Thyroid Problems in the Philippines: Goiter, Hypothyroidism & Hyperthyroidism Explained

The thyroid is a small, butterfly-shaped gland at the front of your neck. It controls your metabolism, so when it produces too much or too little hormone, you can feel it almost everywhere in your body. Thyroid problems are common in the Philippines, and they affect women much more often than men.

Hypothyroidism: An Underactive Thyroid

When the thyroid makes too little hormone, the body slows down. Common signs include:

• Tiredness and sluggishness, even after sleeping well
• Weight gain without eating more
• Feeling cold when others don't
• Dry skin, hair loss, and brittle nails
• Constipation
• Heavy or irregular menstrual periods
• Low mood and poor concentration

Hyperthyroidism: An Overactive Thyroid

When the thyroid makes too much hormone, the body speeds up:

• Fast or irregular heartbeat and palpitations
• Weight loss despite a good appetite
• Feeling hot and sweating a lot
• Shaky hands, nervousness, and irritability
• Trouble sleeping
• Bulging or irritated eyes, seen in Graves' disease

Goiter ("Bosyo") and Thyroid Nodules

A goiter is an enlarged thyroid that may appear as a swelling at the front of the neck. A nodule is a lump within the thyroid. Both can occur with normal, low, or high hormone levels. Most nodules are benign, but every new lump should be checked by a doctor.

Iodine deficiency used to be a major cause of goiter in the Philippines. Using iodized salt in cooking is a simple way to get enough iodine, but avoid taking iodine supplements unless a doctor advises it.

Which Tests Will You Need?

• TSH (thyroid-stimulating hormone): the main screening test. High TSH usually points to an underactive thyroid; low TSH to an overactive one.
• FT4 and sometimes FT3: the actual thyroid hormone levels
• Thyroid ultrasound: to examine goiters and nodules
• Fine needle aspiration biopsy (FNAB): to check suspicious nodules

Prices vary by laboratory and hospital. Blood tests are widely available in diagnostic centers, and many HMOs cover them with a doctor's request. Ask your HMO or the laboratory for current rates.

How Is It Treated?

• Hypothyroidism is usually treated with a daily thyroid hormone tablet, with regular blood tests to adjust the dose.
• Hyperthyroidism may be treated with medicines that reduce hormone production, radioactive iodine, or surgery.
• Large goiters or suspicious nodules may need surgery by an ENT or general surgeon.

Never stop or change thyroid medication without talking to your doctor.

Thyroid and Pregnancy

Thyroid hormone is important for a baby's brain development. If you have a thyroid condition and are planning a pregnancy or are already pregnant, tell your OB-GYN right away, since your treatment may need adjusting. See our pregnancy checklist.

When to See a Doctor Urgently

• A neck lump that grows quickly, feels hard, or comes with hoarseness or trouble swallowing or breathing
• A very fast or irregular heartbeat, chest pain, or fainting
• High fever, confusion, or severe agitation in someone with known hyperthyroidism

Which Doctor Should You See?

An endocrinologist specializes in thyroid and other hormone disorders. An internist can do the first tests, and an ENT or general surgeon handles thyroid surgery.

Find an endocrinologist or find an ENT specialist on MyDoktor.ph. For related reading, see our guide to diabetes and endocrinologists.