Do you know where your thyroid gland is and why it’s so important?
Perhaps you’ve been told you have a thyroid problem but have been taking the same medications for it for years and don’t really feel any better?
Here’s what you need to know about the thyroid and how to keep it healthy to not only make you feel GREAT again but also to look after your heart.
What is the thyroid?
The thyroid is a butterfly-shaped gland in your neck, just behind the ‘V’ where your collarbones meet. It produces hormones – thyroxine (T4) and triiodothyronine (T3) – that tell your cells if they need to speed up or slow down things like energy production, heart rate, hair growth, heat production etc. Thyroid hormone is a very important hormone for normal heart function, but if the thyroid gland is overactive or underactive, the result is a number of consequences and symptoms, sometimes involving the heart.
The connection to the heart is well established, but thyroid problems are often overlooked as the cause of heart problems. Your doctor should be checking your thyroid function if you have any of the following:
- Arrhythmia (fast, slow or irregular heart rhythm)
- High blood pressure
- Heart failure
- Heart disease or hardening of the arteries
Thyroid disease affects the heart either by producing too little thyroid hormone (called hypothyroidism) or too much thyroid hormone (hyperthyroidism). Both types of thyroid disorders are common and both can have a significant effect on the heart.
Hypothyroidism affects approximately 80% of people who have a thyroid disorder. Hypothyroidism indicates that the thyroid is not producing enough thyroid hormone or the body is attacking the thyroid gland and thus the gland becomes spongy and ineffective. Hashimoto’s thyroiditis is the most common cause of hypothyroidism, which is an auto-immune condition in which the body’s immune system gradually destroys the thyroid gland. As a result, the amount of circulating thyroid hormone in your body is too low. Hypothyroidism is characterised by some of the following symptoms:
- Feeling tired in the morning, even after sleeping well
- Feeling cold a lot of the time
- Weight gain and difficulty losing it
- Hair loss
- Dry skin
- Muscle loss
- Poor digestion
- Low libido
- Depression or low mood
In terms of the heart, you may not be able to SEE what is happening, but hypothyroidism can lead to:
- Hypertension (high blood pressure)
- Diastolic dysfunction, where the ventricles or ‘pump’ of the heart do not pump as strongly, which can lead to heart failure
- Bradycardia (slow heart rate)
- Heart palpitations and atrial fibrillation
One of the most important reasons to find out what is going on with your thyroid is because without treatment you will continue to have symptoms and a heart condition can result from being untreated.
In a person who has almost any type of heart disease, disorders of the thyroid gland can worsen cardiac symptoms or cause new ones and can accelerate the underlying cardiac problem. Thyroid disease can also cause new heart problems in people with otherwise healthy hearts.
An overactive thyroid, also known as hyperthyroidism, is where the thyroid gland produces too much of the thyroid hormones and thus the hormone levels rise.
The thyroid can become overactive due to a number of factors, including:
- Graves’ disease – where the body’s immune system mistakenly attacks and damages the thyroid
- Lumps (nodules) on the thyroid – this results in extra thyroid tissue, which can mean extra thyroid hormones are produced
- Certain medications – such as Amiodarone, a medication for atrial fibrillation
Symptoms are quite different from low thyroid hormones and can include:
- Nervousness, anxiety and irritability
- Mood swings
- Difficulty sleeping
- Persistent tiredness and weakness
- Sensitivity to heat
- Swelling in your neck from an enlarged thyroid (often called a goitre)
- Palpitations or atrial fibrillation
- Weight loss
Checking your thyroid
Talk to your doctor about your symptoms and ask if it could be your thyroid. If you haven’t had one recently, they should take blood to check on your thyroid function.
Have your doctor examine your neck to see if your thyroid gland is enlarged.
Here are the results to look for when looking at your blood tests and what they may mean.
TSH: Normal or High Free T3: Low Free T4: Low = Hypothyroidism
TSH: High Free T3: Normal Free T4: Normal = Possible Hypothyroidism (which may respond well to treatment)
TSH: Low Free T3: High Free T4: High = Hyperthyroidism
If all levels are normal but you have Thyroid Antibodies in your blood, this could be Hashimoto’s Hypothyroidism.
Talk to your doctor and make sure that they are giving you the correct treatment and monitoring you regularly. You should see an improvement in your symptoms once your levels normalise.
If you are taking Amioderone for atrial fibrillation, get your thyroid levels checked regularly (at least every 3 months) to ensure that your thyroid is not being damaged by the medication.
What can you do about it?
Depending on the cause of your thyroid problem, it is important to try and reduce any causes that could worsen the problem. For example, ask your doctor if you can stop the Amioderone if that has caused the thyroid problem.
Optimising treatment is essential and once your levels are normalised, you should feel a lot better and your risk of heart problems reduce.
Treatment is not a ‘once size fits all’. Some people do well on synthetic thyroid replacement, others see no improvement. If you are still suffering symptoms then ask to be referred to an endocrinologist or gynaecologist who specialises in hormones.
Talk to your doctor about other ways you can improve your thyroid function, but some things that have been shown to help include:
- Avoiding gluten. If your thyroid problem is caused by an autoimmune condition then giving up gluten has been shown to help. There has also shown to be a link between those who are sensitive to gluten or Celiac and thyroid disease.
- Avoid alcohol – although the occasional drink probably won’t cause any lasting thyroid problems, when consumed regularly, alcohol can become a serious health risk. Regularly drinking inhibits the thyroid hormones, free T3 and T4. Also, beer, wine and some spirits contain plant versions of the hormone oestrogen, known to trigger the human immune system. This might explain why some people with Hashimoto’s experience flare-ups in conjunction with drinking alcohol. Alcohol also prevents the immune system from defending itself against infections and inflammations in the body. Try reducing your intake and see if it helps.
- Caffeine – Studies have found that drinking coffee at the same time or shortly after taking your Levothyroxine tablets can significantly lower the absorption of the thyroid medication in your intestines. The caffeine in coffee is believed to be the cause of this effect. Take your tablets at least 30 minutes before food or coffee.
- Low stomach acid or Proton Pump Inhibitors (Omeprazole etc) – those with low stomach acid were found to absorb less of their Thyroxine. If possible, reduce the amount of PPI or take a small amount of lemon in water with your tablet on an empty stomach to improve absorption.
Make sure that you don’t put up with symptoms of a thyroid disorder. Keep going back to your doctor until they listen to you (or change your doctor!).
Have a great week 🙂