Understanding Thyroid Health: Insights from an Endocrinologist

The thyroid, a small butterfly-shaped gland located in the neck, plays a significant role in regulating our overall health. In a recent Baptist HealthTalk podcast hosted by Emmy-award-winning journalist Sandra Peebles, Angel Alejandro, M.D., an endocrinologist at Baptist Health, shed light on the importance of thyroid health, common misconceptions, and actionable steps for maintaining a healthy thyroid.

Why the Thyroid Matters

Dr. Alejandro emphasized that the thyroid is the body’s metabolic regulator. "It regulates your heart, blood pressure, heart rate, and energy levels," he explained. “You can really tell the difference on how important the thyroid it is when it's not working.”

When the thyroid isn’t functioning properly, the effects are noticeable. Hypothyroidism, or an underactive thyroid, can cause fatigue, weight gain, and sensitivity to cold. In contrast, hyperthyroidism, or an overactive thyroid, leads to symptoms like nervousness, weight loss, and insomnia.

Identifying Thyroid Issues

Many thyroid-related symptoms, such as mood swings, fatigue, or weight changes, can be mistaken for other conditions. Dr. Alejandro advised that if you suspect thyroid issues, the first step is blood work.

"There are two labs to look out for: TSH (thyroid-stimulating hormone) and free T4," he explained. TSH provides an average measure of thyroid function, while free T4 offers a snapshot of current activity. These tests, which can be done through a primary care provider, are simple and don’t require fasting.

 
(Watch now: The Baptist HealthTalk podcast the sheds light on the
importance of thyroid health, hosted by Emmy-award-winning
journalist Sandra Peebles and featuring Angel Alejandro, M.D.,
an endocrinologist at Baptist Health.)

Dr. Alejandro likened diagnosing thyroid issues to detective work. "You have to be careful because we don’t want to do any harm," he said, emphasizing the importance of accurate diagnosis and appropriate treatment. Whether it’s through regular check-ups, blood tests, or lifestyle adjustments, taking charge of your thyroid health can lead to significant improvements in overall well-being.

“We're talking about a medication that may be for life, so you have to be a 100 percent sure the patient needs the medication,” he emphasized.

For those experiencing unexplained symptoms like fatigue, weight changes, or mood swings, Dr. Alejandro’s advice is clear: "Start with your primary care provider and get your thyroid levels checked. It’s a simple step that can make a big difference."

Gender, Age, and Family History

Thyroid conditions are more common in women due to their autoimmune nature, but men are not immune. Age also plays a role, with thyroid nodules becoming more prevalent as people get older. Dr. Alejandro recommended that individuals with a family history of thyroid disease get their thyroid levels checked. "There’s a hereditary component, so it’s important to be proactive," he advised.

Natural Remedies and Supplements: Proceed with Caution

For those seeking natural solutions, Dr. Alejandro urged caution. "There are products called thyroid support supplements, but many of them contain actual thyroid hormone," he warned.

Unmonitored use of these supplements can lead to hyperthyroidism and heart issues. However, selenium, found in Brazilian nuts, has been shown to reduce thyroid inflammation and may help prevent hypothyroidism in certain cases.

When it comes to diet, Dr. Alejandro highlighted the importance of moderation. Foods like broccoli, which contain substances that can interfere with thyroid function, are safe when cooked. He also debunked the need for iodine supplements, explaining that the U.S. diet already provides sufficient iodine through iodized salt.

The Role of Autoimmune Conditions

Dr. Alejandro explained that hypothyroidism is often caused by Hashimoto’s thyroiditis, an autoimmune condition where the body attacks the thyroid. Interestingly, there’s a connection between autoimmune conditions and gluten. "A gluten-free diet may improve autoimmune conditions, but it’s not necessary for everyone," he said. Testing for gluten antibodies can help determine if dietary changes are needed.

Thyroid Myths and Misconceptions

One common myth is that thyroid medication is a lifelong commitment. Dr. Alejandro clarified that this is true for hypothyroidism, as the gland’s function typically declines over time. However, hyperthyroidism is different. "With hyperthyroidism, we use antithyroid medications for six to twelve months, and many patients go into remission," he explained.

Another misconception is that thyroid nodules—small growths in the thyroid—are always dangerous. "The majority of nodules are benign," Dr. Alejandro said. These are often discovered incidentally during imaging for other conditions. An ultrasound can determine whether a biopsy is needed or if the nodule can simply be monitored.

Emotional and Mental Health Connections

Thyroid health can also impact mental well-being. Hypothyroidism is linked to depression, while hyperthyroidism can cause anxiety and insomnia. "Sometimes, treating the thyroid resolves these issues," Dr. Alejandro said. He emphasized the importance of addressing the root cause rather than just managing symptoms with medications like antidepressants or anti-anxiety drugs.

Thyroid Cancer: A Manageable Diagnosis

While the word "cancer" can be alarming, Dr. Alejandro reassures that thyroid cancer is highly treatable. "The survival rate for thyroid cancer is exceptional," he said. Treatment typically involves surgery and, in some cases, radiation. Unlike many other cancers, thyroid cancer often doesn’t require an oncologist. "It’s something that’s very controllable and curable."