Understanding Autoimmune Thyroid Disease
Are You at Risk for Thyroid Disease?
Some people are more likely than others to develop thyroid problems, and although you can't prevent thyroid disease, it's important to detect it early.
By Diana Rodriguez
Medically Reviewed by Niya Jones, MD, MPH
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Thyroid disease is a common cause of hormonal imbalance in the body. The thyroid can make either too much thyroid hormone (hyperthyroidism) or too little thyroid hormone (hypothyroidism).
Thyroid disease generally isn't preventable, but awareness of risk factors and symptoms, and regular screening by your doctor, can help prevent serious complications if you do have a thyroid disorder.
The most common cause of hyperthyroidism, or overactive thyroid, is an autoimmune disorder known as Graves' disease.
Graves' disease occurs when your body's immune system, which usually protects you from viruses and bacteria, mistakenly attacks your thyroid gland. Damage to your thyroid causes it to produce too much thyroid hormone.
Pituitary gland problems and certain medications (e.g., iodine pills, amiodarone, and interferon) can also lead to hyperthyroidism.
Risk factors for hyperthyroidism include:
- Being female
- Being over age 60
- Recent pregnancy
- Having an autoimmune disease (such as type 1 diabetes)
- Family history of thyroid disease or autoimmune disease
- Personal history of thyroid problems, like goiter (an abnormally large thyroid gland) or having had thyroid surgery
- Consuming significant amounts of iodine through food or medication
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Hypothyroidism, or underactive thyroid, occurs when your thyroid gland doesn't produce enough thyroid hormone, causing your body's metabolism to slow down.
Hashimoto's thyroiditis, another autoimmune disease, is the most common cause of hypothyroidism.
Pituitary gland dysfunction can slow down thyroid production, and some medications (such as lithium, amiodarone, and interferon) can result in hypothyroidism as well.
Risk factors for hypothyroidism include:
- Being female
- Being older than age 60
- Exposure to radiation in the neck
- Prior thyroid surgery
- Having a family history of thyroid disease
- Having a family history of autoimmune disease
- Having an autoimmune disease
- Being of Caucasian or Asian ethnicity
- Experiencing hormonal changes due to pregnancy, childbirth, or menopause
- Personal history of lithium use (often prescribed for bipolar disorder)
- Having chromosomal abnormalities like Down syndrome or Turner's syndrome
Getting Screened for Thyroid Disease
If you have symptoms related to thyroid disease — such as depression or anxiety, intolerance to hot or cold temperatures, or unexpected changes in your weight — in addition to risk factors for thyroid disease, particularly a family history of autoimmune disease, you should be screened for thyroid disease, advises Pamela Allweiss, MD, MSPH, an endocrinologist and an assistant professor in family practice at the University of Kentucky College of Medicine in Lexington.
While not much can be done to prevent thyroid disease, Dr. Allweiss says early detection is important. Oftentimes, thyroid disease symptoms can be vague, but people with a family history or other thyroid-disease risk factors should "think about [the possibility of] thyroid disease" and talk to their doctor if they notice any unusual ailments, Dr. Allweiss notes.
If a person has ever been told that they have an enlarged thyroid or goiter in the past they should also be tested periodically for thyroid disease, Allweiss also suggests. Prompt diagnosis of thyroid disease is crucial since there's not much you can do to prevent it and treatment is the only way to bring your hormone levels back into balance.
What You Need to Know About Nodules
Thyroid nodules — lumps and bumps that form on the thyroid gland — are very common. Though nodules can indicate cancer, they're usually benign (non-cancerous). Approximately 5 percent of thyroid nodules turn out to be cancerous.
Women are much more likely than men to develop thyroid nodules, but men are at higher risk for cancerous nodules. Allweiss suggests that all men with thyroid nodules have a biopsy to determine whether they have thyroid cancer.
Risk factors for thyroid nodules include:
- Insufficient dietary iodine
- Personal history of thyroid disease
- Family history of thyroid nodules
- Hypothyroidism (especially Hashimoto's thyroiditis)
Getting regular physical exams can help your doctor detect thyroid nodules early. Additional testing (such as a thyroid scan, ultrasound, and/or biopsy) may also be necessary if a nodule is found.
Being aware of your level of risk for thyroid disease, and telling your doctor about any symptoms, can allow for early diagnosis of thyroid problems. Early detection is key because it can prevent the development of additional health problems. If you have a family history of thyroid disease and notice possible thyroid disease symptoms, don't hesitate to talk to your doctor.
Video: Thyroid Disease in Pregnancy Video – Brigham and Women’s Hospital
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