Tired? Moody? Heavier? Might be your thyroid

Dr. Judith Reichman 'Today' show contributor • Profile • E-mail

Feeling unusually tired, depressed, or nervous? Are you experiencing unexplained hot flashes, changes in your menstrual cycle, or weight fluctuations? These symptoms may be due to thyroid abnormalities. Dr. Judith Reichman was invited to appear on “Today” to help us understand the workings of the thyroid — the gland “that rules the body” — works, and what can happen if it doesn’t function properly.

If your thyroid is working as it should, you won’t even realize that you have one. But if it isn’t, you’ll definitely notice it. If the gland doesn't make enough hormones, this is called hypothyroidism, a condition which causes your metabolism to slow down. And if your thyroid makes too much, it will cause hyperthyroidism, a condition that causes your metabolism (you guessed it) to speed up. 

What is the thyroid gland?
The thyroid is a butterfly-shaped gland found at the base of your Adam’s apple. It secretes the hormones that influence the growth and development of all your tissues, and regulates metabolism for your entire body. These hormones, T3 (triiodothyronine) and T4 (thyroxine), are the only ones in your body that contain iodine. T4 is the primary product of thyroid secretion. Once T4 is in the body’s tissues, its iodine portion is removed and it becomes T3. This is the biologically active thyroid hormone that enters the cells and “does its thing.”

Production and secretion of the thyroid hormones is controlled by another hormone, one that is produced in the pituitary gland of the brain. This is aptly called the thyroid-stimulating hormone (TSH). If the pituitary gland and the brain center that controls its hormone production sense that there’s too much T3 and T4 in the body, it ceases to make and release TSH. To determine thyroid activity, we can either measure T3 and T4 levels in the blood or we can measure TSH. Low levels of TSH will occur when T3 and T4 are too high. High TSH means the pituitary gland is working hard to try to elevate T3 and T4 levels in an inadequately responsive thyroid.

Only on TODAY.MSNBc.com! Dr. Judith Reichman addresses your questions about women's health. LAST WEEK: Will removing my ovaries prevent cancer? GO TO ALL HEALTH TUESDAY COLUMNS

Who is at risk for hypothyroidism?
In the U.S., the most common cause of hypothyroidism is a chronic autoimmune disorder (that’s when the body’s antibodies attack the thyroid gland) called Hashimoto’s disease. You’re at risk if you have a family history of thyroid disease, if your thyroid becomes enlarged (this may be due to an inflammation called thyroiditis), if your thyroid develops an irregular shape (due to a benign growth or goiter), or if you have an autoimmune disorder such as lupus or rheumatoid arthritis.

Hypothyroidism is 10 times more likely to affect women than it is men. It occurs in 4 percent to 11 percent of all women. The female prevalence of this disorder may have to do with our fluctuating hormones during puberty, periods, pregnancy, and peri-menopause. Changes in estrogen and progesterone may also trigger an autoimmune reaction so that antibodies mistakenly attack and destroy thyroid tissue. This is more likely to occur as we get older and after pregnancy (especially in diabetic women). In as many as 5 percent of postpartum women, the thyroid may undergo nonspecific inflammation (thyroiditis) and, at least for a short period of time, produce inadequate amounts of thyroid hormones. In some cases, the thyroid remains slow (symptoms that mimic postpartum depression may persist) and therapy is needed. 

What are the symptoms of hypothyroidism?

• Lethargy
• Weight gain from fluid retention
• Cold intolerance
• Constipation
• Dry skin
• Coarseness and loss of hair
• Memory and mental impairment
• Decreased concentration
• Depression
• Irregular or heavy periods, or infertility
• High cholesterol
• Symptoms that mimic those of menopause

Hypothyroidism can directly affect the central nervous system, cellular metabolism, utilization of glucose, the inner thermostat, bowel function, and production of lipids. It can cause the skin to lose water content. Because of the central nervous system effects and the general slowing down of metabolism (and weight gain), depression may follow. Appropriate amounts of  the thyroid’s hormones are necessary for regular ovulation, cycles, and fertility. An insufficiency disrupts these functions.

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