The thyroid gland is a butterfly-shaped gland and is located in the anterior portion of the neck. It is easily palpated and your doctor will often do this during your standard physical exam to make sure it is not enlarged or has any nodules, which would indicate a malfunctioning thyroid gland.

The thyroid gland produces two important hormones: thyroxine (T4) and triiodothyronine (T3). The active form of thyroid that interacts at the tissue level is T3, and T4 gets converted into T3. The thyroid produces about 80% T4 and 20% T3. There are certain nutrients that are important for this conversion to occur, including zinc, selenium and the B vitamins. Also, conversion can be decreased when cortisol levels are too high, usually as a result of chronic stress.

The production of T3 and T4 is regulated by thyroid stimulating hormone (TSH), produced by the pituitary gland. When thyroid hormone levels are low with hypofunction of the thyroid, TSH increases in an effort to stimulate the thyroid gland to produce more T3 and T4. This is why an elevated TSH is the most commonly used screening tool for detecting hypothyroidism. In contrast, TSH becomes low in hyperthyroid conditions as a result of thyroid hormone levels being elevated.

With thyroid dysfunction the gland can become under-active (Hypothyroidism) with decreased production of thyroid hormones or over-active (Hyperthyroidism). Cancer can also occur in the thyroid gland and is more common in women than men. It usually presents as a painless mass or nodule in the front of the neck. A biopsy is necessary for proper diagnosis and surgery is the treatment. However, most thyroid nodules are benign, so further evaluation is needed to differentiate between the two.

Hypothyroidism is 4 times more common in women than men. Typical symptoms include fatigue, weight gain, depression, cold intolerance, constipation, dry skin, thin and brittle hair and nails, and thinning of the lateral portion of the eyebrows. Many cases of hypothyroidism are idiopathic (no known cause) but there are certain known risk factors. These include family history (heredity), times of sex hormone changes (post-partum or menopause), adrenal dysfunction, nutritional deficiencies such as iodine or zinc, and possibly exposure to toxins in our food or environment.

Hypothyroidism is typically treated with thyroid hormone medication. The most commonly prescribed is Levothyroxine (Synthroid) which contains synthetic T4. Thyroid glandulars can also be prescribed and many people seem to respond better to these because they are natural and contain both T3 and T4 in a similar ratio to what our bodies normally produce.

Hyperthyroidism is typically caused by either Hashimoto's thyroiditis or Grave's disease, both are autoimmune disorders. Typical symptoms of hyperthyroidism include increased heart rate, agitation or anxiety, heat intolerance, increased perspiration and weight loss. Hashimoto's thyroiditis is a relatively common auto immune disorder where the body's own immune system attacks the thyroid and causes tissue destruction. This condition starts as a hyperthyroid condition but eventually leads to hypothyroidism and decreased production of thyroid hormone. This condition is especially common after child birth, with a prevalence of about 5%, and 1 in 5 of those women will develop permanent hypothyroidism as a result. It's prevalence is also increased in people with type I diabetes and Celiac disease.

Hyperthyroidism is often treated with medication to control symptoms (eg. beta blockers for increased heart rate) and to suppress hormone production if it really high, but it is also commonly treated with thyroid hormones, especially if it is in the later stages when levels are low.

Thyroid function can be improved by supplementing with specific nutrients and herbs that help the thyroid gland to function more optimally and help to increase or decrease thyroid hormone production, depending on what is needed. Acupuncture and traditional chinese medicine can also help support normal thyroid function. These treatments can be used in conjunction with thyroid medication and can sometimes allow for a decrease in the dose of medicine needed, as well as decrease clinical symptoms. Treatment is very individualized and based on the patient's specific symptoms and laboratory results.

There is a very close connection between thyroid, adrenal and ovarian function. So, with thyroid issues it is important to evaluate these glands as well and provide support as needed. This can be done with simple laboratory tests and correlation with clinical symptoms.

Thyroid gland dysfunction is fairly common and laboratory testing to evaluate thyroid function is very important and should be performed at least annually. A complete thyroid panel should include TSH, free T3 and free T4. Additional tests may also be ordered, including TPO and Thyroglobulin antibodies (to evaluate auto immunity) and reverse T3 (an inactive form of T3). Also, if a thyroid nodule is detected it is important to get further testing done which might include an ultrasound of the thyroid and/or a radioactive iodine uptake test in order to rule out thyroid cancer.

Thyroid dysfunction is easy to detect and treat, left untreated though it can lead to serious health problems. So, it is important to have proper laboratory screening and physical exam on a regular basis to ensure that your thyroid gland is functioning optimally.