Thyroid Problems: Symptoms, Causes, Tests and Treatment

Thyroid problems are common in India, and the hard part is how gradually the symptoms arrive. Weight gain, tiredness, hair fall — these complaints are so ordinary that few people connect them to a gland.

The good news is that testing is straightforward and, in most cases, the condition is well controlled with medication.

What the thyroid does

It is a butterfly-shaped gland at the front of the neck, sitting over the windpipe. It makes two hormones, T3 and T4, which set how quickly your body uses energy — think of it as the accelerator.

The pituitary gland in the brain instructs it by sending out TSH. That is why TSH is checked first: it shows how much work the body is asking the gland for.

Hypothyroidism vs hyperthyroidism

Hypothyroidism is the more common of the two in India, and it is more frequent in women than in men.

Symptoms to notice

When the thyroid is underactive:

• Weight gain without any change in diet
• Persistent tiredness and sluggishness
• Dry skin and hair fall
• Feeling cold more than others do
• Constipation
• Heavier or irregular periods
• Poorer memory and concentration
• Puffiness, particularly around the eyes

When it is overactive:

• Weight loss despite a good appetite
• A fast or noticeable heartbeat
• Trembling hands
• Sweating and difficulty tolerating heat
• Irritability and trouble sleeping
• Visible swelling in the neck

Why it happens

• Autoimmune conditions, where the body’s own defences affect the gland — the commonest cause of hypothyroidism
• Too little or too much iodine
• Temporary changes in some women after pregnancy
• Neck surgery or radiation
• Certain medicines
• A family history of thyroid problems

Tests and ranges

TSH is checked first. Where needed, a doctor will also order T3, T4 and antibody tests.

Laboratories differ, so read the range on your own report. Pregnancy uses different TSH ranges altogether — there, even a normal-looking result should be interpreted by your doctor.

How it is treated

Hypothyroidism is usually treated with a daily tablet that replaces the hormone the body is short of. It is generally taken in the morning on an empty stomach, with a gap before eating, because food reduces how much is absorbed.

Treatment for an overactive thyroid depends on the cause and ranges from medication to other approaches. In both cases the dose is set from test results and changes over time — which is why starting or stopping the tablet on your own is not safe.

What about diet?

No food fixes a thyroid problem, though balanced eating helps generally. Ordinary use of iodised salt is enough — there is no need to increase it. Some people are advised to avoid very large quantities of raw cabbage and similar vegetables, but in normal amounts these are not a concern.