The thyroid gland might be small, but any changes to its function can pack a huge wallop on how you feel every day. During January’s national Thyroid Awareness Month, pay attention to any possible symptoms that could indicate problems in you or any of your patients.

According to the American Thyroid Association (ATA), some of the more common diseases of this small gland include an overactive thyroid (hyperthyroidism), an underactive thyroid (hypothyroidism), and even thyroid cancer. Symptoms of these endocrine diseases can overlap with each other and can be mistaken for many other conditions.

Hypothyroidism

Symptoms of hypothyroidism are frequently dismissed by patients. As a nurse, your patients may complain about being excessively tired or lacking energy or even that they have a worsening mood. They may have noticed their hair is thinning or falling out or seems especially brittle. Hypothyroidism can cause people to gain weight and to feel cold in temperatures that were previously comfortable. Often, people will attribute these symptoms to stress, a particularly busy time, or seasonal changes.

Hyperthyroidism

It might seem that symptoms of hyperthyroidism would be the polar opposite of having hypothyroidism, but that’s not always the case. Because hyperthyroidism can speed up the metabolism, patients might also pass off symptoms like a racing heart, more-than-normal sweating, or mood changes to job stress, lots of activity, or even an increased fitness routine. But they can also experience the fatigue and hair loss that hypothyroidism presents. Some patients may notice more prominent eyes (Graves’ disease) or even feel their thyroid gland itself is enlarged.

Thyroid Cancer

According to the American Cancer Society, rates of this cancer have increased in the last decade in young adults (3 percent increase annually) and adolescents (4 percent increase annually), and even those who have had no prior thyroid problems can have thyroid cancer. This highly treatable cancer often presents as a lump in the neck rather than with symptoms like those of hyperthyroidism or hypothyroidism, and even blood tests don’t show anything abnormal.

If any of your patients mention these symptoms, a blood test may be in order. According to the ATA, a simple lab test will check thyroid hormone levels. If the levels of thyroxine (T4) or triiodothyronine (T3) or of the thyroid-stimulating hormone (TSH) are too high or too low, follow up will help determine next steps of medication, treatment, and referral to a specialist. If you or they notice any kind of lump in the thyroid gland, follow up tests are necessary to check for cancer.

Thyroid problems are fairly common and approximately 20 million Americans have some kind of thyroid disease. Listen to your patients as they describe any physical, cognitive, or emotional changes they have experienced to help detect any changes in the early stages.

Julia Quinn-Szcesuil
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