The thyroid is a small, butterfly-shaped gland at the front of the neck, but it has a powerful effect on the body.
It makes hormones that help control how quickly the body uses energy and influence the heart, muscles, digestion, body temperature, and many other functions.
When the thyroid makes too little hormone, the condition is called hypothyroidism. People may feel unusually tired or cold, gain weight, have dry skin, or notice slower thinking and movement.
When the thyroid makes too much hormone, it is called hyperthyroidism. This can cause weight loss, a fast or irregular heartbeat, sweating, anxiety, shaking hands, and trouble sleeping.
One of the biggest causes of thyroid disease is a problem with the immune system. Normally, the immune system attacks viruses, bacteria, and other threats, but sometimes it mistakenly attacks the body’s own tissues.
Hashimoto’s thyroiditis is a common example. The immune system attacks the thyroid and gradually damages it, making it harder for the gland to produce enough hormones and often leading to hypothyroidism.
Graves’ disease has the opposite effect. In this condition, the immune system produces substances that push the thyroid to make too much hormone, causing hyperthyroidism.
Scientists do not know exactly why these immune problems begin. Research suggests that a person’s genes can increase the risk, while factors in the environment may help trigger the disease in people who are already more likely to develop it.
Family history is therefore important. Having a close relative with thyroid disease or another immune system disorder can increase a person’s chance of developing a thyroid problem, although it does not mean the condition is certain to occur.
Iodine also has an important role because the thyroid needs it to make hormones. Too little iodine can prevent the gland from working normally, but very high amounts can also cause thyroid problems in some people, particularly those who already have thyroid disease.
Radiation can damage the thyroid as well. People who have received radiation treatment to the head or neck, or who have been exposed to large amounts of radiation, may have a higher risk of developing thyroid disorders later.
Women develop thyroid disease much more often than men. Researchers believe differences in the immune system and changes in hormones may help explain this pattern, and thyroid problems can sometimes appear during pregnancy or after giving birth.
Some medicines can also affect thyroid function. Lithium, which is used to treat certain mental health conditions, can interfere with thyroid hormone production, while other medicines can cause the gland to become either underactive or overactive.
Smoking has also been linked to some thyroid problems, especially Graves’ disease and the eye problems that can occur with it. The relationship between long-term stress and thyroid disease is less clear, and researchers are still studying whether stress can help trigger illness in people who are already at risk.
Treatment depends on the type of thyroid disorder. An underactive thyroid is commonly treated with a replacement thyroid hormone, while an overactive thyroid may be treated with medicines, radioactive iodine, or surgery depending on the cause and severity.
Thyroid disorders are usually diagnosed with blood tests that measure thyroid hormones and another hormone called TSH, which helps control the thyroid. Doctors may also use antibody tests or scans when they need more information about what is causing the problem.
Research into thyroid disease and the factors that cause it has been published widely in medical journals, including The Lancet and Nature Reviews Endocrinology. Although thyroid problems can have many causes, proper diagnosis and treatment allow most people to manage them successfully and continue living active lives.
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