Understanding Your Thyroid

What can go wrong and treatment options

Wil DuboisBy

It's a small pill. A battleship grey oval, with a score mark down the middle should you need to cut it in half. One side has "L-10" etched into the surface and the other side simply has a large capital "M." Even though it's the only pill I take in the morning, I keep my supply in one of those little pill organizers. Today happens to be a Wednesday… I think. But Tuesday's pill is staring me in the face.

Well, crap. No wonder I was so tired yesterday. I forgot to take my damn thyroid pill.

Oh yes, I have much more than just diabetes. Diabetes doesn't like to play alone. It has a host of friends that crowd around it to party in your body, and one of the most common of these is thyroid troubles.

How common? Well, while estimates vary depending on which studies you look at, in general experts agree that a hair over six percent of the general population suffers from some sort of funky thyroid; but diabetes and thyroid problems go hand in hand. If you have type 2 diabetes, that percentage nearly doubles. If you have type 1 diabetes, there's a one-in-three chance you'll have some sort of thyroid disease. That makes it common enough that the American Thyroid Association recommends screening type 1 diabetes patients for thyroid disease, even if we aren't showing any symptoms.

But don't freak out; this buddy of diabetes is an "easy" one to deal with. Well, at least compared to your diabetes.

So what is the thyroid? Where is it? What's its job? Why does it do that job badly in people with diabetes? The thyroid is a small gland that wraps around your windpipe like an octopus. Well, like an octopus missing more than a few legs. The thyroid, when it's working properly, produces a pair of hormones called T-3 and T-4. These two hormones regulate your metabolism—basically, how your body uses its energy. They also play a role in helping you maintain your body temperature. Sounds pretty simple, and it is when everything is working the way nature intended. But when the thyroid is not functioning properly, it can literally affect every organ and system in your entire body.

How these two hormones work is sufficiently complicated that no one has ever published Thyroid Hormones T-3 and T-4 for Dummies, so can we just agree that it's magic, and go on to what can go wrong?

So the most common thing that can go wrong with the thyroid is that it can get lazy. Lazy thyroid is actually called hypothyroidism. Of course, it's also possible to have an overactive, or hyper thyroid, but underactive thyroid and diabetes seem to be the most common dance partners in our little corner of the medical universe.

Although I ducked the issue of how the T-3 and T-4 hormones actually regulate your body's metabolism, I am going to take a stab at explaining how the system can break down. While it's the thyroid that makes the hormones that regulate the body's energy utilization, it does not decide how much to make. The thyroid is sort of like the line cook who takes orders from the sous-chef, who in turn takes orders from the head chef who's managing the whole show. Five Star Restaurant kitchen politics and human anatomy: Nothing is ever simple.

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Last Modified Date: January 31, 2014

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