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The Thyroid Crisis Currently Affecting Millions Worldwide

written by Dr. Christine Bishara - Mar 18, 2024

The Thyroid Crisis Currently Affecting Millions Worldwide

Thyroid health plays a crucial role in our overall health. This small, butterfly-shaped gland affects every aspect of wellbeing; especially since the incidence of thyroid disease has been steadily increasing. The thyroid gland plays a crucial role in many functions such as regulating metabolism and energy. Despite its size, the thyroid has a significant influence on various bodily functions including heart rate, digestion, and weight. Diseases of the thyroid affect an estimated 200 million people worldwide and an estimated 40% of the world's population are at risk of iodine deficiency, a nutrient that is essential for the production of thyroid hormones.

What is Hypothyroidism and Why is the Incidence on the Rise?

Hypothyroidism, also known as an underactive thyroid, occurs when the thyroid gland does not produce enough thyroid hormone to meet the body's needs. This can lead to a slowing down of the body's functions, causing symptoms such as fatigue, weight gain, cold intolerance, dry skin, and muscle weakness. Severe hypothyroidism, known as myxedema, is characterized by swelling and thickening of the skin, especially in the lower legs, face and tongue which can be life-threatening if left undiagnosed. The increase in hypothyroidism in the US is a growing concern. In the 1980s to the 1990s, the prevalence of overt hypothyroidism in the US population ranged from 0.3% to 0.4%. However, more recent studies have shown higher prevalence rates rising from 10% in 2012 to 12% in 2019, continuing to rise according to a large retrospective study.

The incidence of hypothyroidism is higher in females affecting an estimated 4% of women aged 18–24 years and 21% of women older than 74 years in the US. The causes of this increase are multifactorial and may include factors such lifestyle and dietary influences as well as iodine deficiency.

The most common cause of hypothyroidism is an autoimmune disease called Hashimoto's disease.

A Closer Look

Hashimoto's disease, also known as Hashimoto's thyroiditis, is an autoimmune disorder that leads to an underactive thyroid. This condition is characterized by an immune system attack on the thyroid gland, leading to a decrease in the production of thyroid hormones. The presence of specific thyroid antibodies in the blood distinguishes Hashimoto's disease from other causes of hypothyroidism. While hypothyroidism can be caused by various factors, the majority of hypothyroidism cases are due to this autoimmune condition.

Iodine Deficiency: An Important Factor

Iodine is a mineral that is required for the production of thyroid hormones. Without sufficient iodine, the thyroid gland cannot produce enough of the active forms of thyroid hormone. Since iodine is not naturally synthesized in the body, it must be obtained through food or supplements.

Deficiency can cause various symptoms, including:


Goiter: Swelling of the neck resulting from thyroid gland enlargement.

Increased risk of stillbirth: Severe iodine deficiency may increase the risk of stillbirth.

Impaired cognition and growth: Iodine deficiency early in life can impair cognition and growth in children.

Iodine is found mainly in animal protein, sea vegetables, and fortified foods like breads, cereals, and milk. Iodized salt was also commonly a source of iodine. Therefore, not regularly consuming these iodine-rich foods or iodized salt can lead to iodine deficiency.

Some groups at higher risk for iodine deficiency include those who do not use iodized salt or supplements, pregnant women and vegans who do not eat any animal foods. Those living in areas with low levels of iodine in the soil or not near the sea or ocean which are good sources of iodine are also at risk.

Good sources of iodine include:

● Seaweed (such as kelp, nori, kombu, and wakame)

● Fish and other seafood

● Dairy products

● Eggs

● Iodized salt

A major contributor to the problem: 100 years ago, iodine deficiency was not common in the US and in most seaside areas. This is because Iodine was added in minuscule amounts to table salt, so most people were getting adequate iodine. Now, many restrict salt or use other salts like Himalayan salt which may not have iodine, contributing to an iodine deficiency crisis.

Hyperthyroidism (Grave’s Disease)

On the other end of the spectrum lies Hyperthyroidism, also known as an overactive thyroid. This occurs when the thyroid gland produces an excess amount of thyroid hormones, leading to a faster metabolism, heart palpitations and various other symptoms such as heat intolerance and diarrhea. The most common cause of hyperthyroidism is Graves' disease, also an autoimmune disorder that leads to a generalized overactivity of the entire thyroid gland.

The condition is 7-8 times more common in women than men and is characterized by the immune system once again attacking the thyroid, leading to an excessive production of thyroid hormones. This results in a faster metabolism and can cause symptoms such as:

● weight loss

● rapid heartbeat

● anxiety

● tremors

● sweating

In some cases, it can also lead to eye issues such as exophthalmos which is a protrusion of one or both eyes. The onset of symptoms is usually gradual, often taking several weeks or months to develop.

Prevention & Treatment Options:

If you have symptoms of either hypothyroidism or hyperthyroidism:

1. Seek medical advice: Speak to your healthcare provider to rule out either condition with a simple blood test that can measure thyroid levels.

2. Iodine intake: While self medicating with iodine is NOT recommended, regularly consuming iodine rich, fortified foods as well as iodized salt are usually enough to prevent iodine deficiency. Avoid excessive iodine intake including iodine supplements, as that can exacerbate hyperthyroidism or even hypothyroidism.

3. Treatment adherence: If you have Graves' disease. Adhering to the prescribed treatment plan, which may include medications, radioactive iodine therapy, or surgery, is crucial for controlling your overactive thyroid.

4. Regular check-ups: Undergoing regular medical check-ups to monitor thyroid function and overall health is important for early detection of any potential issues or changes in the condition.

Treatment options for Graves' disease include:

* Antithyroid Medications: methimazole (Tapazole) and Propylthiouracil are commonly used to reduce the production of thyroid hormones and achieve a normal thyroid state.

* Radioactive Iodine Therapy: This treatment involves the oral administration of radioactive iodine, which is taken up by the overactive thyroid cells, leading to a reduction in their function. This may result in the development of hypothyroidism, which would then require lifelong thyroid hormone replacement therapy.

* Thyroid Surgery (Thyroidectomy): In some cases, the surgical removal of a part or all of the thyroid gland may be recommended, particularly if other treatments are not suitable or if there are other complications.

* Beta-Blockers: These may be prescribed to manage symptoms such as rapid heartbeat, tremors, and anxiety while other treatments take effect. The two most common ones used are Propranolol and Metoprolol.

Treatment options for Hypothyroidism includes:

Thyroxine sold as Synthroid.

If you are someone who needs to take medications for your thyroid condition, offers affordable and safe options. Always seek medical advice from your physician or a qualified healthcare provider.


* The untapped potential of the thyroid axis - The Lancet Diabetes & Endocrinology

* Thyroid Emergencies - PMC

* Hypothyroidism Prevalence in the United States: A Retrospective Study Combining National Health and Nutrition Examination Survey and Claims Data, 2009–2019 - PMC

* Hypothyroidism in Context: Where We’ve Been and Where We’re Going - PMC (

* Graves' Disease (


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