How Should I Treat Thyroid Problems?

Warning signs, symptoms and solutions for hypothyroidism and hyperthyroidism

Adam Rosenbluth, M.D.,

AARP

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illustration on a blue background showing a doctor in a white coat reaching toward an older adult woman. The woman has a small, door-like panel on her back, which the doctor is opening to represent a check-up or adjustment of her internal "metabolic dial."

James Yates

Based on my recent blood test, my doctor told me that my thyroid is sluggish. What can I do to boost it, both medically and holistically?

Just last week, a patient came to my office exhausted and frustrated. “I’m doing everything right,” she said, “but I can barely get off the couch.” Her recent thyroid test told the story. Her TSH level was elevated and indicated hypothyroidism. Your situation sounds similar, so I want to share what I told her: “This is fixable. You have more options than you may think, and you’re not alone.”

Older adults are at an increased risk of developing some form of thyroid dysfunction, so the overall incidence of thyroid disorders is increasing simply because we’re living longer. The good news? Whether your thyroid is overactive or underactive, you can be helped.

Let me walk you through what’s probably happening and what you can do about it.

Your thyroid is a butterfly-shaped gland at the base of your neck, just above your collarbone. Despite its small size, it’s literally the power manager of your entire body. Your thyroid regulates the speed of your heart rate, your energy levels, body temperature and digestion. For instance, an underactive thyroid can leave you constipated, while an overactive one might cause diarrhea. It affects your mood, weight, skin texture, hair and cognitive function.

When your thyroid isn’t producing enough hormone, it’s called hypothyroidism. Think of it like turning down the metabolic control dial in your body. Everything slows. You might feel perpetually tired, gain weight despite careful eating and exercise, struggle with constipation, experience brain fog or feel freezing cold all the time. Your skin might become dry, your hair may thin, and you just feel low and slow.

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The opposite condition is hyperthyroidism, where that metabolic dial gets turned all the way up. People with an overactive thyroid might experience anxiety, nervousness, heart palpitations or a rapid heartbeat; some develop atrial fibrillation, which is an irregular heart rhythm. You might feel constantly hot and sweaty, lose weight even while eating more, struggle with insomnia or develop a tremor in your hands.

Your doctor will likely check your TSH, or thyroid stimulation hormone. Your brain produces it in order to tell your thyroid how active it should be. Even though it’s counterintuitive, if your TSH is very high, it means your thyroid isn’t working hard enough. Think of it like a seesaw: High TSH means low thyroid function (hypothyroidism), and low TSH means high thyroid function (hyperthyroidism).

The most common cause of hypothyroidism is your body making antibodies against your thyroid, an autoimmune condition which is more common as we get older. The tricky part is that thyroid problems develop slowly, over months or even a year. That’s why people often don’t notice the changes. It happens in such an imperceptible fashion that you might just think, “Well, this is happening because I’m getting older.”

The good news? Hypothyroidism is very treatable. Your doctor will likely prescribe thyroid hormone replacement, Synthroid being the most common medication. There are also natural options, such as desiccated thyroid. Most people continue on medication for the rest of their lives. That’s OK; it’s simply giving your body what it no longer produces on its own.

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Make sure to take your thyroid medications as directed. Many people don’t realize that Synthroid should be taken on an empty stomach, early in the morning, 30 minutes to an hour before eating or drinking anything other than water. People sometimes struggle with achieving the right dose because they’re not taking it the right way.

For hyperthyroidism, treatment options include oral medications, radioiodine treatments or sometimes surgical removal of the thyroid.

Because the thyroid affects many body systems, you’ll want to pay attention to other areas of your health. Low thyroid function can affect bone strength and raise your LDL cholesterol, often referred to as the “bad cholesterol.”

While medication is the cornerstone of treatment, lifestyle factors also support thyroid health. The foundation is eating well, exercising regularly, having adequate sleep and getting enough iodine. This last one is crucial, since your body needs iodine to produce thyroid hormone. That’s why salt in this country is iodized. If you buy only organic or natural salt, you might not be getting enough iodine. Excessive iodine can exacerbate symptoms, so it’s important to find the right balance.

Selenium helps convert inactive thyroid hormone to its active form. Iron and zinc are also involved in thyroid function. While I don’t generally endorse supplements and suggest you get those nutrients from a balanced diet, this may be an exception. If you’re deficient, it can affect your thyroid.

Stress is terrible for your thyroid, just as it is for your heart and blood pressure. If you’re not sleeping well, constantly stressed, not exercising, or eating a highly processed diet, you’re not doing your thyroid any favors. If you’re a smoker, this is another reason to quit.

Living well with a thyroid condition is entirely doable with the right diagnosis and treatment plan. Work with your health care provider, be patient as medications are adjusted, and don’t hesitate to ask questions. Taking charge of your thyroid health can make a remarkable difference in your overall quality of life at any age.

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