The thyroid is one of the body’s key endocrine glands. It secretes two essential hormones thyroxine (T4) and triiodothyronine(T3). These hormones are vital because they control metabolism and regulate a large number of bodily functions including respiration, heart rate, weight, temperature, and menstrual cycles. When the thyroid gland is not functioning properly it can affect any of the functions the hormones regulate, and the effects depend on the levels of hormones released.
If you have problems with your thyroid , it is because the communication between the hypothalamus in the brain and the pituitary gland is misfiring, causing an imbalance in the levels of T3 and T4 being released. The issue is identified with a blood test and is classed as either hypothyroidism (an underactive thyroid) or hyperthyroidism (an overactive thyroid). The blood test also checks for levels of the thyroid-stimulating hormone (TSH).
Symptoms of hypothyroidism
These are symptoms if levels of T3 and T4 are low:
- Problems sleeping
- Fatigue
- Difficulty in concentrating
- Depression
- Muscle and joint pain
- Heavy and/or frequent periods
- Dry hair and skin
- Sensitivity to low temperatures
Symptoms of hyperthyroidism
These are symptoms if levels of T3 and T4 are high:
- High blood pressure
- Anxiety
- Hyperactivity
- Nervousness
- Mood swings and irritability
- Light and/or missed periods
- Hair loss
- Sensitivity to high temperatures
Treatments for Hypothyroidism
The usual treatment for hypothyroidism is hormone replacement therapy. A daily dose of levothyroxine is prescribed to give your body the hormone that your underactive thyroid is not producing. Although the HRT is universal, the dosage has to be adjusted for each individual, so hormone levels and symptoms are monitored until the right level/dosage is achieved.
The thyroid HRT targets the T4 hormone thyroxine, but there is also T3 medication that can be taken in tablet form which is a dose of triiodothyronine to supplement the HRT. T3 medication is liothyronine and is beneficial to patients who are not experiencing sufficient improvements in their hypothyroidism symptoms from their T4 medication. (This is usually because the body is unable to or is inefficient at converting the T4 into T3, which is the more active hormone).
Treatments for Hyperthyroidism
An overactive thyroid is generally treatable, and patients are usually referred to a specialist endocrinologist who will plan a treatment which may include any or all of the following singly or in combination:
- medicine
- radioactive iodine treatment
- surgery
Medication prescribed for hyperthyroidism is thionamide which suppresses the overproduction of T3 and T4 hormones. The common forms are propylthiouracil and carbimazole. Patients need to take the medication for one to two months before any benefits are noticed and during this build-up period. A beta blocker may also be prescribed to help relieve some of the hyperthyroidism symptoms. The medication may stimulate the thyroid gland to work properly in some patients, while others will have to take the medicine for life.
Radioactive Iodine Treatment is used to destroy some of the cells in the thyroid to reduce its ability to produce and release hormones and is a highly effective treatment.
Surgery may remove part or all of the thyroid gland. Usually, the best option is to remove the whole gland but then the patient will need to take HRT for the rest of their life as their body will no longer produce those vital T3 and T4 hormones.
Treatments will always be personal to each individual patient and whether they have hypo or hyper thyroidism. If you experience any signs that might lead you to believe your thyroid is not functioning correctly, see your GP.
