With respect to thyroid illness, myths and misconceptions abound. Here are 8 of these myths debunked.

Myth 1: Only Older Women Develop Thyroid Problems

While a woman by the age of 60 has a 1 in 5 chance of developing a thyroid problem, they are not the only people who develop thyroid conditions.

Women are vulnerable to thyroid conditions at any age, and in particular, during the postpartum period, and as our hormones begin to change beginning in our late thirties.

Men also develop thyroid conditions, and the symptoms in men don’t differ much from women’s experiences: weight changes, fatigue, anxiety, depression, loss of sex drive, hair loss–all are common complains of men with thyroid conditions.

Myth 2: Thyroid Disease Is Easy to Diagnose and Easy to Treat

Many people have a difficult time getting diagnosed with thyroid disease, and even when diagnosed, discover that radioactive iodine or antithyroid drugs for hyperthyroidism haven’t resolved their symptoms, or receiving that so-called “easy pill a day” treatment for hypothyroidism is leaving them miserable, sick, and still suffering symptoms.
Many innovative practitioners and millions of patients know that thyroid disease is a complex, multi-faceted condition that requires a variety of approaches to diagnose and resolve.

Myth 3: Everyone With Graves’ Disease or Hyperthyroidism Will Get Bulging Eyes

“Bulging eyes” are one symptom of thyroid eye disease, also known as Graves’ opthamalopathy.

While this condition is more common in Graves’ disease and autoimmune hyperthyroidism patients, not everyone who has Graves’ will develop the eye-related symptoms. A small percentage of Hashimoto’s thyroiditis or autoimmune hypothyroidism patients also develop thyroid eye disease. And, having any thyroid problem is not a prerequisite.

A very small percentage of people with thyroid eye disease have no active form of thyroid disease.

Myth 4: Hypothyroidism Will Cause Only a Weight Gain of Several Pounds

While it’s hard to always identify exactly how much weight gain is the direct result of the hypothyroidism, the fact is, the reduced metabolism, reduced energy for exercise, and other metabolic changes can result in weight gains of 20, 30 or 40 pounds or more, for some people, depending on their metabolism and genetics.

Myth 5: Graves’ Disease or Hyperthyroidism Always Causes You to Lose Weight

Some people with an overactive thyroid will actually gain weight while they are hyperthyroid.

Myth 6: If You Have a Thyroid Problem, You Will Develop a Goiter (Enlarged Thyroid)

The majority of thyroid patients will not develop a goiter, or enlarged thyroid.

Myth 7: A lump or Nodule in the Thyroid Means You Have Thyroid Cancer

Actually, only 5% of thyroid nodules are cancerous. Various diagnostic procedures can evaluate whether your nodule or lump is one of the rare cancerous lumps.

Myth 8: You Won’t Have Hypothyroidism Symptoms Unless Your TSH Is Significantly Elevated

While some less enlightened practitioners believe that there are no symptoms unless TSH is significantly elevated, many patients report significant symptoms at high-normal TSH levels, or at elevated levels in the 6.0 to 10.0 range.

Researchers have also found that not treating even mild or subclinical hypothyroidism in the range under a TSH of 10.0 puts you at risk of a variety of conditions, including heart disease, and high cholesterol.

What Happens When You Have No Thyroid Gland?

Some thyroid patients say “I don’t have a thyroid! I read information about hypothyroidism and hyperthyroidism, but there’s nothing for people like me with NO thyroid.” This is a misunderstanding, because if you don’t have a thyroid, or your gland is unable to produce sufficient thyroid hormone, you are in fact hypothyroid, and most information regarding hypothyroidism applies to you.

Why Some People Don’t Have a Thyroid

Why are some people missing a thyroid gland?

  • A small percentage of people are born without a thyroid or with a malformed thyroid, a condition known as congenital hypothyroidism.
  • The treatment for thyroid cancer is usually surgical removal of all or part of the thyroid gland.
  • Some people with thyroid nodules or goiter (thyroid enlargement) that are cosmetically undesirable or affecting breathing or swallowing have the thyroid gland removed surgically.
  • Some people with Graves’ disease or hyperthyroidism have their thyroid removed surgically.

If you don’t have a thyroid gland at all, or you have a non-functioning thyroid gland, your condition is now hypothyroidism, irrespective of what disease or treatment led to the condition.

Underactive Thyroid/Hypothyroidism

In addition to those who were born without a thyroid gland, or who have had the gland surgically removed, there are other causes of hypothyroidism. These include:

  • Radioactive iodine (RAI) treatment for your Graves’ disease or hyperthyroidism is also known as ablation therapy. RAI either greatly impairs or completely destroys your gland’s ability to produce thyroid hormone, leaving you hypothyroid.
  • Hashimoto’s disease, an autoimmune condition where antibodies gradually destroy your thyroid’s ability to produce hormone over time.
  • Medications, such as lithium, that damage your thyroid’s ability to produce thyroid hormone.

Ultimately, if you do not have any—or enough—circulating thyroid hormone due to any cause, then you are hypothyroid.

So, a reminder: If you have no thyroid or a thyroid that has been treated by RAI, most of the information on hypothyroidism here at Verywell applies to you. A good starting place for research is our Hypothyroidism Information Page.

Special Considerations For People With No Thyroid

There are, however, some special considerations for people without a thyroid gland.

If you were born without a thyroid, your thyroid has been surgically removed, or you have had total or near total ablation with RAI, you don’t need to be concerned about goitrogenic foods (i.e., brussels sprouts, broccoli, kale etc.) and their ability to interfere with your thyroid function. You should, however, still be careful about overconsuming soy-based foods, as excessive soy intake may affect your ability to properly absorb your thyroid hormone replacement medication.

Those without a functioning thyroid gland may find that you have fewer fluctuations in thyroid function and greater ease in keeping an optimal TSH level on a consistent medication dose, as compared to patients who still have a gland. (Patients who still have a gland find that it occasionally produces thyroid hormone, and can erratically increase or decrease its functioning, making it harder to regulate thyroid levels.)

I f you are a  thyroid cancer patient who has had your thyroid gland removed, you are in a unique situation in that you are typically given thyroid hormone replacement drugs at “suppressive” levels. Suppression means taking a sufficient level of medication to keep your thyroid stimulating hormone (TSH) level very low or even undetectable. This is considered “hyperthyroid” by most lab standards, but suppression is necessary to prevent cancer recurrence in some patients. So, while you may refer to yourself as “hyperthyroid,” your underlying condition of having no thyroid gland means that you are actually hypothyroid, and much of the advice about hypothyroidism still applies to you.

A Word from Verywell

Whatever the cause of your hypothyroidism, if you are still experiencing thyroid symptoms, you may not be receiving optimal treatment for your condition. You’ll need to proactively work with your practitioner to get better treatment. This may involve:

  • Trying a different brand of levothyroxine.
  • Increasing the dose, so that your TSH is lower. For example, some patients report feeling the best when TSH levels are between 1 and 2. (Remember, however, that thyroid cancer patients often need to follow a different protocol to prevent cancer recurrence).
  • Adding a T3 drug (i.e., Cytomel, or compounded T3), to your levothyroxine, referred to as combination therapy, or T4/T3 therapy.
  • Switching to a natural desiccated thyroid drug, such as Nature-throid or Armour
  • Complementing your treatment with alternative, nutritional and mind-body support to help improve overall health and relieve symptoms.

If you are hypothyroid and still don’t feel well, a helpful next step is reading Help, I’m Hypothyroid and I Still Don’t Feel Well.

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