by Sasha Reddy
One of the smallest organs – a butterfly-shaped gland that sits at the front of the neck – contributes to countless processes in our bodies. From the rate our eyelashes grow to how quickly we metabolize food, the thyroid is the conductor that sets the pace for the orchestra of systems that help us move through the world. It’s become a hot topic in the medical community in recent years as doctors have begun diagnosing thyroid disease at a concerning rate. What could be causing this spike in cases? Is thyroid disease really becoming more common, or is it just getting easier to spot?
How Does the Thyroid Work?
Your thyroid produces two regulatory hormones, T3 and T4. These hormones are significantly linked to the performance of your metabolism. When there is not enough thyroid hormone in the body (known as hypothyroidism), bodily processes slow down. This can leave people feeling lethargic and unable to concentrate or think efficiently, along with a slew of other symptoms. Hypothyroidism is the most common type of thyroid disease. Conversely, when there is too much thyroid hormone in the body (known as hyperthyroidism), bodily processes speed up, which can cause weight loss, anxiety, fatigue, heart arrhythmia, and more.
Together, the thyroid and the pituitary gland – another key player of the endocrine system and part of the brain – create a feedback loop. When levels of T3 and T4 are low, the pituitary gland releases a different hormone that stimulates production of T3 and T4 in the thyroid. While an imbalance of T3 and T4 can be caused by a pituitary problem, it’s usually the result of thyroid dysfunction.
For those with undiagnosed thyroid dysfunction, it’s easy to chalk up many of the symptoms to simply “feeling off.” It isn’t unheard of for a “healthy” person to feel fatigued, for example – maybe they just need to pin down a regular bedtime or give their body time to recoup. Weight fluctuation isn’t uncommon, either – that can usually be ascribed to a lack of exercise or an unhealthy diet. What’s important to recognize is that these otherwise unremarkable sensations and changes could indicate a bigger systemic issue. The nation’s best thyroid research institutions estimate that for every five Americans with thyroid disease, three are undiagnosed. So, if you are experiencing any of these symptoms, it’s worth having a conversation with your doctor or an endocrinologist to rule thyroid issues in or out.
| Hypothyroidism | Hyperthyroidism | |
| Meaning | Underactive thyroid; not enough thyroid hormone is produced | Overactive thyroid; too much thyroid hormone is produced |
| Prevalence1 | Occurs in ~5% of Americans | Occurs in ~1% of Americans |
| Examples of associated disorders | – Hashimoto’s – Thyroiditis (inflamed thyroid) | – Graves Disease – Thyroiditis (inflamed thyroid) |
| Symptoms2 | – Weight gain – Tiredness – Constipation – Menstrual irregularities – Depression – Feeling cold – Dry skin | – Weight loss – Tiredness – Increased appetite – Menstrual irregularities – Irritability – Palpitations – Hair thinning |
The Consequences for Women
Women are up to eight times more likely than men to have thyroid problems.3 Moreover, the implications of a thyroid disorder are more severe for women than men. When levels of T3 and T4 are not optimal, the female reproductive system is one key area where issues can manifest:
Effects on Conception –
Both hypothyroidism and hyperthyroidism can disrupt ovulation, the release of egg cells to the uterus for fertilization. Furthermore, individuals with thyroid issues may get their periods at varying intervals, and menstrual flow can be impacted as well.4 Any of the above side effects make it more difficult to become pregnant.
Effects During Pregnancy –
Thyroid hormones contribute to the development of a child’s brain in the womb. If left untreated, imbalances of T3 and T4 in an expecting mother can cause problems for mom and baby, from preeclampsia and miscarriage to a birth weight of less than five pounds, poor brain development, and other birth defects.4
Are More People Being Affected?
In short, maybe. A study compiling data on thyroid disease diagnoses in Scotland between 1994 and 2001 found that the population-wide prevalence of thyroid dysfunction increased from 2.3% to 3.8% during those years. The study also found that the age at which subjects were being diagnosed decreased over time.5 Furthermore, the American Thyroid Association estimates that 20 million Americans – or roughly six percent of the US population – have some thyroid dysfunction, whether diagnosed or not. All this would make it appear that rates of hypo- and hyperthyroidism are increasing. But there are a few reasons why that may not be the case.
Firstly, our ability to test for thyroid disease is now better than ever. The most common blood tests measure levels of T4 and TSH (thyroid stimulating hormone – this is the hormone produced by the pituitary gland when the body runs low on T3 and T4). Various methods of imaging as well as tissue biopsies are available and are often used to find or analyze thyroid nodules. Heck, the American Association for Clinical Endocrinology even has a guide for performing a preliminary thyroid check for yourself at home with a gulp of water and a mirror.6
Secondly, increasing awareness and media coverage of thyroid diseases may be leading more individuals to get tested. Think about it: you probably know at least one person who has spoken with an endocrinologist or expressed concerns about their thyroid brought on by their struggle to focus or lose weight. The thyroid has also gotten more attention since the beginning of the COVID-19 pandemic, as several studies have described the increased prevalence of thyroid issues in patients following a severe case of coronavirus.7
Finally, there’s the growing life expectancy. With the exception of the post-COVID 19 years, the average life expectancy in the US has steadily gone up throughout the country’s history. The incidence of thyroid disease increases with age, meaning it affects older individuals at a higher rate. Therefore, part of the reason we’re seeing more Americans with thyroid disease is simply because those with a diagnosis are living longer.
to perform a preliminary at-home thyroid check:
- While holding or standing in front of a mirror, tilt your head back and take a drink of water.
- As you swallow, look for any bulges around the lower are of your neck below your Adam’s apple but above the collarbones. This is where your thyroid is.
- If you do see any unusual protrusions, this may indicate an enlarged thyroid or thyroid nodule. Talk to a physician for further testing and guidance.
At the end of the day, it may be that the incidence of thyroid disease is increasing – it’s hard to say for sure. What’s definitely true is that we’re more medically and culturally equipped to identify it. Thankfully, thyroid illnesses are generally pretty manageable when identified and properly treated. Again, speak with your physician if you suspect you may be suffering from a thyroid issue.
