The thyroid is a small, butterfly-shaped gland located near the throat. Two major hormones are produced by your thyroid gland–T3 and T4. The T3 and T4 hormones work together to regulate how your body uses energy, which can impact a person’s metabolism, menstrual cycles, heart rate, body temperature, and more.

How do I know that I have a thyroid problem?

Generally, the most common symptoms of thyroid conditions are fatigue, cold intolerance, hair thinning, weight changes and menstrual cycle changes. There are two types of thyroid conditions. Symptoms vary based on whether there is too much or too little thyroid hormone in the body.

The most common condition is hypothyroidism. In hypothyroidism, the thyroid is considered underactive and does not create enough thyroid hormone in the body. Supplementation with thyroid hormone medication is necessary. The second type is hyperthyroidism where there is too much thyroid hormone being produced (an overactive thyroid gland).

Certain medications can also cause changes in thyroid hormone levels. In addition, changes in hormonal states, such as pregnancy, can change the thyroid levels in the body.

What are the signs and symptoms of thyroid problems in women?

The most common thyroid problems come with hypothyroidism. Common symptoms are fatigue, cold intolerance, weight gain, constipation, hair loss, "brain fog," skin dryness, nail changes, and menstrual cycle changes (typically irregular cycling).

Symptoms of hyperthyroidism include unintentional weight loss and a rapid or irregular heartbeat. Hyperthyroidism can also increase feelings of anxiety.

What problems can thyroid conditions cause?

In addition to symptoms not being managed, if a thyroid condition is not adequately treated it can lead to mood changes. For women trying to conceive, they may have difficulty getting pregnant.

An underactive thyroid gland can increase the risk for heart disease, making your heart beat slower and less efficiently. This, in turn, increases the risk of coronary artery disease and congestive heart failure. If you have heart disease already, hypothyroidism can make it worse. An overactive thyroid is also something that should be monitored and treated, particularly in the elderly, as not treating an overactive thyroid can increase the risk of a potentially dangerous heart rhythm called atrial fibrillation. Over time, an overactive thyroid can increase the risk of bone loss (osteoporosis) and the risk of a fracture.

How are thyroid conditions treated?

Most thyroid conditions can be easily treated with medication, along with monitoring the hormone levels in the blood. In more serious conditions, such as an enlarged thyroid gland or thyroid cancer, the thyroid can be surgically removed. A person who has a thyroidectomy can take medications to replace the thyroid hormones in the body.

Can I check my thyroid at home?

Traditionally, thyroid levels are most reliably and accurately tested in a laboratory with set protocols for appropriate testing and knowledge of normal and abnormal result ranges.

Should my provider do additional lab tests even if my TSH level is normal?

Patients frequently ask about additional thyroid testing for T3 and T4 levels even when their thyroid stimulating hormone (TSH) level is normal. There is information on the internet and in the press about checking additional levels even if the TSH level is normal to be "thorough."

Many people (including those with and without symptoms) have TSH values which may be elevated but their T4 level is normal. This is called mild or subclinical hypothyroidism. Our Lifespan Laboratories, like many standardized labs, will automatically draw T3 and T4 level if the TSH result is abnormal. Endocrinology societies do not support any additional lab testing beyond this when screening for thyroid conditions.

A primary care physician can order lab work that includes thyroid level testing and refer a patient to a doctor who specializes in endocrinology, or the treatment of diseases related to hormones. 

Mariah H. Stump, MD

Mariah H. Stump, MD, MPH, FACP, DipABLM, ABOIM

Dr. Mariah Stump is an attending physician in Women’s Primary Care at the Women's Medicine Collaborative. She is board certified in internal medicine, integrative medicine, and lifestyle medicine.