Dr Michelle O'Driscoll: Are you suffering from Thyroid issues?

A WIDE variety of symptoms can prompt the question “have you had your thyroid checked?”

This is because the thyroid has the very overarching job in the body of regulating our metabolism and energy levels. It releases thyroid hormone in response to a messenger hormone Thyroid Stimulating Hormone (TSH) that gets released from the pituitary gland at the base of the brain.

If there is a thyroid imbalance present, it can show up in our energy levels, sleep, gut and bone health, heart and mental health, and even our skin, hair and fertility.

Low thyroid levels, known as hypothyroidism, causes everything to slow down, and this manifests as lack of energy, cold intolerance, tiredness, weight gain, dry skin and constipation as well as low mood.

Conversely, high thyroid levels can show up as anxiety and irritability, sweating, diarrhoea and heart palpitations.

Some patients with an overactive thyroid have a bulge in their neck where the gland is located, known as a goitre.

Thyroid issues seem to have a genetic component for up to 50% of cases, and they tend to affect women more commonly than men, so it’s something to be extra aware of.

Some medications can cause low thyroid levels, such as lithium or amiodarone.

Pregnancy can be a time when thyroid issues occur initially, or pregnancy may need to be taken into account in the management of pre- existing thyroid issues. Low thyroid levels are most commonly caused by an autoimmune disease that attacks the cells of the thyroid gland, and prevents sufficient levels of thyroid hormone being produced. This is called Hashimoto’s Disease. It can be counteracted by taking thyroid hormone in a tablet form on prescription.

Some common hyperthyroid causes are Graves’ disease, toxic multinodular goitre, and thyroiditis. Depending on the cause, overactive thyroid may need treatment with radioactive iodine or surgery to remove part of the gland and reduce the amount of thyroid hormone being produced.

In some cases, there is also an option of medication management.

If you’ve been prescribed medication for thyroid dysfunction, it’s very important to follow the directions that you’ve been given as every patient case is unique. For example, starting a medication for low thyroid levels, you should be cognisant of your dose, as this can change over time, being reviewed every three to four weeks until the ideal levels are found. Your prescribed dose may involve taking several different strengths of tablets to tally to the precise amount. It’s advised to take this medication first thing in the morning, approximately thirty minutes before your breakfast.

Calcium in particular can bind to it and interfere with its efficacy.

In the case of high thyroid levels, treatment may sometimes start as a twice or three times a day dose, and then potentially switch to once daily dosing. There are also specific cases where you may be prescribed medication for high thyroid levels in combination with meds to prevent the levels going the other extreme, and too low.

In terms of maintaining a good diet to prevent the onset of thyroid issues, one should be aware of the amount of iodine they’re consuming. Iodine is a very important part of the diet to ensure properly functioning thyroid hormone. It can be obtained from seafood such as cod and haddock, and it’s also present in dairy.

Despite the array of issues that thyroid problems can present us with health-wise, treatment for the most part is very manageable. 

Once diagnosis of the problem has occurred, an endocrinologist will be very capable of getting a system in place that either eliminates or manages the problem for you.

For many, thyroid issues can be like having high blood pressure – a daily tablet is incorporated into their routine, and order resumes. For others, a scheduled procedure takes place and it’s onwards and upwards from there. While it can come as a shock, it’s not something to despair over – you’re in good hands.

If in doubt as to the source of any vague symptoms, it’s always worth chatting to your GP to determine whether a blood test to check thyroid levels would be wise. If they’re deemed to be normal, then other avenues as to what might be causing your symptoms can be explored. In the meantime, support your health with the usual advice around things like sleep, exercise, hydration and adequate nutrition.

Dr Michelle O’Driscoll is a pharmacist, researcher and founder of InTuition, a health and wellness education company. Her research lies in the area of mental health education, and through her company InTuition she delivers health promotion workshops to corporate and academic organisations nationally. See www.intuition.ie and @intuitionhealthandwellness