What women need to know about thyroid disease

Maybe you’ve been running to the bathroom more often than usual. Or you’re having thermostat wars with your family (you turn it up, but they’re sweating). Or you’ve been feeling nervous with no explanation. Or maybe you’ve gained a little weight lately. One of the things all these conditions have in common is your thyroid. 

Your thyroid is a butterfly-shaped gland at the front base of your neck. Its responsibility is to make thyroid hormones, which play a key role in the body’s metabolism. In turn, that affects how fast your body burns calories, as well as your heart rate, energy levels, ability to regulate temperature,  mood and even the health of your skin, according to the U.S. Department of Health and Human Services’ Office on Women’s Health.¹

Thyroid problems are 5 to 8 times more prevalent in women than men, according to the American Thyroid Association.² "The reasons for the higher rate in women may be chromosomal," says Terry Davies, M.D., the Baumritter Professor of Medicine at Mount Sinai Medical Center in New York City. “We certainly know there’s a strong genetic component to thyroid disease,” he says. What’s more, women are twice as likely as men to carry certain antibodies that indicate an increased risk of developing autoimmune thyroid disorders, such as Hashimoto’s disease or Graves’ disease.³

If your thyroid is producing too little thyroid hormone, you have hypothyroidism — an underactive thyroid. That’s when many of your body functions slow down and you may experience symptoms such as:⁴

• Weight gain
• Constipation
• Trouble tolerating cold
• Dry skin
• Hair thinning or loss
• Depression
• Fatigue

It’s important to keep in mind that weight gain that occurs because of an underactive thyroid is typically modest. You might gain 5 to 10 pounds depending on the severity of the hypothyroidism, according to the American Thyroid Association.⁵ That’s because your basal metabolic rate (BMR, the minimum number of calories your body burns to keep you alive) decreases, but generally not enough to cause substantial weight gain. 

When your thyroid produces too much thyroid hormone, you have hyperthyroidism — an overactive thyroid. Essentially, your metabolism is revved up, which can cause:⁶ 

• Weight loss
• A rapid or irregular heartbeat
• Anxiety, nervousness or irritability
• Feeling hot, sweating
• Shakiness
• Frequent bowel movements or diarrhea
• Fatigue

Considering a diagnosis of thyroid disease can be complicated because the symptoms of both hypothyroidism and hyperthyroidism can also be caused by other conditions. Having just one of these symptoms alone isn’t enough to help determine that you have thyroid disease, says Dr. Davies.

For example, if weight gain is your only symptom and you aren’t experiencing any others, it’s less likely to be because of your thyroid and more likely to be for other reasons (overeating, lack of physical activity, etc.).

Fatigue is a common symptom in both hypothyroidism and hyperthyroidism, but it can also happen because of a variety of other conditions, such as an iron deficiency, Dr. Davies says. Diarrhea could also be caused by a number of conditions including irritable bowel syndrome.

Thyroid disorders can cause an irregular menstrual period or cause your period to stop altogether, which can affect ovulation and your ability to become pregnant.¹ Untreated hypothyroidism or hyperthyroidism during pregnancy can affect your baby’s health too, which is why it’s especially important to have your thyroid levels checked as part of your family planning. 

In addition, there’s a condition called postpartum thyroiditis, which is an inflammation of the thyroid gland that begins after birth for up to 10% of women.¹ “Women may come in with postpartum depression. We measure the hormone levels in the thyroid and find that it’s a bit low,” Dr. Davies explains. The good news, he says, is that this usually goes away on its own.⁷ But you don’t want to suffer through fatigue, low moods, muscle pain or constipation if you don’t have to, especially when caring for a new baby.⁸ Talk with your doctor about monitoring your thyroid levels and when to get checked.

If you have some of the symptoms above, talk to your doctor, who may suggest getting a simple blood test that looks at your thyroid function.  

• Hypothyroidism: Here, the goal is to replace the thyroid hormone that you’re lacking. For that, your doctor may prescribe an oral medication called levothyroxine, which contains the same hormone that your thyroid normally makes, according to the National Institutes of Health.⁹
  
• Hyperthyroidism:  The goal of treatment is to reduce thyroid hormone production.  Antithyroid medication, which decreases the amount of hormone your thyroid makes may be used. And your doctor may also recommend beta-blockers to reduce certain symptoms, like shakiness and rapid heartbeat. Radioiodine therapy, which is an oral therapy, is another option that may also be recommended.⁶ Less common is thyroid surgery. The choice of treatment may depend on a number of factors including the cause of your condition.

The bottom line: The good news is that thyroid issues can be treated — as long as you know there’s a problem. If you’re concerned about your thyroid, if there’s a history of thyroid problems in your family, or if you’re looking to become pregnant, ask your doctor if your thyroid should be tested.