While not every thyroid disorder can be prevented—especially if you have autoimmune-related conditions—you can take steps for early detection and long-term management, says Chien-Hsiang Weng, MD, MPH, a clinical associate professor at Warren Alpert Medical School of Brown University and an attending physician at Brown University Health.

Routine thyroid screening is not necessary for everyone, but it becomes more important as risk factors increase. Watching for subtle signs helps, too. These can include persistent fatigue, unexplained weight gain or loss, mood or personality changes, and problems with memory or concentration. People often mistake these symptoms for stress, aging, menopause, or depression, but they can indicate thyroid dysfunction.

For patients with a thyroid disease, the goal is to maintain stable thyroid hormone levels over time. This requires:

• Regular thyroid function tests. Key blood tests measure levels of thyroid-stimulating hormone (TSH) and free thyroxine (free T4).
• Medication consistency. For hypothyroidism, patients should take levothyroxine (and sometimes liothyronine) on an empty stomach, with water, and at least 30 to 60 minutes before breakfast. Patients should avoid consuming calcium, iron, soy, and certain drugs close to taking their thyroid medication, as these can interfere with absorption.
• Managing hyperthyroidism after treatment. Clinicians must closely monitor people who take radioactive iodine or undergo surgical removal of the thyroid. Many patients eventually end up with hypothyroidism and need lifelong thyroid hormone replacement, as untreated hypothyroidism can raise the risk of cognitive decline and cardiovascular disease.

In aging populations, changes in thyroid hormone levels can have outsized impacts on heart rhythm, bone health, and cognitive performance. Small shifts in medication dosage can make a big difference, and frequent reassessments are essential.

Collaboration among primary care physicians, endocrinologists, neurologists, and mental health providers is key since thyroid disease often affects—and is affected by—other organ systems. Collaborative care can help address mood disorders linked to thyroid imbalance, cognitive symptoms such as brain fog, and cardiac or metabolic complications.

Even when thyroid disorders can't be prevented, Dr. Weng notes, awareness, regular monitoring, and coordinated care can improve quality of life and help prevent serious long-term complications.

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