Medically reviewed by
Dr. Katie Rothwell, ND, a licensed Naturopathic Doctor with clinical focus in thyroid conditions and Hashimoto's disease through The College of Naturopaths of Ontario, Canada.
What do you know about the thyroid gland and thyroid disorders? How much of what you know is accurate? Honestly, that may even be hard to tell. Given the abundance of easily accessible information about almost anything you can think of, we, more often than not, will likely come across inaccurate or misleading information in the guise of fact.
According to the American Thyroid Association, about 20 million Americans are affected by some form of thyroid disease. However, despite how common thyroid disorders are, many misconceptions exist about these thyroid conditions and how the thyroid gland works.
Some of these misconceptions stem from generalizations of very specific instances and conditions. Some are also “half-truths” which could be harmful when considered to be entirely factual. Therefore, it is necessary to strive to equip ourselves with the truth so we can separate fact from myth as far as our health is concerned.
The rest of this article briefly addresses and debunks some common misconceptions about thyroid diseases.
Myth #1: Thyroid nodules are the same as goiter
No, they are not the same. Thyroid nodules are simply lumps within the thyroid gland. Goiter, on the other hand, is a smooth and uniform enlargement of the thyroid gland (diffuse goiter) and can be caused by one or more thyroid nodules (nodular goiter).
Myth #2: A lump or nodule means you have cancer
If you feel a lump or nodule in your neck, it is probably benign. Only a small percentage (about 5% to 15%) of thyroid nodules are cancerous. Like breast cancer and other cancers, a lump does not always indicate malignancy (cancer).
If you have thyroid nodules, it is crucial, however, to seek medical attention immediately, especially if you have trouble swallowing or breathing.
Myth #3: Thyroid cancer has no cure
Thyroid cancer is curable. Most thyroid cancers can be cured with treatment, especially if detected early before metastasis (spread to other parts of the body). Treatment options include thyroidectomy (surgical removal of all or most of the thyroid gland), thyroid lobectomy (surgical removal of a section of the thyroid gland), lymph node dissection (surgical removal of lymph nodes found in the neck).
After surgery, thyroid hormone therapy may be required to restore thyroid hormones and suppress the growth of thyroid cancer cells. Radioactive iodine may also be used to kill thyroid cancer cells that remain after surgery.
In cases where the cancer cannot be outrightly cured, treatment options aim at killing as many cancer cells as possible and stopping the spread of the cancer cells.
Myth #4: Only women are affected by thyroid disorders
This is a false claim. Thyroid disorders can affect a person without regard for gender. While women are statistically much more likely to be affected by thyroid disease than men, men still account for a fraction of cases of thyroid disorders, which is not too uncommon.
Myth #5: Hypothyroidism only occurs in adults
This is simply not true. Although older people, especially women over 60, are at significant risk of developing hypothyroidism, thyroid conditions such as hypothyroidism can affect anyone.
Babies can be born with hypothyroidism, too. This condition, commonly known as congenital hypothyroidism, presents just about the same symptoms experienced by adults with hypothyroidism, but with a higher risk of impaired cognitive development and intellectual disabilities.
This, therefore, underscores the importance of newborn screening for thyroid disorders to ensure early diagnosis and treatment.
Myth #6: You would know if you had a thyroid condition
Thyroid conditions do not always present apparent signs and symptoms. In fact, the majority of Americans with thyroid conditions are not aware of their condition.
The symptoms can also be vague and easily attributed to other conditions with similar sets of symptoms, making it hard to properly diagnose based on the symptoms alone. You need a thyroid panel test to be correctly diagnosed.
Myth #7: Thyroid diseases are easy to treat
Treatment isn’t always straightforward. Thyroid diseases are generally complex in terms of suitable treatment options. Each person may require a different management approach than someone else with the same condition.
Even though their blood work suggests normal levels of thyroid-stimulating hormone (TSH), some people still experience significant symptoms.
This highlights the value of a personalized treatment regimen as one’s dosage needs to be monitored and adjusted, if necessary, by one’s endocrinologist based on one’s disease progression and treatment outcomes.
Myth #8: If medication doesn’t effectively manage your hypothyroidism, you must have surgery
Surgery is rarely the first point of call when treating hypothyroidism. This is because it may be counterproductive to operate on an underactive thyroid unless it is medically necessary.
Surgical procedures that involve removing a portion or all of the thyroid are more likely for hyperthyroidism than hypothyroidism. When a goiter negatively affects breathing or swallowing, surgery is often the best option if medication fails to reduce the goiter.
Currently, levothyroxine remains the standard treatment option for hypothyroidism. If it isn’t effectively managing your symptoms, your doctor should be able to help you adjust your dosage for an optimal therapeutic outcome.
Myth #9: Once your TSH levels are normal and you don’t feel any symptoms, it’s okay to stop taking or skip your medication
This is highly inadvisable. If you discontinue your medication intake just because your symptoms got better, your symptoms are likely to return. You may also begin to experience health issues ranging from heart disease to infertility since the thyroid is essential in regulating many vital bodily functions which will be negatively impacted by the cessation of your treatment regimen.
Normal TSH levels should not warrant termination of your prescription. In fact, most people with thyroid conditions like hypothyroidism will be on medication for life.
Also, TSH levels alone may not be enough indication of your treatment outcome. Unless instructed otherwise by your doctor, it is best to stick to your prescription.
Myth #10: Hypothyroidism can be managed with a special diet
Your special diet alone is insufficient to manage your hypothyroid condition. While eating a balanced diet is essential for maintaining optimal overall health, it won’t necessarily restore your thyroid hormone levels.
You require effective treatment (typically levothyroxine) for that. Therefore, a special diet should not be used as a substitute for treatment. Your doctor will let you know if you need any dietary restrictions because of your thyroid treatment.
Myth #11: You need to start taking iodine supplements if you’re hypothyroid
You cannot and shouldn’t try to self-treat your condition with iodine. If you live in the United States, chances are that you already have enough iodine in your diet. Self-treatment with iodine is only likely going to worsen your hypothyroidism.
Studies have shown that excessive consumption of iodine could be just as detrimental as a lack of it. Unless your doctor okays your intake of extra iodine, you do not need iodine supplements.
Myth #12: You need to avoid cruciferous vegetables if you're living with a thyroid condition
Cruciferous vegetables like cabbage, broccoli and cauliflower are filled with loads of nutrients that are good for critical organs like the liver and your overall health.
While some research indicates that these vegetables could negatively affect thyroid hormone production as they may disrupt iodine absorption by the thyroid gland, it has not been established how much one needs to consume to have their thyroid hormone production negatively impacted.
Since there aren’t enough studies involving humans that conclusively establish that cruciferous vegetables should be avoided in order to promote thyroid health, it is safe to occasionally consume them cooked (rather than raw) and in moderation.
Myth # 13: You can’t become pregnant if you’re hypothyroid
Fertility concerns are common with hypothyroidism. However, it is not impossible to get pregnant with hypothyroidism. With proper management of your hypothyroid condition, you can practically plan and work towards pregnancy and lower your risk of miscarriage.
Myth #14: You cannot take thyroid medications during pregnancy
You can safely take your thyroid medications during pregnancy. Through your regular thyroid check-ups, your doctor can monitor your response to your thyroid treatment during pregnancy and ensure that you take the correct medication dosages.
You need thyroid treatment, especially during pregnancy, to prevent complications such as preeclampsia, stunted fetal development, and miscarriage. It is, therefore, important to stick to your medication as prescribed by your doctor.
Myth #15: Hypothyroidism is always due to an autoimmune condition
The most common cause of hypothyroidism is an autoimmune disease known as Hashimoto’s disease. However, not every case of hypothyroidism results from an autoimmune condition. Genetic factors, a defective pituitary gland, and certain medications may also account for the development of an underactive thyroid gland.
Myth #16: Fluctuations in weight are because of a thyroid problem
Blaming the thyroid for fluctuations in your weight may be misguided, especially if you have no medical confirmation of this.
Many factors beyond the thyroid gland are responsible for weight management. Such factors include your diet, how much sleep you get, and how much you exercise.
While hypothyroidism and hyperthyroidism cause weight gain and weight loss, respectively, not every case of weight change is due to a thyroid problem.
Myth #17: People with thyroid conditions will have to be on medication for life
While this is true for most people with thyroid disorders, it is not entirely true for everyone. There are some key exceptions. For instance, some women may develop thyroid disorders during or after pregnancy due to hormonal imbalances.
After some time, however, this condition may self-correct once the hormonal balance has been attained. Another exception is the transience of neonatal Graves’ disease.
- Most misconceptions about thyroid diseases stem from half-truths and generalizations not concretively backed by research.
- One common misconception about thyroid diseases is that you would know if you were affected by one. This is not true, as symptoms can be vague and hard to use as a basis for diagnosis. Your best bet at a proper diagnosis is through a thyroid panel test.
- While some myths may seem accurate at first glance, they are actually false because they are either too general or too specific. For instance, while it is true that the majority of people living with thyroid disorders are women, women are not the only ones affected.
- There is much about thyroid diseases that are not very well-known. More research is hence needed to separate myth from fact concretively.