Ask the Doctor


Brain Fog? Sensitivity to Cold? Maybe it’s Your Thyroid.

Michael Starks, M.D., a surgeon specializing in thyroid disorders, answers questions about thyroid issues.

According to the American Thyroid Association, the world’s leading professional association on thyroid health and diseases, more than 12% of the U.S. population will develop a thyroid condition during their lifetime. Here are the basics of what you need to know.


What is the thyroid and what does it do?

The thyroid is a butterfly-shaped gland in the neck that releases hormones that maintain the metabolic state of the body, controlling everything from your breathing and heart rate to body temperature, muscle control and mood. “The thyroid gears your body up for meeting its daily challenges,” explained Dr. Starks. “If your body produces too much thyroid hormone, your body is revved up; too little and you’re having a hard time getting out of your own way.” What are common thyroid issues? The most common thyroid-related issues in the U.S. today are hypothyroidism, which is an underactive thyroid; hyperthyroidism, an overactive thyroid; non-cancerous thyroid nodules, thyroid cancer and goiter or an enlarged thyroid.

How do doctors test for thyroid issues?

A simple blood test for thyroid stimulating hormone (TSH) or the other hormones produced by your thyroid will give your doctor clues about how your thyroid is working to regulate systems throughout your body. What are symptoms of underactive or overactive thyroid and how are these conditions treated?

An underactive thyroid, known as hypothyroidism, is recognized by a combination of symptoms including weight gain, memory issues, fatigue or lethargy, constipation, brain fog and sensitivity to cold. Medicine is used to treat hypothyroidism. Conversely, an overactive thyroid, called hyperthyroidism, is characterized by anxiety, feelings of irritation, hyperactivity, hair and weight loss, skipped periods, tremors and shaking or sweating. This condition is treated with anti-thyroid medications, radioactive iodine or surgery to remove all or part of your thyroid gland.

What if I notice growths or an enlarged thyroid?

Thyroid nodules are very common, occurring in about 50% of people older than age 50. A small percentage of nodules are cancerous. “As surgeons, we sort out the ones that are concerning,” said Dr. Starks. Using a needle biopsy performed in the office, Dr. Starks tests the thyroid cells to determine which will need surgical removal. Thyroid cancers do not typically affect lab tests, and nodules need to be evaluated by an endocrinologist or a surgeon specializing in thyroid disorders. If you notice a nodule or enlarged thyroid, talk to your provider.

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