5 Facts About Your Thyroid

January is Thyroid Awareness Month, the perfect time to pay extra attention to the tiny endocrine powerhouse in your neck that regulates your metabolism and energy levels. R. Mack Harrell, MD, President of the American Association of Clinical Endocrinologists (AACE) offers five key insights about thyroid health:

  • You may not know it’s on the fritz: The symptoms for both hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid) tend to develop slowly, if at all.“The most common symptom of thyroid dysfunction is nothing,” says Harrell. “In the beginning, some people experience minimal deficits—most don’t feel anything.” When symptoms do show up, they’re so generic that it can be hard for doctors to narrow down the source of their patient’s concerns. The fatigue, weight gain, depression, dry skin, constipation, muscle weakness, joint and muscle pain, and irregular menstruation associated with hypothyroidism, as well as the weight loss, anxiety, irritability, sleep issues, irregular heartbeat and increased sweating associated with hyperthyroidism can be caused by a number of different health conditions.
  • Your immune system is probably to blame: Many thyroid disorders stem from a dysfunctional immune response. In Hashimoto’s disease—the most common cause of hypothyroidism in Americans—the immune system sees the thyroid as a foreign invader, launching damaging attacks that damage the gland and prevent it from releasing enough hormones. Grave’s disease—the most common cause of hyperthyroidism in Americans—causes the immune system to induce the thyroid into making too many hormones.
  • Women are more likely to have thyroid issues: Women have a much higher risk than men for developing thyroid problems. The American Thyroid Association reports that women are five to eight times more likely to encounter thyroid dysfunction than men. Many scientists attribute this risk disparity to the fact that the immune systems of men and women operate differently. In order to have a successful pregnancy, a woman’s body must be able to ratchet its immune system down enough so that it won’t attack the developing fetus, which is technically seen as a foreign invader. After the baby is born, the immune system ramps back up. These fluctuations can take a toll on a woman’s immune system, increasing her risk for experiencing autoimmune disorders such as Hashimoto’s, Graves’s, even lupus. Harrell says that many women even experience transient hypothyroidism right after giving birth.
  • Long-term stress increases your risk: According to Harrell, thyroid patients often report enhanced levels of psychosocial stress in the months leading up to their diagnosis, though science has yet to determine why this is the case.
  • All generics aren’t necessarily equal: Synthroid, a form of hormone replacement therapy used to treat hypothyroidism, is the most commonly prescribed brand name medication in America. Synthroid contains levothyroxine sodium, a synthetic hormone used to supplement the thyroxine that is naturally made by a person’s thyroid. Many people with hypothyroidism take a generic form of Synthroid, which Harrell cautions can cause dosage issues. While it’s true that the Food and Drug Administration (FDA) requires all generic medications to be equal to their brand-name counterparts “in dosage form, safety, strength, route of administration, quality, performance characteristics and intended use,” when it comes to treating hypothyroidism, these guidelines contain a potentially dangerous bit of wiggle room. For instance, say drug company A makes a generic, 100 mcg levothyroxine pill that actually contains 104 mcg (still within the FDA’s parameters of a five percent deviation), while drug company B’s generic, 100 mcg pill actually contains 96 mcg. This difference can become problematic if a patient’s insurance company seeks to cut costs by switching their beneficiaries from one generic levothyroxine prescription to another, based on price fluctuations. If these changes occur too often, a vulnerable beneficiary’s hormone balance can be negatively affected. “Thyroid hormone is persnickety,” says Harrell “When you switch form one generic to the next, you change the amount of thyroid hormone that you’re getting, ever so slightly.”

Harrell and the AACE also share this list of 10 Questions to Ask about Your Thyroid Health:

For your physician:

  • Where is the thyroid located, and what does it do?
  • What are the differences between hypothyroid and hyperthyroid patients and what are the symptoms of each?
  • What is Thyroid Stimulating Hormone (TSH), how is it measured, and what should my target number be?
  • What else besides TSH levels are important for making sure my thyroid condition is under control?
  • Why are more people than ever being diagnosed with thyroid cancer and should I be checked for it?

For your pharmacist:

  • What is the difference between a generic thyroid hormone pill and a brand name thyroid hormone pill?
  • Will you notify me in advance if you switch my thyroid medicine from the brand name I normally use to a generic?
  • What time of day is best to take my thyroid hormone pill?
  • May I take my thyroid medication with food, other medications, vitamins or supplements?
  • Can any of my other medications affect my thyroid?

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Philippa P
Philippa Powers9 months ago


Siyus Copetallus
Siyus Copetallus2 years ago

Thank you for sharing.

Analia Mariana Regeni
Analia Regeni2 years ago

Nice article! I should add some questions for doctors: 1) When should I come back?(many patients take the same doses under the asumption they have to take if for ever...and forget the advices of returning for checking). 2)Should I visit a nutricionist? 3) Should I visit a psychologist?. Good look. It helps!

Sarah Hill
Sarah H2 years ago


Natasha Salgado
Past Member 2 years ago


Catrin S.
Catrin C2 years ago

Good to know.

Debbie S.
Past Member 2 years ago

Good article, thanks for sharing.

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Georgina Elizab McAlliste
.3 years ago


Beverly C.
Beverly C3 years ago

Thanks for this info.

Anna Ballinger
Anna Ballinger3 years ago

Thank you for the information. My sister is having issues that point to her thyroid. I shared your article with her.