Patients not uncommonly ask for their thyroid to be checked – concerns can arise because of weight loss, weight gain, feeling tired, sweaty or anxious, or having a family history of thyroid conditions. What a lot of people do not know is that problems with thyroid function can also affect the eyes, heart, cholesterol levels, bone density, memory function and the menstrual cycle.
The thyroid gland sits at the front of the lower neck. The gland can develop physical problems such as enlargement (causing a “goitre”), nodules (which can be single or multiple), or cancer.
It can become inflamed due to auto-immune disease (where the body’s own cells attack it) or other conditions; this sometimes occurs in pregnancy.
The function of the thyroid gland can also be disturbed so it becomes over-active (hyperthyroidism) or under-active (hypothyroidism). Normal thyroid function can also occur in a diseased gland. It’s complicated!
Assessment for thyroid problems is not as simple as a blood test, either. It starts with a history, for example of symptoms, medications, other conditions, family history and iodine intake (a common contributor to thyroid disease). The gland is generally examined, along with other areas that can be affected by thyroid disease (such as the heart, the legs, the eyes, the skin and hair, and the hands, which can develop a tremor).
Then a plan for further assessment can be discussed – this might include various blood tests, or imaging such as ultrasounds or other scans. Sometimes needles are used to collect material from nodules. Referral to an endocrinologist may be required.
To make things more complicated, red herrings are frequent – abnormal test results without thyroid disease, or normal test results when there is a problem.
If you have concerns about thyroid disease, talk to your doctor, but it may not be as simple as just having a quick blood test.
