Feeling too cold, too hot signs of thyroid problem

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Updated: August 4, 2011 4:20PM

Have you been tired lately? Gaining a little weight, too, or maybe you just really felt the cold this winter? Little things that seem easily attributed to working too hard, not eating nutritionally, or just getting old may really be symptoms of thyroid disease, slowly sneaking up.

Having a low-producing thyroid can give such general, vague symptoms that even physicians may place blame elsewhere. A thyroid gland that produces a little too much hormone can even produce feelings like a heart attack or gastrointestinal problems.

“Thyroid hormone plays a role in metabolism,” said Silver Cross endocrinologist Dr. Wassim El-Harake. “It has to do with burning of energy at the cell level. With a low level, you get a lower metabolism, and with an overactive thyroid gland, you get an increase in metabolism.”

The thyroid gland is a butterfly-shaped flattened mass that wraps around the windpipe, or trachea, in the front of the neck. A physician can tell if it is enlarged by feeling the area when the patient swallows.

The thyroid’s T4 and T3 hormones stimulate every tissue in the body to produce proteins and increase the amount of oxygen used by cells. The thyroid gland needs iodine to make the hormones, which is why iodine is added to our table salt as a supplement.

Hypo vs. hyperthyroidism

El-Harake said many physicians now routinely perform blood tests for hormones that the thyroid gland produces or hormones that affect the thyroid, even if there are no symptoms — just to make sure the levels are good.

Having a thyroid that over- or under-produces can cause a multitude of symptoms.

Hypothyroidism, or a low-functioning thyroid gland, can cause feelings of being tired, dry skin, weight gain, “feeling” the cold, constipation, irregular periods in women, coarse hair, depression, difficulty thinking clearly, a puffy face, a large tongue, poor hearing, and painful joints and tingling in hands.

Hyperthyroidism, when the thyroid gland produces too much hormones, can cause nervousness, irritability, increased perspiration, intolerance to heat, fatigue, difficulty sleeping, a fast heartbeat, irregular menstrual periods in girls, and muscle weakness.

People with hyperthyroidism might have eyes that appear to bulge out or look like they’re staring.

Both conditions can be life-threatening if they are allowed to go too far. Fortunately, the test to detect problems is easy, and treatments are available.

Causes and treatment

El-Harake said most cases of hypothyroidism are caused by an autoimmune disease called Hashimoto’s thyroiditis, and other cases can be caused by drug trauma, surgery, or treatment for Grave’s disease. The treatment, he said, is to give replacement T4 thyroid hormone.

Hyperthyroidism, or an overactive thyroid, can have several causes, El-Harake said, such as Grave’s disease, a goiter, an adenoma, or thyroiditis, which is a transient condition.

In the cases of Grave’s disease or cancer, El-Harake said radioactive iodine is usually given. It’s then taken up exclusively by the thyroid gland, and it kills the cells of the thyroid.

“The thyroid destroys itself,” he said.

El-Harake said because thyroid disease can be easily missed or misdiagnosed, it is recommended adults have their T4 and TSH blood levels checked once a year as part of a regular physical examination, in addition to a clinical examination.