Feeling tired & anxious? It may be your thyroid!

Not many people know much about the small gland in your neck, but it could be causing you all sorts of problems, explains Dr Sarah Brewer

What you need to know about the small gland that can cause all sorts of problems

Thyroid problems are common, and women are 10 times more likely to be affected than men. Many cases go unrecognised; an obviously underactive thyroid (known as hypothyroidism) affects one in 50 of us, but one in 12 women have a mild form, which is harder to spot. An overactive thyroid is less common, it affects 1 in 133 people and around half go undiagnosed.

What does it do?

The thyroid is a butterfly-shaped gland in the base of the neck, just in front of the windpipe, that produces two iodinecontaining hormones, thyroxine (T4) and triiodothyronine (T3). These boost metabolism by increasing the speed at which cells work and use energy. That means a thyroid gland that is under or overactive affects every cell in your body.

What causes an underactive thyroid?

Most cases are due to the immune system producing antibodies that attack thyroid cells, leading to inflammation (chronic autoimmune thyroiditis). Many people have no obvious symptoms, but it can cause swelling of the thyroid gland to create a goitre with a sensation of fullness in the neck, pain in the neck or chest and trouble swallowing. Thyroid problems often run in families, suggesting genetic links. They often develop in people with other autoimmune conditions such as coeliac disease and type 1 diabetes. An underactive thyroid gland can also result from treatment to try to correct an overactive thyroid condition.

What causes an overactive thyroid?

The most common cause is Grave’s disease, an autoimmune condition where antibodies cause over-production of thyroid hormones. What triggers these antibodies is unknown. Other causes include overactive nodules in the thyroid gland, viral inflammation of the gland (thyroiditis), excess production of thyroidstimulating hormone (TSH) from the brain’s pituitary gland and high intakes of iodine.