What you Need to Know About Thyroid Problems in Women

By: Divya Yogi-Morren, MD • Posted on November 25, 2014 • Updated October 24, 2023

Thyroid Gland: Gas Pedal of the Body

Many women experience symptoms of fatigue and low energy that they attribute to their busy lives, juggling work and caring for their families. You may accept these symptoms as part of your life never suspecting that there might be a medical reason for the way that you feel.

These symptoms may be caused by problems in the thyroid gland, a butterfly shaped gland that is located in the front of the neck and produces thyroid hormones.

These thyroid hormones have an effect on almost all the organs of the body and affect many aspects of metabolism. I think of the thyroid gland as the “gas pedal" of the body. If it is going too fast, there is too much thyroid hormone and if it is going too slow, there is too little thyroid hormone in the body.

Hyperthyroidism

If there is overproduction of thyroid hormone or hyperthyroidism, you may experience the following signs or symptoms:

• Palpitations
• Weight loss despite increased appetite
• Increased sweating
• Tremors
• More frequent stooling
• Lighter or irregular periods
• Insomnia
• Fatigue
• Anxiety
• Muscle weakness
• Preference for cooler temperatures
• Accelerated aging
• Faster heart rate

Hypothyroidism

If there is underproduction of thyroid hormone or hypothyroidism, you may experience the following signs or symptoms:

• Weight gain
• Fatigue
• Reduced energy
• Heavy periods
• Constipation
• Hair loss
• Dry skin
• Feel cold most of the time
• High Cholesterol
• Infertility

To differentiate between hyperthyroidism and hypothyroidism, thyroid hormone levels will be checked. Hypothyroidism can be treated with replacement of thyroid hormone. One in eight women have thyroid problems, which can run in families. Treatment options for hyperthyroidism include medication, radioiodine ablation or even surgery depending on what is causing the thyroid to be overactive.

Thyroid Nodules

You can also develop lumps on your thyroid gland. These are called thyroid nodules and are quite common in women. Some studies have found the prevalence of thyroid nodules to be as high as 80% in women. About 5-15% of these nodules may harbor thyroid cancer. If you have nodules that can be felt in the neck, a thyroid ultrasound will then be done to assess the size of the thyroid nodule. If the thyroid nodule is large in size or suspicious features that might suggest cancer are noted on the thyroid ultrasound, then you might need to have a fine needle aspiration of the nodule. This is a simple procedure that is done in the office and cells from the nodule are sent to the lab to see if there are cancer cells in the nodule.

If you suspect that you have a thyroid problem, tell your doctor about it. Perhaps there is a medical reason for the way that you feel. Taking care of your thyroid means that you will be taking care of yourself and you may feel much better.

If you have any of the above symptoms, you may want to ask your physician to order a TSH blood test. The goal in young, healthy non-pregnant women is usually between 0.4-3.0. If you are developing swelling or enlargement of the thyroid you should be checked for Hashimoto's thyroid and have a thyroid ultrasound. If you have had neck irradiation or have a family history of thyroid cancer or Cowden's (PTEN) syndrome, be sure to let your physician know as you will need closer surveillance.

If you have low thyroid and have a normal TSH while on T4 but still feel tired and fatigued, you may be low in T3 or more likely may have another medical condition like:

• depression
• vitamin deficiency
• sleep apnea
• other hormonal problem

The good news is that most thyroid conditions are easily treated.

Be Strong, Be Healthy, Be in Charge!

-Divya Yogi-Morren, MD

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