Common Symptoms of Thyroid Disease

Some of the common symptoms of thyroid disease include a range of mental health symptoms. Hypothyroid and depression often coexist along with hypothyroid and anxiety, plus a range of other mental health problems. The assessment and treatment of thyroid problems often results in significant improvements in mental health.

About the Thyroid Gland

The thyroid gland is a soft, butterfly shaped gland situated at the front of the throat, below the larynx (Adam’s apple). It comprises two lobes that lie on either side of the windpipe. The thyroid gland manufactures two main hormones - thyroxine (T4) and tri-iodothyronine (T3). When healthy, the thyroid produces approximately 80 percent of its hormones as T4 and about 20 percent as T3. Up to 80 percent of T4 is then converted to T3. T3 is the more active hormone, being about ten times more active than T4.  

The primary roles of thyroid hormones are to:

• increase the basal metabolic rate of almost all the cells in the body

• increase fat and carbohydrate metabolism

• help regulate bone growth

• stimulate the production of protein necessary for normal growth

• increase heart rate and blood flow to other organs

When working correctly, thyroid hormone production is regulated through its relationship with structures in the brain known as the pituitary (a gland in the base of the brain) and the hypothalamus (a small part of the brain above the pituitary). As shown in the figure opposite, the hypothalamus and pituitary can monitor circulating levels of thyroid hormone (T3 and T4) in the blood. If they are too low, the hypothalamus responds by releasing thyrotropin releasing hormone (TRH). TRH then stimulates the pituitary to produce thyroid stimulating hormone (TSH). The TSH, in turn, stimulates the thyroid to produce more thyroid hormone. When the level of thyroid hormone in the blood returns to normal the pituitary stops producing extra TSH. The opposite process occurs when there is too much thyroid hormone in the blood. The hypothalamus and pituitary release less TRH and TSH which triggers the thyroid to makes less thyroid hormone. This whole regulatory system is often referred to as the 'hypothalamic- pituitary- thyroid axis'.

Factors Affecting Thyroid Function

In Australia there are about 40,000 new cases of thyroid disease every year. This estimate is likely very conservative as there are many people who go undiagnosed.

Some of the causes of thyroid problems are outlined below:

• Nutrients deficiencies/ excesses. Thyroid hormones are made from the nutrients iodine and tyrosine and if there are deficiencies in either, thyroid production will be impaired. Other important nutrients include selenium, zinc, iron, copper, B-vitamins, vitamin A and vitamin C. Studies have also shown that excess intake of lipoic acid (usually through supplementation) impairs the conversion of T4 to T3.

• Diet. A diet very high in cruciferous vegetables, soy, and alcohol has been shown to reduced the output of the thyroid hormones T4 and T3. Chronic dieting and eating low-nutrient, high sugar meals also impairs thryoid production.

• High, prolonged stress. During periods of high stress the adrenal glands excrete increased levels of cortisol and studies show that this can depress TSH levels. Excess cortisol can also impair the conversion of T4 to T3 and decrease the sensitivity of thyroid receptors.

• Antithyroid antibodies. Antibodies are proteins found in the body used by the immune system to identify and neutralise foreign pathogens, such as bacteria and viruses. Sometimes antibodies can be produced in the body that attack the thyroid gland. These antibodies can cause a decreased production of thyroid hormone and may be present in people who have diabetes, lupus, rheumatoid arthritis, chronic hepatitis, or Sjogren syndrome.

• Thyroid diseases. Hashimoto's disease is a condition that results in underactive thyroid production. It is an autoimmune condition where cells of the immune system attack the thyroid gland, causing inflammation and, in many cases, eventual destruction of the gland. In contrast, Graves' disease is an autoimmune condition where the immune system attacks thyroid gland and causes it to overproduce thyroid hormones. These two thyroid diseases can often be caused by some of the factors listed in this section.

• Medication. Some medications can affect thyroid production by either increasing or decreasing thyroid output. Although not an exhaustive list, thyroid health can be affected by beta blockers, birth control pills, lithium, phytoin, steroids, theophylline, oestrogen, and iodinated contrast agents.

• Pituitary adenoma. This is a tumour of the pituitary gland that causes independent TSH production leading to an overstimulation of the thyroid gland.

• Ageing. Studies show that the risk of thyroid problems increase as we age.

• Metal toxicity. An excess level of metals like fluoride, lead, and mercury has detrimental effects on thyroid production.

• Obesity. Although it is often believed that thyroid problems can cause obesity, studies have also shown the reverse to be true. Being overweight can impair thyroid production and thyroid receptor cell sensitivity.

• Environmental toxins. We still have a lot to learn about the effect of toxins in our body, however, studies have shown that toxins like pesticides, PCBs and other industrial petrochemicals can affect thyroid production.

• Low adrenal states. Cortisol produced by the adrenal glands is important for thyroid production and if levels are too low, thyroid problems are likely to result.

Common Symptoms of Thyroid Problems

(Hypothyroidism - Underactive Thyroid)

Hypothyroidism is a condition where the thyroid gland is producing insufficient thyroid hormone. It can result in a large array of symptoms and some of the more common ones are listed below: 

Common Symptoms of Thyroid Problems

(Hyperthryoidism - Overactive Thyroid)

Hyperthyroidism is a condition where the thyroid gland is producing too much thyroid hormone. It can result in a large array of symptoms and some of the more common ones are listed below: 

As can be seen above many of the common symptoms of thyroid disease (hypothyroidism and hyperthyroidism) are similar to many symptoms of depression, anxiety and other mental health problems. If you are suffering from a mental health problem, and suffer from many of the symptoms above then seek support from a knowledgeable and competent practitioner specialising in this area.

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