If your thyroid is overactive or underactive, several problems can arise. Some of the most common thyroid conditions include Hashimoto’s thyroiditis, Graves’ disease, goiter, and thyroid nodules.

Several problems can arise if your thyroid produces too much hormone (hyperthyroidism) or not enough (hypothyroidism).

If your thyroid is underproducing or overproducing hormones, it can cause bothersome symptoms such as:

  • irritability
  • fatigue
  • weight changes
Illustration of the thyroid gland.Share on Pinterest
Anatomical image of the thyroid gland. Illustration by Wenzdai.

Hashimoto’s thyroiditis (or chronic lymphocytic thyroiditis) is the most common cause of hypothyroidism in the United States, affecting about 5 in 100 Americans, most commonly middle-aged women.

This condition occurs when your body’s immune system mistakenly attacks and slowly destroys your thyroid gland and its ability to produce hormones.

Symptoms

Some people with mild cases of Hashimoto’s thyroiditis may have no obvious symptoms.

The condition can remain stable for years, and symptoms are often subtle and not specific, which means they mimic symptoms of many other conditions.

Symptoms are often common to hypothyroidism, and may include:

Diagnosis and treatment

Testing the level of thyroid-stimulating hormone (TSH) is often the first step when screening for any type of thyroid disorder. This involves a blood draw to look for increased TSH levels.

A doctor might also check for low levels of thyroid hormone (T3 or T4) if you’re experiencing some of the above symptoms.

Hashimoto’s thyroiditis is an autoimmune disorder, so a blood test would also show abnormal antibodies that might be attacking your thyroid.

There’s no known cure for Hashimoto’s thyroiditis. Hormone medication is often used to raise your thyroid hormone levels or lower your TSH levels. It can also help relieve your symptoms of the disease.

The condition is usually identified at an early stage and can remain stable for years because it progresses slowly.

Graves’ disease is the most common cause of hyperthyroidism in the U.S., affecting about 1 in 100 people and accounting for approximately 4 out of 5 cases of hyperthyroidism.

It’s an autoimmune disorder that occurs when your body’s immune system mistakenly attacks your thyroid gland, causing your gland to overproduce the hormone responsible for regulating your metabolism.

The disease is hereditary, and anyone may develop it at any age. Risk factors may include:

  • family history of Graves’ disease or Hashimoto’s
  • living with other autoimmune diseases, such as vitiligo, gastritis, type 1 diabetes, and rheumatoid arthritis
  • nicotine products

Symptoms

If there’s a high level of thyroid hormone in your bloodstream, your body’s systems can speed up and cause symptoms that are common to hyperthyroidism, including:

You may also experience bulging eyes and thickened and reddened or discolored skin, generally on your shins and upper feet. These are unique to Graves’ disease.

Diagnosis and treatment

Doctors typically diagnose Graves’ disease with:

While there’s no treatment to stop your immune system from attacking your thyroid gland, the symptoms of Graves’ disease are often manageable with a combination of treatments. These treatments may include:

Successful hyperthyroidism treatment usually results in hypothyroidism. If you develop hypothyroidism, you’ll typically have to take hormone-replacement medication from that point forward.

A goiter is a noncancerous enlargement of your thyroid gland that can affect anyone at any age, but it’s more common in women and those over 40 years old. The most common cause is iodine deficiency.

Worldwide, an estimated 15.8% of the general population has a goiter. In the U.S., goiter affects 4.7% of the general population.

Iodine deficiency doesn’t always cause goiters. Other causes may include:

Risk factors, besides iodine deficiency, for a goiter may include:

  • pregnancy or menopause
  • family history of autoimmune disease or goiter
  • exposure to radiation or radiation treatment
How much iodine do I need?

Most adults need 150 micrograms of iodine daily. However, the FDA doesn’t require most food labels to list iodine content.

Symptoms

A goiter itself can be a symptom of a thyroid condition, or it may cause its own symptoms.

However, you might not have any symptoms unless it grows large enough. These symptoms may include:

Diagnosis and treatment

Diagnostic hyperthyroidism tests can determine if an overactive thyroid is the cause of your goiter. A doctor may also perform a thyroid ultrasound.

Goiters are often associated with highly treatable thyroid disorders, such as Graves’ disease. But it’s usually treated only once it becomes severe enough to cause symptoms.

Treatment can include RAI to shrink your thyroid gland or surgery to remove all or part of your thyroid gland.

Although goiters aren’t usually a cause for concern, they may cause serious problems if left without proper treatment, such as difficulty breathing.

Thyroid nodules are growths that form on or in your thyroid gland. They’re less noticeable than a goiter.

It’s estimated that up to 50% of people may have at least one thyroid nodule, even without knowing it. As with other thyroid-related problems, the risk of developing nodules increases with age.

The causes aren’t always known but can include iodine deficiency and Hashimoto’s thyroiditis. The nodules can be solid or fluid-filled.

Nodules are benign (noncancerous) a majority of the time, but they may be cancerous in up to 6.5% of cases.

Symptoms

Most thyroid nodules don’t cause symptoms. But if they grow large enough, they may cause:

  • swelling in your neck
  • breathing and swallowing difficulties
  • neck pain

A cancerous nodule may involve:

  • a painless hard lump in the lower part of your throat that slowly gets bigger
  • hoarseness
  • a sore throat
  • pain in the front of your neck, or feeling pressure there
  • difficulty swallowing or breathing

Some nodules may produce thyroid hormone, causing high levels in your bloodstream. Symptoms, then, will likely be similar to those of hyperthyroidism.

If the nodules don’t produce thyroid hormone or result in hypothyroidism instead, symptoms will likely be similar to those of hypothyroidism.

Diagnosis and treatment

A physical exam alone can detect approximately 5% to 7% of nodules in adults. But a doctor will likely run additional tests, including:

  • thyroid ultrasound
  • other imaging tests, such as a CT scan
  • a TSH test and a thyroid scan
  • a fine-needle aspiration biopsy (to rule out cancer)

Benign thyroid nodules usually don’t need to be removed or treated if they don’t change over time. If the nodule grows, however, a doctor may perform another biopsy and recommend RAI.

The treatment a doctor recommends may vary depending on the type of nodule. Treatment options for cancerous thyroid nodules can typically include:

Consider speaking with your doctor if you experience the following symptoms, as they could be related to your thyroid:

  • a nodule or lump on either side of your throat
  • weight loss or gain that you can’t explain by changes in diet or activity level
  • constantly feeling very hot or very cold
  • mood changes, such as depression, anxiety, or nervousness
  • significant fatigue

Two thyroid-related conditions are considered medical emergencies. You should seek immediate emergency medical attention for either.

  • Myxedema coma: This is the result of severe, untreated hypothyroidism. It’s most likely to happen in the wintertime, particularly after prolonged exposure to the cold. Symptoms include:
    • mental status changes like extreme drowsiness or entering a comatose-like state
    • severely decreased body temperature
    • very swollen tongue
  • Thyroid storm: This is a medical emergency due to excess thyroid hormones. Symptoms include:
    • racing, rapid heart rate that may be 140 beats per minute or higher
    • fever high than 101.5°F (38.61°C)
    • mental status changes that include restlessness, confusion, or agitation
    • sweating
    • loss of consciousness

Tips for a healthy thyroid

How do I know if I have a thyroid problem?

Unless you have a very large nodule on your thyroid, you probably won’t easily know you have a thyroid problem.

However, if you experience changes in your weight, emotions, or skin texture, these may be symptoms of thyroid problems.

A doctor can help by ordering blood tests to check the levels of thyroid hormones in your body. If yours are abnormal, your doctor can recommend the next steps.

What does the thyroid do?

Your thyroid is the metabolic center of your body. This means it controls your:

  • body temperature
  • heart rate
  • how fast you use calories from your food for energy

Your thyroid produces hormones that travel throughout the different parts of your body to better support its functioning.

How does the thyroid affect the body?

A functioning thyroid affects the body by maintaining the following:

  • keeping your body’s temperature at a normal level
  • supporting normal growth and cell turnover
  • maintaining a normal heart rate
  • burning calories in a regular and expected fashion
  • maintaining bone breakdown and reabsorption

If your thyroid hormone production becomes imbalanced (either too high or too low), it can potentially negatively affect your overall health.

Thyroid-related conditions are typically caused by your body overproducing or underproducing the thyroid hormone.

A physical exam, imaging tests, and blood tests can help provide a diagnosis. If nodules are present, a biopsy may be needed to rule out thyroid cancer.

Most of the time, thyroid issues aren’t serious and are only treated once symptoms become bothersome.

Hyperthyroidism treatment typically involves limiting your thyroid’s function. Hypothyroidism treatment often involves taking supplemental thyroid hormone as a medication.