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Are You Sure It's Your Thyroid? What You Can—And Can't—Blame On It

Prevention logo Prevention 12/16/2015 Sarah Klein

© extender01/iStock/Getty Images We seem to like pointing fingers at our thyroids.

The butterfly-shaped gland at the base of the throat releases hormones that help regulate growth, body temperature, and metabolism—and has become a convenient scapegoat for a host of common complaints.

Some of them, rightfully so. When your thyroid doesn't release enough hormones or totally overdoes it, you might notice symptoms that really run the gamut, from feeling unexplainably chilly or constipated if you're on the low end of the spectrum to feeling sweaty or anxious if you're on the high side. 

But unless you've had a blood test confirming your thyroid hormone levels have gone haywire, you might be blaming the wrong culprit.

That blood test will tell you how far away from "normal" your levels are, and the more severe, "the fairer game it is to attribute how you're feeling to your thyroid," says Boston-based endocrinologist Jeffrey Garber, MD. "The closer you get to normal and the longer you feel that way, have your antenna up to consider other causes." They're not to be overlooked, he says, since they could be long-lasting, serious health problems.

So far, it doesn't seem to have stopped all that many of us from muttering something along the lines of, "Oh, yeah, it's my thyroid." Garber points to a University of Nebraska study of thyroid disease prevalence published in JAMA Internal Medicine that found that around 15% of people with normally functioning thyroids reported having 4 or more symptoms that could technically be associated with an under-active gland, called hypothyroidism. Obviously, these are common symptoms, not always attributable to your thyroid alone, no matter how tempting it might be to blame. Here's when your symptoms might actually be thyroid-related—and when they're probably not.

It might be your thyroid if you're tired all the time.

© imageBROKER/REX Shutterstock/Rex Images "There's no question people with markedly under-active thyroids regularly report fatigue," Garber says. Once your doctor has treated your hypothyroidism with medicine, you'll have a better sense of how much of that fatigue was due to your low levels and how much is due to the fact that you've been staying up late streaming season 2 of Transparent.

"If manipulating your thyroid levels doesn't make you feel much better, than you need to look elsewhere," Garber says. After a physical exam and a blood test confirm you have indeed reached the "normal" level of thyroid hormones, if you're still wiped, it could be an underlying condition like sleep apnea or even depression that's draining you. It usually takes somewhere between 6 weeks and 3 months to "see substantial improvement" from thyroid treatment, Garber says.

It's probably not your thyroid if you've gained a significant amount of weight.

© Courtney Keating/iStock/Getty Images We know, we know: You are sure it's your thyroid. Sorry: "Weight gain historically has been over-emphasized as a feature of hypothyroidism," Garber says. Weight gain is usually due to a complicated mix of factors, but when it's legitimately thyroid-related, it's typically just about 5 to 10 pounds and mostly water weight, he says.

"Hypothyroidism decreases your metabolism, which could make you gain weight, but it also decreases your appetite," Garber says, so it's much more common to simply stay about the same. (Similarly, hyperthyroidism increases your metabolism, but also your appetite, "so it's a lousy weight-loss drug," he says.) Fluctuating weight or obesity is likely due to some other cause.

It might be your thyroid if your skin is parched or you're sweatier than usual.

© John DeFeo/iStock/Getty Images When you're low on thyroid hormones, you're likely to feel drier and scalier, while too much can make people drip with sweat, Garber says. There are legitimate changes in body temp associated with wacky hormone levels behind these changes, he says, although how they affect you also depends on how hot or cold you ran before your thyroid rioted. These are also some of the trickier symptoms to treat, simply because you'll have to essentially regrow skin. "If someone tells you their skin got better in a week after thyroid treatment, I think there are other factors that may be affecting them," Garber says. Realistically, if it is your thyroid, you'd probably need more like 9 to 12 months before you saw complete changes to skin, he says, as well as hair, which might be limper and won't hold a curl with hyperthyroidism, while hair can fall out or feel coarse and brittle with hypothyroidism.

It might be your thyroid if your voice has gotten lower.

If your voice is coming out all raspy and husky and not in a good way, hypothyroidism might be to blame. It tends to thicken the vocal cords, Garber says. Hyperthyroidism, on the other hand, is rarely the recipient of any voice-related blame, as the gland would have to be so seriously enlarged to affect the voice at all, he explains.

It might be your thyroid if your muscles keep cramping or have totally disappeared.

© PeopleImages/iStock/Getty Images Muscle cramps are a somewhat mysterious fact of life that science doesn't totally understand. They do seem to be a prominent feature of hypothyroidism, Garber says, so it's worth mentioning constant cramping to your doctor, especially if they are the painful kind. "Muscle cramps can be disabling, just misery," Garber says. Weak and shaky muscles might also be hypothyroidism-related.

In hyperthyroidism, though, your metabolism can be so revved up your body flies through the food you eat and starts burning muscle for energy instead. "I've seen athletic people get cut from all sorts of sports squads, ballerinas who lost their calf muscles," Garber says of people with hyperthyroidism. Athletic performance becomes, understandably, much more difficult.

It's probably not your thyroid if you're depressed (but then again, it could be).

© Mito Images/REX Shutterstock/Rex Images Major depression—when severe depression symptoms get in the way of daily life—affects nearly 15 million Americans, according to the Anxiety and Depression Association of America. In other words, it's relatively common—making it likely to be an underlying condition unrelated to your thyroid, Garber says. Sometimes thyroid treatment will "unmask" depression: It wasn't caused by treatment, as some have claimed, but was instead there all along, he says. Treating off-kilter thyroid hormones won't reverse an underlying mental illness. On the other hand, "depression can be caused by hypothyroidism and completely reversed by treating it, that's what's so confusing about it," he says.

It's also confusing that just about "any organ system you can name" can exhibit symptoms related to the thyroid, Garber says, many of which also have other possible explanations, he cautions. On top of all that, there are always the exceptions: While most people might exhibit certain symptoms in the face of thyroid issues, there are always a few who experience the exact opposite. "It's amazing how people are different," he says. Keep that in mind next time you're about to blame your thyroid for something without any proof.

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