coupled with unexplained weight gain, sensitivity to heat and cold or even hair loss, it could be a sign of a thyroid disorder. More than 20 million people in the country—mostly female—live with thyroid disease. How do you know if you have one of these disorders and how do you treat it?


The thyroid is a small but powerful butterfly-shaped gland at the front of the neck that produces the hormone thyroxine, which affects the entire body—brain, skin, hair, weight, energy and more. Because the thyroid’s influence is so widespread, symptoms alone aren’t enough to diagnose thyroid disease. What makes it even harder to diagnose is the fact that most people with symptoms don’t have thyroid disease, according to Fredric E. Wondisford, MD, professor and chair of medicine at Rutgers- Robert Wood Johnson School of Medicine.


A primary care physician can diagnose thyroid disease by feeling the thyroid gland, considering family history and ordering blood tests. “TSH (thyroid stimulating hormone) is the single best test for detecting thyroid disease,” says Wondisford. TSH is the hormone the pituitary gland produces to regulate the amount of thyroxine the thyroid makes. High TSH is a sign of hypothyroidism, or an underactive thyroid. Low TSH is a sign of hyperthyroidism, or an overactive thyroid.

There are two other blood tests. One checks the thyroxine level; the other checks for antibodies, which can mistakenly attack the thyroid. Antibodies are signs of a possible autoimmune disease. If diagnosed with a thyroid disorder, or if there’s a family history, Wondisford advises patients to see an endocrinologist for treatment.


The most common thyroid disease, hypothyroidism, means the thyroid is not producing enough hormone. Symptoms include fatigue, depression, frequent and heavy menstrual periods, forgetfulness, trouble concentrating, weight gain, hair loss, dry and coarse skin and hair, hoarseness, muscle aches, elevated cholesterol and extreme sensitivity to cold.

Hypothyroidism can also be a symptom of Hashimoto’s disease, an autoimmune disease in which the body attacks the thyroid. Since hypothyroidism involves too little of the hormone being produced, the treatment is to prescribe synthetic or artificial thyroid hormone, like levothyroxine.


With hyperthyroidism, the thyroid produces too much thyroid hormone. This overstimulates the body so it rapidly sucks up all your energy. Symptoms include weight loss, nervousness, irritability, increased sweating, rapid heartbeat, shaky hands, anxiety, difficulty sleeping, thinning of the skin, fine and brittle hair, more frequent bowel movements and light or less frequent menstrual cycles.

With Graves’ disease, the most common form of hyperthyroidism, symptoms also include bulging eyes, eyes that appear enlarged and an abnormally large thyroid, also known as a goiter.

Since hyperthyroidism is caused by the production of too much thyroid hormone, treatment includes taking drugs that block thyroid hormone production, using radioactive iodine to keep the thyroid from making thyroxine hormone or thyroid removal surgery.


Nodules are growths on the thyroid. The best way to detect them is with an ultrasound. Though most are small, noncancerous and don’t require treatment, they should be checked regularly to see if they’ve grown. Depending on the cause, medical treatment includes iodine supplements, artificial thyroid hormone or shrinking the goiter with radioactive iodine. Thyroid cancer develops from the tissues of the thyroid gland. If cancer is detected and treated early, there’s a high chance of successfully removing it.


There are a variety of issues that can affect your thyroid function. According to Mark Hyman, MD, director of the Cleveland Clinic’s Center for Functional Medicine and a New York Times bestselling author, we can improve our thyroid function by taking medication and avoiding the following triggers, he says on his website (drhyman.com). They include:

• Chronic stress—the more stress, the less the thyroid functions

• Diets that lack certain nutrients, such as iodine (which the thyroid needs to make the thyroxine hormone), vitamin D, omega-3 fats, selenium, zinc, vitamin A and B vitamins

• Chronic inflammation caused by gluten and genetically modified grains, which interfere with the thyroid

• Heavy metals, like mercury, in the blood Andrea Beaman, holistic health coach, herbalist and author of Happy, Healthy Thyroid, knows firsthand the importance of addressing lifestyle and dietary patterns that damage the thyroid. After being diagnosed with an abnormally large thyroid, she refused irradiated iodine treatments. “Those would have destroyed [my] goiter and made me have a hypothyroid for life,” says Beaman (andreabeaman.com). Instead, she made dietary and lifestyle changes. She started exercising, actively avoiding stress, eating organic fruits and vegetables and cutting out sugar, artificial sugar, gluten and chemical food additives. Eighteen months later, her goiter disappeared. Within two years, her thyroid levels were normal.

Treatment for conditions like a thyroid disorder is never black and white; patients and circumstances vary. Explore your options, then talk to your doctor about what’s right for you. For more information, head to clevelandclinic.org and womenshealth.gov.

Karen Gibbs is a freelance lifestyle writer based in Louisiana.