8 Common Thyroid Dysfunctions and What Causes Them

The thyroid is a gland inside of our necks, just below the Adam’s apple (in men), which is an incredibly important part of our endocrine (hormonal) system that helps regulate our metabolism, manages protein synthesis, growth and more. Of course, just because it affects mainly physiological processes in the body doesn’t mean it ends there, as energy production through metabolism has a profound effect on our brains.

Around one in eight people have a thyroid disorder. Of these, a majority are unaware they have it, and a huge majority are women. Why are women more susceptible? Because most thyroid disorders are caused by autoimmune diseases, which disproportionately affect women. Because thyroid problems often have numerous nonspecific symptoms, they are very easily misdiagnosed.

 1. Hypothyroidism

Hypothyroidism is a disorder that manifests in reduced activity in the thyroid gland. Because one of the main functions of the thyroid is regulating metabolism, an underactive gland causes slower metabolism. This, in turn, may cause inexplicable weight-gain, loss of appetite, constipation, dry and flaky skin, hair thinning, sensitivity to cold and depression.

In developing countries, the leading cause for hypothyroidism is a lack of dietary iodine, while in developed countries, hypothyroidism is typically associated with an autoimmune disease.

2. Hyperthyroidism

As you can probably tell by the name, this condition is the opposite of hypothyroidism and describes an overactive thyroid gland. Unsurprisingly, the symptoms of hyperthyroidism are nearly an exact mirror image of hypothyroidism: weight loss that is not tied to diet or activity and paired with an increased appetite, frequent diarrhea, irritability, confusion, an increased heartbeat, hand tremors, heat intolerance, sleep disorders, and mood swings.

Like hypothyroidism, the chief culprit behind hyperthyroidism are autoimmune diseases, and so it affects females to a much greater extent than men, but it also appears to be hereditary and can be caused by too much iodine in the diet.

3. Goiter

Rather than a thyroid disorder in and of itself, goiter is a symptom of other thyroid diseases. Goiter is a swelling of the neck due to an enlarged thyroid gland which can be caused by any thyroid disorder, but not having goiter doesn’t rule out a thyroid disorder.

It can present itself as a slight swelling of the neck, as a grapefruit-size globular swelling, or as several smaller balls in the neck. Goiter is typically painless, but a large goiter can make eating and breathing difficult.

Thyroid storm is a rare and life-threatening complication of an overactive thyroid (hyperthyroidism), which causes high fever, vomiting, and hypertension in early stages, followed by dramatically low blood pressure and circulatory shock in later stages. Thyroid storm could result in heart failure or heart attack.

Thyroid storm could be triggered by any number of conditions that aren’t related to the thyroid, such as blood poisoning, fever, dehydration and more. People are at larger risk of a thyroid storm if they leave their hyperthyroidism untreated or if they discontinue their hyperthyroidism treatment.

5. Hashimoto’s disease

Perhaps the leading cause of hypothyroidism in the west is Hashimoto’s disease, an autoimmune disease that causes the immune system to actively attack the thyroid gland. Though this may cause swelling in the thyroid (and goiter as a result), the overall effect is a gradual shrinking of the thyroid until its destruction.

As an autoimmune disease, Hashimoto’s disease is more common among people who suffer from other autoimmune diseases, specifically type 1 diabetes, celiac disease, vitiligo, and alopecia, but it is also genetic and could be inherited.

6. Graves’ Disease

Another autoimmune disease, Graves’ is the most common cause behind hyperthyroidism and can be initially triggered by stress, infection or childbirth. Additional symptoms of Graves’ are discolored, swollen shins with lesions or nodules, as well as eyes that bulge out.

Much like Hashimoto’s, people suffering from a preexisting autoimmune disease are more likely to develop Graves’ disease, and conversely, those with Graves’ are more likely to develop unrelated autoimmune conditions. There also appears to be a genetic factor.

7. Thyroid nodules

The most common thyroid problem and the cause of the least concern are nodules in the thyroid gland. These can be asymptomatic and imperceptibly small or present as lumps in the throat. In the case of goiter, one or more lumps are indicative of nodules. Only 5% of thyroid nodules are malign.

Problems swallowing or speaking and a hard, immobile lump are more indicative of malignancy, while a family history of autoimmune diseases and thyroid conditions accompanied by a nodule that is soft and painful are all signs of the nodule being benign.

Thyroid nodules are extremely common, with about 50% of people having a nodule at some point in their life. Other thyroid conditions, such as Hashimoto’s and Graves’ will often cause nodules as well.

8. Thyroid cancer

Most types of thyroid cancer have an excellent prognosis and are very manageable, as they do not tend to metastasize. Though not overly common, diagnosed cases are on the rise, but that may very well be due to better detection, rather than the cancer being on the rise.

The lack of detection in the past may be due to a lack of complaints from patients, who did not realize something was wrong to begin with. There are four types of thyroid cancer:

• Papillary
• Follicular
• Medullary
• Anaplastic.

Of those, only anaplastic thyroid cancer, which is an extremely rare, fast-acting and metastasizing type of cancer, is of great concern. For the other three types of cancer, the survival rate over five years is 90% and 84% over ten years.

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Myth stating menstrual cycle lasts for 28 days busted

Remember how you learnt about the 28-day menstrual cycle in school? If you’ve been privileged to have period lessons at all, that is. Also recall how anything out of the 28-day time-frame was considered to be abnormal? Well, a new study suggests that all of this isn’t a common occurrence.

Natural Cycles, a contraceptive app joined hands with London's UCL to conduct a study on 600,000 cycles of about 125,000 women from Sweden, the US, and the UK. The research revealed that only 13 per cent of menstrual cycles were based on the 28-day framework. For about 65 per cent of participants, the cycles lasted between 25 to 30 days.

Professor Joyce Harper from the UCL Institute for Women's Health opined that the world’s understanding of menstrual cycles could be flawed. "Our study is unique in analysing over half a million cycles and rewriting our understanding of the key stages," she explained. "Traditionally, studies have concentrated on women who have approximately 28-day cycles. For the first time, our study shows that few women have the textbook 28-day cycle, with some experiencing very short or very long cycles."

The study also focused on the concept of fertility. Most of the people think that ovulation occurs on the 14th day of the menstrual cycle. However, this might not be completely true. The study discovered many differences in follicular phase length (the time from the first day of menstruation to ovulation).

The average follicular phase length turned out to be 16.9 days, with the overall menstrual cycle length dictating the former. Long cycles (31 to 35 days) implied an average follicular phase of 19.5 days, while short cycles meant an average follicular length of 12.4 days. Those who had extremely long cycles (36 to 50 days) showed an average of 26.8 days, while the ones with extremely short cycles (15 to 20 days) had an average of 10.4 days.

"It is important that women who wish to plan a pregnancy are having intercourse on their fertile days," said Professor Harper. She suggested considering “other measures such as basal body temperature” to identify the fertile period instead of solely relying on the menstrual cycle.

Dr. Simon Rowland, head of medical affairs at Natural Cycles, pointed out the connection between this result and the possible inaccuracy of fertility calendar apps. Meanwhile, Elina Berglund, co-founder of Natural Cycles app, focused on how every female body is unique. She said, “Reflecting the increasingly mainstream use of femtech, studies like this — powered by data — empower women to better understand their bodies by offering a more individualised approach to health. For me personally, the more entrenched I became in my own fertility data at the start of Natural Cycles, the more I learnt about my body — and the importance of this agency cannot be overstated.”

Chances are that similar studies will be conducted across the globe, considering the growing awareness on menstruation and pregnancy. Nonetheless, it has certainly made us question facts and take a second look at our menstrual health.

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