Diseases

What are early warning signs of thyroid problems in females?

what are early warning signs of thyroid problems Posted On
Posted By SUMIT SHARMA

Introduction

Want to know what are early warning signs of thyroid problems?

Well! You are not the only one suffering from thyroid issues because thyroid disease is a common global health problem.

If you do not take enough iodine in your food, you may have thyroid dysfunction. So, Iodine nutrition deficiency is a primary culprit of all thyroid disorders.

In iodine deficiency conditions, your body does not naturally make thyroid hormones that may lead to thyroid problems like hypothyroidism, hyperthyroidism, Goiter, Hashimoto’s thyroiditis, Grave’s disease, and thyroid cancer. 

Hypothyroidism has been seen most common among these thyroid disorders in clinical practice. 

Globally, up to 5% of people suffer from hypothyroidism. In a study, researchers have found that females are ten times more prone to hypothyroidism than men. 

Thyroid disorder might affect you or your relatives at any stage of your life but most probably with increasing age, especially in females. 

If you are dealing with this problem, you need to know everything about thyroid disorder.

Since thyroid disorder is challenging to diagnose, you should be aware of its signs and symptoms. 

In this post, we will discuss – what are early warning signs of thyroid problems?

But before going to the signs and symptoms of the thyroid problem, we need to understand the synthesis and secretion of thyroid hormones.

So, let’s start the topic as usual with the basics.

 

What are thyroid disorders? 

The thyroid is a butterfly-shaped gland located at the front of your neck below the voice box. This thyroid gland naturally produces two essential thyroid hormones – triiodothyronine (T3) and thyroxine (T4).

T3/T4 are essential hormones for our body growth, nerve cell growth, and reproductive system, to maintain basal metabolic rate (BMR) and energy balance.

The imbalance of T3/T4 hormones in your body causes thyroid disorder. 

What are early warning signs of thyroid problems

Suppose your thyroid gland does not make as enough thyroid hormones as the body requires. In that case, it will disturb the normal functioning of your body. This medical condition is called “Hypothyroidism” or “underactive thyroid.” 

Conversely, when these thyroid hormones may get aggravate and increase the level of T3/T4 in your body. This medical condition is known as “Hyperthyroidism” or “overactive thyroid.” 

Autoimmune disorders may also influence hypothyroidism and hyperthyroidism. Sometimes your body’s immune system mistakenly affects the healthy cells of the thyroid gland. As a result, it causes Hashimoto’s thyroiditis and Grave’s disease

Hashimoto’s thyroiditis is an autoimmune medical condition where immunity destroys your thyroid gland. Due to this, you do not get enough thyroid hormones. 

In Graves’s disease, your body produces enormous thyroid hormones (hyperthyroidism) when it attacks by the immune system. 

Hence, you must have thyroid hormones within the normal range in your body to maintain homeostasis. 

 

What are the steps of thyroid hormone synthesis and secretion?

Control of thyroid hormone release

Normally, your brain has an important autonomic control center, i.e., the paraventricular nucleus (PVN), which secretes TRH (Thyrotropin-releasing hormone) from the hypothalamus.

This TRH helps to stimulate the release of TSH (Thyroid-stimulating hormone) from thyrotropes that are present in the anterior pituitary.

After that, TSH goes to the systemic circulation and stimulates the thyroid follicular cells (thyroid gland) to release thyroid hormones (T3 and T4).

Then these T3/T4 hormones bind with TBG (Thyroxine-binding globulin), which is released from the liver. TBG acts as a transporter that helps carry the thyroid hormones into the bloodstream.  

As soon as thyroid hormones bind with TBG (TBG+T3/T4), they act on every cell of your body. It helps maintain your body’s normal function through a negative feedback mechanism.

It means if there is a high T3/T4, then your body will stop the secretion of TRH and TSH levels.

Conversely, if you have low T3/T4, your body will start releasing TRH and TSH levels. 

Paraventricular nucleus

Release TRH

Stimulate Pituitary gland

Release TSH

Stimulate Thyroid gland

Release T3/T4 in the bloodstream

T3/T4 bind with TBG

Bind on every cell

 

Steps of thyroid hormone synthesis

Step 1 – Iodide (I-) trapped by the thyroid follicular cells

Iodine trapping is the first step in the synthesis of thyroid hormones. 

When you take table salt (iodized salt), it goes to your gastrointestinal region and then reaches the systemic circulation.

The thyroid gland utilizes around 20% of iodized salt, and the rest of 80% is eliminated from urine.

Thyroid tissues (also known as thyroid follicular cells) contain sodium iodide symporters (thyroid pumps). These symporters help in the absorption of iodized salts into thyroid tissue. 

Meanwhile, follicular cells start to produce a lot of thyroglobulins. Generally, one thyroglobulin contains many tyrosine residues.

 

Step -2 Diffusion of iodide to the apex of the thyroid cells

After absorption of iodized salt, Iodide molecules start to move towards the apex of thyroid follicular cells.

 

Step 3 – Transport of iodide into the colloid

There is an important enzyme in the synthesis of thyroid hormones, i.e., thyroid peroxidase or thyroperoxidase (TPO). TPO is generally secreted into the colloid (or lumen) of the thyroid follicular cell.

TPO helps pump out trapped iodide from the follicular cell into the colloid and enters the lumen of thyroid follicles by pendrin transporter. 

 

Step 4 – Oxidation of inorganic iodide to iodine

TPO enzyme also helps in the oxidation of iodide that converts into iodine (I2). 

 

Step 5 – Iodination of tyrosine or organification of iodide

TPO has another role in the incorporation of iodine into thyroglobulin. It means each iodine fuse with tyrosine residues.

If one iodine fuse with tyrosine residues = Monoiodotyrosine (MIT)

If two iodine fuses with tyrosine residues = Diiodotyrosine (DIT)

It makes a long peptide chain in the form of series MIT/ DIT.

 

Step 6 – Coupling reaction 

TPO also has a crucial function in leading to coupling reactions. It helps to fuse iodinated tyrosine with each other.

MIT + DIT = Triiodotyrosine (or triiodothyronine) – T3

DIT + DIT = Tetraiodotyrosine (or thyroxine) – T4

 

Eventually, the exocytosis of T3/T4 in blood plasma. These thyroid hormones (T3 and T4) act on every cell of your body.

 

What symptoms indicate thyroid problems?

Typically, thyroid hormones regulate every aspect of our body. You may experience hypo or hyperthyroidism symptoms if these hormones do not sufficiently produce or release in excess quantity.

Here, I have mentioned 12 early warning signs of thyroid problems. Let’s see – what are early warning signs of thyroid issues from top to bottom of your body: –

1. Fatigue or excessive tiredness

The excessive feeling of tiredness is the first sign of thyroid problems. You may feel lethargy and muscle weakness; either you have overactive (hyperthyroidism) or underactive thyroid (hypothyroidism) problems. 

In underactive thyroid, you may get slow metabolism if you have low thyroxine production in your body. As a result, it leads to excessive tiredness.  

This excessive tiredness is the universal symptom of the underactive thyroid problem. You may have extreme feelings of exhaustion and sleep throughout the day. 

Even a study published in European Journal of Endocrinology, 2012 evaluated that fatigue is a very noticeable symptom of hypothyroidism.

Lethargy can also be seen in an overactive thyroid problem.

In hyperthyroidism, your body secretes an excess of thyroxine hormone that speeds up your metabolism. This overactivity of metabolism can lead to excessive tiredness and difficulty in sleeping. 

You will be unable to sleep properly (insomnia) and get anxious early. 

What are early warning signs of thyroid problems

 

2. Weight gain or loss

Thyroid hormones have a crucial role in controlling your weight as it regulates your metabolism.

Weight gain or loss can be the early warning signs of thyroid problems. 

In hypothyroidism, you get rapid weight gain that reflects low thyroid hormones. 

In a retrospective and observational study published in saudi medical journal, 2008, researchers have revealed that low thyroid function causes obesity. 

In these conditions, your body is unable to break fatty tissue. Due to this, you may get more fat in your body and become obese. 

In contrast (in hyperthyroidism), suppose your thyroid gland produces large quantities of T3/T4 hormones (overactive thyroid). In that condition, it speeds up the process of your metabolism that cause accidental weight loss. 

A study shows patients got lean body mass during hyperthyroidism.

It would be best if you calculated your BMR (Basal metabolic rate) for appropriate calorie intake. 

What are early warning signs of thyroid problems

 

3. Hair loss 

Thyroid hormones (T3/T4) have a significant role in developing hair and hair follicles. 

Hair loss is an important visible sign of thyroid problems, whether you have hyperthyroidism (overactive thyroid) or hypothyroidism (underactive thyroid).

As per the international journal of trichology 2013, diffuse hair loss or alopecia are common signs of a thyroid problem. It impairs the quality of hair.

You may struggle with hair problems like dry hair, brittle hair, thin hair, and hair loss. 

What are early warning signs of thyroid problems

 

4. Decrease brain functioning 

Thyroid hormones also have a crucial role in developing and normal functioning of your brain

According to a study journal endocrine connections 2018, disruption in thyroid hormone causes neurological impairment and neurodevelopmental disease.

It makes sluggish your all brain function. If you are dealing with hypothyroidism, you may have specific symptoms – 

  • Lack of energy (lethargy)
  • Hyporeflexia due to disruption of the sensory pathway
  • Low IQ
  • Low intelligence
  • Confusion
  • Increased response time

 

Memory loss is often seen in clinical practice in subclinical hypothyroidism (mild thyroid failure). 

The longstanding extreme deficiency of thyroid hormones (or severe hypothyroidism) may cause loss of the function of your brain. As a result, you may develop a life-threatening medical condition called Myxoedema coma

Conversely, if you have a hyperthyroidism problem, you may develop too much frustration, anxiety, and hyperreflexia. 

Some common symptoms like depression, bipolar disorder, dementia, confusion, and personality changes occur in both hypo or hyperthyroidism conditions.

What are early warning signs of thyroid problems

 

5. Facial swelling and hyperpigmentation 

In a case reported in the Netherlands journal of medicine, 2013, a female patient was found with severe facial edema during myxoedema (severe hypothyroidism).

In this condition, glycosaminoglycans (especially hyaluronic acid) get a deposit into the dermis.

Due to this, you may have facial swelling or puffiness on your face.

In contrast, hyperpigmentation is often associated with hyperthyroidism

The excess secretion of thyroxine hormone stimulates the pituitary gland that releases ACTH (adrenocorticotrophic hormone). Then, this ACTH triggers the release of the cortisol hormone. 

Cortisol is responsible for the blackening of your skin. 

 

6. Voice changes 

Voice changes are also noticeable early warning signs of a thyroid problem. As per a study, the quality of voice is generally hampered by both hypothyroidism and hyperthyroidism. 

You may experience low voice, roughness, heaviness, or hoarseness of your voice.

What are early warning signs of thyroid problems

 

7. Cardiovascular health problems

The thyroid hormone has a significant role in cardiac physiology. It promotes normal cardiac output and heart rate.

When you have low thyroxine hormones (or hypothyroidism), your heart rate will slow, and your blood pressure will drop.

Even it is mentioned in a study published in Methodist DeBakey Cardiovascular Journal 2017; that hypothyroidism can cause bradycardia (decreased heart rate) and decreased cardiac output (low blood pressure).

So, slow heart rate and low blood pressure are early warning signs of hypothyroid problems. In this condition, you may face dizziness and light-headedness. 

According to open cardiovascular medicine journal 2011, hypothyroidism worsens the lipid profile.

It decreases the LDL uptake into the liver, resulting in more LDL remaining in your blood. It increases your cholesterol level, which is the main reason for developing cardiovascular disease.

Conversely (in hyperthyroidism), if your body produces excess thyroid hormones, your heart will start to beat faster, and you may experience high blood pressure

Therefore, increased heart rate (or atrial fibrillation) and hypertension (especially systolic blood pressure rise) are common signs of hyperthyroid problems.  

Over time, you may develop angina pectoris and congestive heart failure (CHF) problems in untreated hyperthyroidism. 

8. Sensitivity to heat or cold

Normally, thyroxine hormones regulate the temperature and make your body slightly warm.

In an underactive thyroid condition, your body does not produce enough thyroxine hormone, leading to enhanced hypothermia (or cold intolerance).

It means you will generate less heat and be more sensitive to cold. You cannot tolerate freezing conditions even at room temperature. You may often experience cold hands and feet. 

While the unusual sensitivity to heat or heat intolerance is a common sign of an overactive thyroid problem, you may experience abnormal sweating, frustration, and anxiety.

 

9. Alteration of skin (dry or oily skin)

The thyroid hormone has a pivotal role in skin homeostasis. It makes your skin hydrated and warm usually. The deficiency of thyroid hormone may cause dry skin

Dry skin is one of the most associated physical signs of hypothyroidism

If you have low thyroid hormone in your blood, it will alter the sweat gland and produces xerosis (dry skin). You will get less sweating, and your skin will become dry.

In hyperthyroidism, you may experience warm, soft, oily, or moist skin. When your body releases too much thyroid hormone, your skin gets too wet or hydrated. 

What are early warning signs of thyroid problems

 

10. Digestive issues 

Typically, thyroid hormones promote the motility and secretion of the stomach.

A study published in Gastroenterology Research and practice 2009 reveals that hypothyroidism decreases gastroesophageal motility and secretion.

It means your feces will stay longer in the gastrointestinal region if you are struggling with hypothyroidism. 

You may have constipation and hard stool, which is a very irritating symptom of hypothyroidism. 

But conversely, you may have loose stool (or diarrhea) if you are struggling with a hyperthyroidism problem.
What are early warning signs of thyroid problems

 

11. Changes in Menstrual Cycle

Menstrual irregularities are also the most common sign of thyroid problems. Usually, the thyroid gland controls your reproductive function, like the menstrual cycle

The dysfunction of thyroid hormones may cause a delayed period or early before period. It means you may have increased or decreased bleeding during menstruation.

If you don’t have enough thyroid hormones, you may experience polymenorrhea (increased menstrual bleeding). As per a study, polymenorrhea is a very common sign of hypothyroidism

Conversely, you may experience oligomenorrhea (decreased menstrual flow) during a hyperthyroidism condition.

 

12. Decrease sexual performance 

Low sexual performance is also an early warning sign of thyroid problems

Whether you have hyperthyroidism or hypothyroidism, it increases the miscarriage rate and decreases the fertility rate in women. 

Concerning males, if you are unable to maintain an erection, you may have difficulties achieving orgasms and may have diminished sperm count. These symptoms can indicate a thyroid-related problem.

What are early warning signs of thyroid problems

 

What are early warning signs of thyroid cancer?

It is possible to develop thyroid cancer if you do not receive appropriate treatment for hypothyroidism or hyperthyroidism. There are certain signs and symptoms of thyroid cancer – 

a. Swelling in your neck is the most common early warning sign of thyroid cancer. 

b. Sudden abnormal growth of thyroid tissue or gland. You may feel a lump around your front neck. 

c. Hoarseness of voice

d. Difficulty in swallowing (Dysphagia)

e. Difficulty in breathing (Dyspnea)

f. Persistent cough 

g. Neck pain

 

Conclusion 

Having a healthy thyroid gland is essential. It releases thyroid hormones (T3/T4) that regulate every part of your body.

In case of thyroid dysfunction, you may experience hypothyroidism or hyperthyroidism. 

Untreated or under-treated thyroid issues can lead to heart disease and increased mortality.

In this post, we have seen – what are early warning signs of thyroid problems?

These warning signs may help you make a timely diagnosis and receive appropriate treatment. If you experience any thyroid symptoms, you must consult your doctor. They will recommend the best treatment plan for you. 

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