By: Ashima Mittal, M.D.
UPMC Endocrinology

There are many reasons a person may experience fatigue or a general lack of energy, and an important one to consider is the activity of the thyroid gland. While many people may not be aware of the gland, it plays a role in controlling how the body uses and stores energy. The thyroid gland is a butterfly-shaped gland located in the neck, below the Adam’s apple, and it may not be obvious that the symptoms your experiencing may be related to a thyroid issue.

Too Much or Too Little

Your thyroid gland can cause problems when it produces too much thyroid hormone, called hyperthyroidism, or too little, which is known as hypothyroidism. Both conditions, when left untreated, can have a negative impact on your energy, your heart, digestion, and fertility.

While some people with too much or too little thyroid hormone are symptom-free, the most common symptom of hypothyroidism, or low hormone levels, is feeling tired. Additional symptoms include:

• Becoming cold easily
• Changes in hair texture
• Constipation

Hypothyroidism occurs most often in women over age 60. Untreated hypothyroidism can weaken or slow your heart, making you feel tired or out of breath when you exercise. It can also cause obesity, joint pain, high blood pressure, swelling in your ankles, as well as raise your cholesterol levels, which can increase your risk for heart problems.

With hyperthyroidism, or high hormone levels, a person often feels anxious, irritable, and may have difficulty sleeping. Additional symptoms include:

• Weakness in the arms and thighs that makes it difficult to lift heavy things or climb stairs
• Trembling
• Sweating and difficulty with hot weather
• Fast or uneven heart beats
• Feeling tired
• Weight loss while eating normally
• Frequent bowel movements

Hyperthyroidism is also more common in women. Some people with hyperthyroidism may have swelling in the neck, called a “goiter.” When hyperthyroidism is caused by a medical problem called Graves’ disease, the condition can also make the eyes bulge.

Without treatment, hyperthyroidism can cause a heart rhythm disorder known as atrial fibrillation. In women, hyperthyroidism can also disrupt monthly periods and impact fertility. In men, it can cause the breasts to grow and lead to sexual difficulties.

Treating Thyroid Conditions

Fortunately, hypothyroidism and hyperthyroidism can be diagnosed with a simple blood test. There are also effective treatments for both conditions.

If you have hypothyroidism, your doctor will likely treat you with a daily thyroid hormone pill to supplement the underactivity of the thyroid gland. After about six weeks of treatment, your doctor will test your blood again to make sure the thyroid hormone levels are at sufficient levels. Because there are many different brands and generic forms of thyroid hormone, it is important to stick to the one your doctor prescribes. Switching medications can cause thyroid levels to fluctuate. Taking too much thyroid hormone can cause heart rhythm problems and may even damage your bones over time.

With a diagnosis of hyperthyroidism, your doctor may prescribe anti-thyroid or beta-blocker medicines to reduce your symptoms.

Radioactive iodine, taken in pill or liquid form, is used to destroy the thyroid gland in order to reduce production of the hormone. Another rarely used option is the surgical removal of the gland. Following these treatments, you would take thyroid hormone pills to maintain a healthy level of the hormone in your blood.

Many of the symptoms of thyroid disease look like symptoms of other common conditions, and these may be easy to ignore for a time. However, if you have any of the symptoms above for longer than two weeks, it’s advised to have those checked by your doctor.

Ashima Mittal, M.D., is with UPMC Endocrinology and sees patients at UPMC Cole, 1001 East 2^nd St., Coudersport, and Port Allegany Community Health Center, 45 North Pine St., Port Allegany. To schedule an appointment with Dr. Mittal, call 814-642-5072. For more information about endocrinology services visit UPMC.com/EndocrinologyNCPA.