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Fatigue, dry skin and brain fog: How to tell if you have a thyroid issue, A doctor explains

By Mercey Livingston


If there's a list of sneaky health issues out there, thyroid problems would top the list. Up to 60% of people with thyroid disease don't even know they have it thanks to common, widespread symptoms that can point to many other health issues. But with an estimated 20 million Americans affected by thyroid issues at some point, they're far from rare. Since thyroid problems can affect so many processes in your body from your mood to your body temperature and digestion, they often go undiagnosed because the symptoms can point to make other kinds of health issues. And if a thyroid issue is left untreated, it can often get worse over time, leading to more severe issues that can be difficult to treat.

When it comes to thyroid problems, it helps to first know the potential symptoms and then ask for testing if you suspect a problem. Thyroid tests are very routine and relatively easy to get -- the key is to know what to ask for. Not all doctors will want to test your thyroid, but if you suspect it's off, it never hurts to ask them to double check.

Your thyroid basically runs the show behind the scenes for a lot of things you may have never considered, like your mood, ability to focus, and sleep so don't overlook the importance of a healthy thyroid. Below are the most common thyroid health problems, explained with information on the symptoms to look out for and how to get tested and treated.

What is your thyroid and what does it do?

Your thyroid is a very important endocrine gland located in your neck.  It's responsible for regulating many functions in your body, and it produces hormones that regulate your body temperature, metabolism and your brain function.

Your thyroid function can also affect your fertility and reproductive health, as well as the health of a mother and baby during pregnancy. Thyroid hormone touches virtually every tissue and cell in your body. This is why when your thyroid function is suboptimal, you can experience a variety of symptoms that make you feel off.



The most common thyroid issues, explained

"The most common thyroid conditions are Hypothyroidism, Hashimoto's Thyroiditis, Hyperthyroidism, Thyroid nodules and Graves Disease," Dr. Kristine Blanche, PA.-C., Ph.D. told CNET.

Oftentimes, thyroid disorders go undetected until symptoms are pretty severe. "Unfortunately, all too often thyroid conditions go undetected until they are seriously symptomatic. I have had many patients see numerous doctors for fatigue and they have signs of thyroid dysfunction that was not detected previously," Blanche said.

Below are the most common disorders and symptoms of thyroid dysfunction. Remember, you do not have to have all of the symptoms below to get tested, even a few symptoms could signal something is wrong with your thyroid. In general, thyroid symptoms can vary and be unspecific, which is good to keep in mind as you read through the information below.

Hypothyroidism

Hypothyroidism is when your thyroid cannot make enough thyroid hormone, which causes important processes in your body to "slow down." Oftentimes this slowing can affect your digestion, energy levels, brain function and mood.

Symptoms can include but are not limited to:

Feeling coldFatigueDry skinWeight gainForgetfulnessDepressionBrain fogConstipationHair loss or thinning of the last third of eyebrows

Hashimoto's Thyroiditis

Hashimoto's Thyroiditis is an autoimmune condition and is the leading cause of hypothyroidism. People with Hashimoto's have chronic inflammation in the thyroid, which results in an under functioning thyroid or hypothyroidism. It's more common in women than men, and oftentimes Hashimoto's develops slowly over the course of time. Sometimes there are no symptoms at first, which is why it can be hard to detect and is often caught after the thyroid has already become very inflamed. Symptoms can be similar to hypothyroidism, since eventually, the inflammation slows the thyroid.

One way to detect Hashimoto's is by testing for thyroid peroxidase antibodies (TPO) in a blood test. If you are getting your thyroid checked, you should ask your doctor to also check antibodies or TPO to rule out Hashimoto's, especially since Hashimoto's is often asymptomatic at first.

Hyperthyroidism

Hyperthyroidism is when the thyroid is producing too much thyroid hormone (basically the opposite of hypothyroidism). The overproduction of thyroid hormone causes processes in your body to "speed up," which can cause feelings of nervousness, anxiety and weight loss. Hyperthyroidism is not as common as hypothyroidism, and the most common cause is Graves' Disease (see below).

Symptoms can include:

IrritabilitySleeplessnessWeight lossFeeling hotHeart racingDifficulty sleeping

Graves' disease

Graves' disease is an autoimmune disease (like Hashimoto's) except it causes the thyroid to overproduce thyroid hormone. It is the most common cause of hyperthyroidism, which is why when someone has hyperthyroidism or symptoms of an overactive thyroid, a doctor will test for Graves' Disease.

Thyroid nodules

Thyroid nodules are cell growths or lumps of cells found on the thyroid. Oftentimes they do not cause problems, but if you or your doctor find one, it's important to get it checked. Sometimes the nodules can produce excess thyroid hormone, and very rarely the nodules can be cancerous.

The best thing you can do is make sure your doctor checks your neck in addition to getting your thyroid tested through blood labs.

What to do if you think your thyroid is off

If you suspect that your thyroid could be off, ask your doctor for a test or to refer you to someone that can test you. Some doctors will only check for TSH (thyroid stimulating hormone) but according to Blanche, TSH alone is not enough to rule out potential thyroid dysfunction.

"Ask to check a complete thyroid panel: TSH, T4, T3, free T4, free T3, reverse T3, TPO ab, Anti-thyroglobulin, and a thyroid ultrasound," Blanche suggests.

How to test your thyroid at home

If you have trouble getting a full thyroid panel, you have several options to check your thyroid at home. While these thyroid panels can't always check for every single thing a doctor can order for you, they are often a good start.

Paloma Thyroid Test Kit

Paloma is an at-home thyroid testing kit that only requires a finger-prick sample and checks your T4, T3, TSH and TPO (antibodies). Once you complete the test (which costs $99) you can get your results in about one week. The results are then reviewed by a physician and you get recommendations on what to do next if your results aren't normal.

The Paloma test could be considerately cheaper than seeing a doctor and paying for traditional blood labs, depending on if you have health insurance and what it covers. It's also an option if you want to skip the in-office doctor's visit and blood draw typically required for a test. In certain states you also have access to Paloma affiliated doctors who can affordably treat you (via telemedicine) and prescribe medication if you need it. Paloma also has a team of nutritionists who specialize in thyroid health if you are interested in purchasing nutrition consult services.


EverlyWell Thyroid Test Kit

Everlywell is another option for at-home thyroid testing. The test kit costs $159 and tells you your TSH, T3, T4, and checks for thyroid antibodies. You take your own blood sample with a finger prick tool included in the kit. Like Paloma, a doctor will review your results and you get a report back explaining the numbers.

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