Should I Get Evaluated for Thyroid Disease?

3 Steps to Help You Decide on Thyroid Testing

Mature woman sitting on sofa, looking away in thought
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As you peruse the Internet, contemplating whether you have a thyroid problem, you may be questioning whether you're making too much of your symptoms. Or, perhaps you are worried that exploring a thyroid diagnosis will make you look like a hypochondriac to your doctor or loved ones.

Why You May Be Explaining Away Your Thyroid Symptoms

There are a couple reasons why people explain away their thyroid symptoms:

Symptoms are Nonspecific or From Stress

While it's true that symptoms of thyroid disease are nonspecific, meaning many of them are seen in other health conditions or are manifestations of outside factors, like stress or sleep deprivation, do not automatically explain away your symptoms or ignore that "something is off" feeling in your gut.

Compounding the fact that thyroid symptoms are nonspecific is the fact that, like other autoimmune diseases, the autoimmune thyroid conditions, Hashimoto's thyroiditis and Graves' disease, frequently appear during and after periods of great stress.

Whether it's having a baby, coping with the death of a loved one, changing jobs, going through a divorce, or experiencing a car accident, autoimmune thyroid conditions commonly show up after these types of crises and stressors. But that's also the same time that you (and your doctor) might expect you to endure symptoms such as fatigue, depression, sleep disorders, and weight changes.

Your Doctor Never Advised Thyroid Testing

You may think that because your doctor has not tested you for thyroid disease, he or she does not suspect it. But the truth is that some people with thyroid disease have no symptoms, especially at the beginning, or their symptoms are too subtle to draw attention. Moreover, it is not necessarily standard for doctors to screen for thyroid disease, like they do for diabetes or high cholesterol.

In fact, despite the high prevalence of thyroid disease in the United States, professional societies disagree about whether or not to screen adults for thyroid dysfunction. For instance, the American Thyroid Association recommends screening all adults over the age of 35 every five years while the American Association of Clinical Endocrinologists recommends screening only older patients.

On the complete opposite end of the spectrum, the United States Preventive Service Task Force states there is, "insufficient evidence to recommend routine screening for thyroid disease."

With these variable guidelines for thyroid testing, many adults have never had a thyroid test, and probably won't receive one unless they request it, or their doctor specifically suspects a thyroid problem.

3 Steps to Help You Decide on Thyroid Testing

Taking matters into your own hands, below are three steps you can take to help you decide whether or not you should undergo a thyroid evaluation:

Step 1: Write Down Your Symptoms

The first step is to write down all of your symptoms.

While not an exhaustive list, a few symptoms of hypothyroidism include:

  • Feeling fatigued, even after a long sleep
  • Feeling depressed or blue
  • Gaining weight, despite no change in exercise and a healthy diet
  • Experiencing “brain fog” and difficulty concentrating
  • Feeling feel cold when others feel hot
  • Noticing hair that is coarse and dry, breaking, brittle, or falling out
  • Noticing skin that is coarse, dry, scaly, and thick, especially the soles of your feet
  • Puffiness in the face, especially around the eyes
  • Irregular menstrual cycles

Likewise, some symptoms of hyperthyroidism include:

  • Anxiety and/or irritability
  • Weight loss without dieting
  • Feeling hot when others are cold
  • Sweating more than usual
  • Thinning hair and unusually smooth skin
  • Muscle weakness

Step 2: Perform a Thyroid Self-Check

It's a good idea to perform the "Thyroid Self-Check" at home to assess whether you have an enlarged thyroid and/or neck lumps, swelling, or tenderness, which can be a further sign of thyroid disease, including thyroiditis, nodules, or cancer.

Other symptoms in the thyroid area (base of the front of the neck) that may suggest a thyroid condition include:

  • A sore throat
  • Neck discomfort
  • Hoarseness
  • Difficulty swallowing

Step 3: Access Your Risk Factors

There are numerous risk factors for developing thyroid disease. Here are just a few examples— the tip of the iceberg, so to speak.

  • Having a family history of thyroid disease
  • Being female, as women are more likely than men to develop a thyroid problem
  • Getting older, as the risk of thyroid problems increases with age, especially over the age of 50
  • Having other autoimmune diseases like type 1 diabetes, pernicious anemia, or rheumatoid arthritis
  • Having a history of neck radiation to the thyroid gland
  • History of thyroid surgery
  • Taking certain medications like amiodarone or lithium

If you have any thyroid risk factors and/or symptoms or have a thyroid self-check that doesn't seem right (for example, you notice a neck lump or swelling), you should definitely talk to your doctor about getting your thyroid tested.

The good news is that besides a medical history and physical examination, evaluating your thyroid function is quite easy, requiring a simple blood test called a thyroid stimulating hormone (TSH) test. Other thyroid diagnostic tests may include a thyroid ultrasound, or additional blood tests like a free thyroxine (T4) level or thyroid antibodies.

A Word From Verywell

The bottom line here is that the symptoms of thyroid disease, especially in its early stages, can be quite subtle, drawing little to no attention, or easily explained away by life's run-of-the-mill stresses.

In the end, do not worry about "being wrong" about your thyroid diagnosis. Instead, take the leap, write down your symptoms and risk factors, perform your thyroid self-check exam, and go see your doctor. While you may not have a thyroid problem, there may be another medical explanation for why you are feeling the way you are—and you deserve to get to the bottom of it.