Hyper / Hypothyroidism

The thyroid is a butterfly-shaped gland in the neck which produces hormones essential for regulating basic bodily functions such as heart rate. The most common thyroid conditions are hyperthyroidism – when the gland produces too much of these hormones – and hypothyroidism – when not enough is produced. These can cause a wide range of symptoms that require treatment. It is thought that around 2% of the UK population has an underactive thyroid (more women than men) and an overactive thyroid is slightly less common, but still more prevalent in women.

What are the signs and symptoms of a thyroid condition?

A thyroid condition can cause many symptoms including:

  • Nervousness and anxiety
  • Mood swings
  • Extreme fatigue
  • Heat/cold sensitivity
  • Heart palpitations
  • Loss of libido
  • Muscle cramps
  • Enlarged thyroid gland, causing swelling in the neck (hyperthyroidism)
  • Rash (hyperthyroidism)
  • Red or dry eyes (hyperthyroidism)
  • Weight loss (hyperthyroidism) or weight gain (hypothyroidism)
  • Diarrhoea (hyperthyroidism) or constipation (hypothyroidism).

Children with hypothyroidism may have an abnormal growth pattern or start puberty earlier than normal. The condition can cause memory problems in an older person. Hair loss, anaemia and a slowed heart rate are the more serious symptoms that can arise when hypothyroidism is not treated.

Someone with low levels of thyroid hormones is at increased risk of heart problems as the body cannot process fat as effectively and the arteries can become clogged with fatty deposits.

How is a thyroid condition diagnosed and treated?

A thyroid condition is diagnosed using a thyroid function test to measure hormone levels. Test results can indicate present under or overactivity, as well as susceptibility to developing these problems in the future. Repeat blood tests can monitor the development over time.

A thyroid antibody test can be used to rule out an autoimmune thyroid condition such as Hashimoto’s thyroiditis, which can be managed with medication to supplement the low levels of hormones produced. This is the same course of treatment as for hypothyroidism. People taking these hormone replacements will usually need to take them for life.

People with an overactive thyroid are prescribed medication to reduce the levels of hormone produced. Many people do not need to stay on this medication for life.

If this doesn’t work, people with hyperthyroidism may undergo surgery to reduce the size of their thyroid and limit hormone production this way.

There are a few ways to confirm what sort of reasonable adjustments should be made for an employee with a thyroid condition:

An employee may not disclose their thyroid condition upfront, but if they do, questions regarding the nature of an employee’s thyroid condition and what extra support they may need can be broached sensitively. For example:

  • Have they required adjustments in the past? For example, too much time in front of a bright screen or in bright light.
  • Encouraging the employee to express their strengths and interests and which tasks they might enjoy doing is a positive way of adapting to their needs and empowering them, in spite of their thyroid condition.
  • Even if the employee does not wish to disclose their thyroid condition – or they have not even received a precise diagnosis – an employer can focus on making reasonable adjustments, rather than seeking to determine the precise disability their employee has.

What reasonable adjustments are possible for employees with a thyroid condition?

Employers have a legal duty to make reasonable adjustments for employees with a thyroid condition if they know, are aware of, or could ‘reasonably be expected to know’ that the employee has a thyroid condition. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.

If the employee does not disclose a health issue or disability which may affect their performance up front, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of a thyroid condition:

  • Flexible working hours to accommodate medical appointments and periods of increased absence or decreased productivity following a flare-up in symptoms.
  • Additional breaks if the person’s medication causes them to experience nausea, aching joints or fever-like symptoms (as is sometimes the case in the first few weeks of taking thyroid medication).
  • Adjustment to work set-up depending on the severity of their symptoms – eye problems may be exacerbated by high levels of indoor lighting or screen brightness, so lighting could be adjusted.
  • Raising awareness so that colleagues understand the employee’s thyroid condition and can help ensure the employee feels comfortable at work, for example, when taking additional breaks or regarding their swollen neck or eyes (noticeable symptoms of hyperthyroidism).
  • Ergonomic equipment to reduce pressure on the joints and other susceptible parts of the body while sitting at a desk.

Thyroid condition Signposting

The British Thyroid Foundation – charity working alongside medical professionals to provide evidence-based advice to help people in the UK live with thyroid disorders. Social media groups and local groups led by volunteers also help support people with the conditions (01423 810093).

The British Thyroid Association – charity dedicated to furthering research into the thyroid and to improving patient care for people with a thyroid condition. Patient information is informed by accredited medical professionals who specialise in the thyroid.

Thyroid UKcharity supporting people with thyroid conditions through their diagnosis and treatment by providing advice and resources and advocating for clinical care tailored to the individual.

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