Dr. Lovelace of Family Medicine Associates in Westfield, MA, recently sat down to discuss one of the most commonly overlooked conditions in primary care: thyroid disorders. Below is a recap of the key takeaways from that conversation.
You’ve been feeling tired. But it’s not the kind of tired that goes away after a good night’s sleep. Instead, it’s a deep, dragging fatigue that’s been hanging around for months. You may have noticed some unexpected weight changes, your mood has been off, or maybe your hair isn’t what it used to be. It’s easy to chalk those things up to stress or getting older. But what if your thyroid is behind it?
Dr. Akinyele Lovelace breaks it down simply: your thyroid is small, but it runs the show. And when it’s not working right, you can feel it everywhere.
What Does the Thyroid Actually Do?
The thyroid is a small, butterfly-shaped gland that sits at the base of your neck. Its job is to produce and regulate hormones that control how your body uses energy. This process, known as metabolism, affects almost every organ and system in your body.
When your thyroid hormones are balanced, you feel like yourself. Your heart beats steadily, your weight stays relatively stable, your digestion works, and your mood is even. When those hormones are off, either too high or too low, things start to unravel in ways that can be hard to connect back to one cause.
Two Main Types of Thyroid Disorders
Hypothyroidism: The Underactive Thyroid
Hypothyroidism means your thyroid isn’t producing enough hormone. Everything in your body slows down as a result. Common symptoms include:
- Fatigue and sluggishness that doesn’t improve with rest
- Unexplained weight gain, even without changes to diet or exercise
- Hair thinning or loss
- Dry or changes in skin, such as rough, pale, or puffy skin
- Constipation
- Depression or low mood
- Feeling cold all the time
- Slowed heart rate
- Brain fog or difficulty concentrating
- Fertility issues in both men and women
Hypothyroidism is the more common of the thyroid disorders, and it can creep up slowly. Many people live with symptoms for years before getting a diagnosis, not because the condition is hard to treat, but because the symptoms are easy to dismiss.
Hyperthyroidism: The Overactive Thyroid
Hyperthyroidism means your thyroid is producing too much hormone, pushing your body into overdrive. Symptoms often include:
- Unintentional weight loss, despite a normal or increased appetite
- Rapid or irregular heart rate
- Anxiety, nervousness, or irritability
- Tremors in the hands
- Excessive sweating
- Difficulty sleeping
- Hair thinning
- More frequent bowel movements
Both hypothyroidism and hyperthyroidism are real, diagnosable, and treatable conditions, but you have to know when to look for them first.
Who Is at Risk for a Thyroid Disorder?
Thyroid disorders are more common than most people realize, and certain groups are at higher risk:
- Women are significantly more likely to develop a thyroid condition than men
- Family history of thyroid disease increases your risk
- Age; risks increase as you get older, particularly for women over 60
- Those with other autoimmune conditions (such as Type 1 diabetes or rheumatoid arthritis)
- People with prior thyroid issues or who have had radiation treatment to the neck area
The takeaway: if you are a woman, have a family member with thyroid disease, or are over 60, it is worth having a direct conversation with your doctor.
The Thyroid-Mood Connection
One factor Dr. Lovelace emphasizes is how much thyroid dysfunction affects mental and emotional health. Patients with undiagnosed hypothyroidism are frequently treated for depression before anyone checks their thyroid. Similarly, people with hyperthyroidism are sometimes told they’re having anxiety or panic attacks.
This is not to say every mood issue is a thyroid issue, but thyroid hormone imbalances are a real and underrecognized contributor to how you feel emotionally. If you’ve been struggling with persistent low mood, anxiety, or mental fog alongside physical symptoms, it’s worth asking your doctor to check your thyroid.
How to Get Your Thyroid Checked
Here is something important that Dr. Lovelace wants patients to know: thyroid testing is not automatically included in routine bloodwork. A standard metabolic panel or annual physical does not typically include a thyroid-stimulating hormone (TSH) test unless you or your doctor specifically requests it.
You have to ask.
If you are experiencing symptoms that could be related to your thyroid, including fatigue, weight changes, hair thinning, mood shifts, skin changes, constipation, or heart palpitations, bring it up at your next appointment and say: “I’d like my thyroid levels checked.” Your doctor can order a TSH test, and if needed, follow-up tests for hormone levels.
Don’t wait for it to be offered. Advocate for yourself.
Treatment Options for Thyroid Disorders
Thyroid disorders are very manageable with the right treatment. But Dr. Lovelace is clear about one thing: supplements are not the answer. While there is a large market of thyroid-support supplements, they are not regulated, not proven to treat thyroid disease, and may interfere with actual treatment.
Effective treatment depends on whether your thyroid is underactive or overactive:
- Hypothyroidism is typically treated with a daily oral medication called levothyroxine, a synthetic thyroid hormone that replaces what your thyroid isn’t producing enough of. Most people feel significantly better and more like themselves once their levels are stable.
- Hyperthyroidism may be treated with medications that slow thyroid hormone production, radioactive iodine therapy, or in some cases, surgery.
Rather than a one-and-done situation, both of these conditions require regular follow-ups with your physician to monitor your hormone levels and adjust treatment as needed. Ongoing care and staying consistent with your care is what keeps you feeling well.
When Is a Specialist Involved?
Most thyroid conditions are managed effectively at the primary care level. However, there are situations where a referral to an endocrinologist, a specialist in hormone disorders, is necessary:
- When thyroid nodules or a goiter are detected
- When a thyroid condition is difficult to control with standard treatment
- When thyroid cancer is suspected or diagnosed
- When a patient requires a thyroidectomy (surgical removal of the thyroid), often due to cancer, a large goiter, or severe hyperthyroidism
If part or all the thyroid is removed, patients will need lifelong thyroid hormone replacement therapy to maintain normal hormone levels. Your care team will manage this closely over time.
The Bottom Line
Your thyroid affects your energy, your weight, your heart, your mood, your skin, your digestion, and even your fertility. When it’s off, you know something isn’t right – even if you can’t name it. The encouraging message from Dr. Lovelace is this: you don’t have to keep feeling that way.
If you’ve been experiencing symptoms that sound familiar, such as the unexplained fatigue, the weight that won’t budge, the hair thinning, or the mood changes, bring it up at your next appointment. Ask for the test. It’s a simple blood draw, and the results can genuinely change how you feel day to day.
You deserve to feel like yourself again. That starts with a conversation with your doctor.
Are you a patient at Family Medicine Associates and wondering if your thyroid could be affecting how you feel? Contact our office to schedule an appointment and talk with one of our expert providers today.