Many symptoms that people think are “normal” actually indicate that there is a hormonal imbalance. A common form of hormonal imbalance involves the thyroid gland, an important organ that affects almost every function of your body.
What does the thyroid do?
The thyroid gland is a small butterfly-shaped gland on the front of the neck. “It acts as the body’s thermostat, making thyroid hormones and turning the metabolism up and down,” says Melissa Groves Azzaro, a registered dietitian and author of A Balanced Approach to PCOS. Thyroid hormones are used by every cell in the body, she says, so they affect almost every body system.
Thyroid health isn’t just a matter of producing thyroid hormone, however. This gland works through a complex series of actions, says Dr. Jessica Wright, owner and medical director at Rejuvenate Austin.
This is how it works:
- Your pituitary gland (a small gland at the base of your brain) produces thyroid stimulating hormone, or TSH.
- But the pituitary gland only secretes TSH when the hypothalamus (a small part of your brain near the pituitary gland) secretes thyrotropin-releasing hormone, or TRH.
- This feedback loop helps balance thyroid hormone levels in the body.
- When everything works in harmony, the thyroid gland produces thyroxine (T4) and triiodothyronine (T3), two thyroid hormones needed for a number of bodily functions.
Signs of a thyroid hormone imbalance
Thyroid hormone imbalance can lead to some very uncomfortable symptoms. They differ depending on whether you have too much or too little thyroid hormone.
Signs of hyperthyroidism (too much thyroid hormone) include:
- Weight loss
- Feeling hot
- Fast heartbeat or palpitations
- Irregular menstrual cycle
Signs of hypothyroidism (low levels of thyroid hormone) include:
- Weight gain
- Dry skin
- Brittle nails
- Hair loss
- Feeling cold (especially hands and feet)
- Little energy
- Low body temperature
- Irregular menstrual cycle
What causes a thyroid hormone imbalance?
Most thyroid problems are symptoms of medical conditions, Wright says, but lifestyle factors, such as diet and stress, can also contribute.
Autoimmune and Medical Conditions
Hyperthyroidism is caused by a number of diseases, Wright says, with Grave’s disease being the No. 1 cause. In people with Grave’s disease, the immune system produces antibodies that bind to thyroid-stimulating hormone receptors and tell your thyroid to produce more thyroid hormone. “There’s no off switch here,” says Wright, and it requires medical treatment.
Other conditions behind hyperthyroidism include:
- Plummer’s disease: enlargement of the thyroid gland and overproduction of T4
- Hyperfunctioning thyroid nodules: Parts of your thyroid gland produce too much T4
- Thyroiditis: inflammation of the thyroid gland
The most common cause of hypothyroidism is Hashimoto’s thyroiditis, an autoimmune disease that occurs when your immune system produces antibodies that attack your thyroid even when there is no disease.
Hypothyroidism can also be caused by:
- Over-correction of hyperthyroidism
- Removal or radiation of the thyroid gland
- Cancer treatments
“The thyroid gland is affected by your adrenal glands at the level of the hypothalamus,” explains Wright. “Too much cortisol and you suppress the thyroid by limiting the amount of thyrotropin-releasing hormone, which in turn decreases the thyroid stimulating hormone.”
Low TSH decreases the amount of thyroid hormone secreted, “and you now have a picture similar to hypothyroidism when the problem is the adrenal glands,” says Wright.
Many lifestyle factors can cause this, but physical or mental stress is at the top of the list, she says. Excessive exercise and dieting can strain the body and cause this effect, as can stressors such as work and relationships.
Eating patterns and nutritional status have a major impact on all hormone levels, including thyroid hormones.
“Malnutrition in general causes the body to slow down the metabolism by lowering the production of thyroid hormones,” says Azzaro. “In addition, it takes several important nutrients to make enough thyroid hormones and convert them into the active, usable form. These are iodine, selenium, zinc and iron.” Too little of these can negatively affect your thyroid.
Iodine is of particular concern, Wright says. A diet with insufficient iodine can lead to hypothyroidism because the thyroid gland needs iodine to produce the hormone. “In this situation, the thyroid gland becomes enlarged and can form a goiter,” she says, which is an abnormal enlargement of the thyroid gland. However, too much iodine can stimulate hyperthyroidism.
What happens if you don’t treat it?
Mild consequences of hypothyroidism include weight gain and high cholesterol, Azzaro says. Chronically low thyroid hormones can lead to much worse effects, including infertility and nerve damage.
Hypothyroidism also carries pregnancy risks and “absolutely must be corrected during pregnancy for the normal development of the fetus,” says Wright. It also increases your risk of heart disease.
Hyperthyroidism often results in emergency medical care because of an increased heart rate, abnormal heart rhythms and palpitations, Azzaro says. It can also lead to osteoporosis and eye problems. In many cases, hyperthyroidism requires removal or radiation of the thyroid gland, and the person has to use thyroid hormone replacement for the rest of their life.
“If hyperthyroidism is not controlled, it can lead to life-threatening cardiac arrhythmias and damage to the myocardium or heart muscle,” added Wright.
How to Fix Thyroid Problems
Azzaro recommends starting with your diet and making sure your levels of thyroid supporting nutrients like iodine, zinc, selenium and iron are within normal ranges. Then make sure you don’t exercise too much or are under prolonged stress, she suggests.
If you’re making your lifestyle in vain, definitely consider seeing a functional medicine doctor or endocrine specialist to assess your thyroid health. An endocrine specialist should run several tests to check for any underlying causes of a thyroid imbalance.
Some cases of hypo and hyperthyroidism can be resolved with lifestyle changes under the guidance of a specialist, while others require surgery or treatment for underlying medical conditions.
The information in this article is for educational and informational purposes only and is not intended to be health or medical advice. Always consult a physician or other qualified health care practitioner if you have any questions about a medical condition or health goals.