The thyroid is a small gland located at the base of the neck. This butterfly-shaped gland is a part of an intricate network of organs, also known as the endocrine system. Besides, the endocrine system takes care of a number of body activities.
The thyroid gland is responsible for the regulation of the body’s metabolism. Also, it's the primary function is to manufacture hormones for the same.
For example, when the thyroid gland produces too much or too little of the hormone, it may lead to a number of disorders.
Some of the common thyroid disorders include-
Hyperthyroidism
Hyperthyroidism is a condition that occurs when the thyroid gland is overactive, producing too much hormone. Also, one of the most common causes of hyperthyroidism is Graves’ disease. Below, we have mentioned some of the symptoms of hyperthyroidism-
- Nervousness
- Irritability
- Shaking
- Restlessness
- Racing heart
- Increase in swelling
- Anxiety
- Insomnia
- Thin skin
- Muscle weakness
- Brittle hair and nails
- Bulging eyes (Graves’ disease)
- Weight loss
Hypothyroidism
Hypothyroidism is the exact opposite of hyperthyroidism. In this condition, the thyroid gland is less active than it should be. As a result, this leads to the production of lesser hormones. Also, it is often a result of Hashimoto’s disease, damage from radiation treatment, surgery to remove the thyroid gland. Also, some of the major symptoms of hypothyroidism include-
- Dryness of skin
- Fatigue
- Also, increased sensitivity to cold
- Constipation
- Weakness
- Weight Gain
- Memory loss
- Depression
- Slow heart rate
- Coma (In some instances)
Goitre
Goitre is an enlargement of the thyroid gland that is non-cancerous. Also, the primary cause behind goitre is iodine deficiency in the diet. Goitre is often a result of hyperthyroidism where iodised salt provides excessive iodine.
Though the disease may affect anyone regardless of age, it is more common in people over 40. Also, one may also be prone to the disease in case of the presence of any medical history, pregnancy, and medication usage and radiation exposure. Goitre may cause the following symptoms if it grows too large.
- Difficulty in breathing and swallowing
- Hoarseness of the voice
- Wheezing/ coughing
- Difficulty in breathing
Thyroid Nodules
Thyroid nodules are growths forming on the thyroid gland. These nodules are not usually large enough to feel and can be fluid-filled or solid. The reason behind these are not known but do include iodine deficiency and Hashimoto's disease.
While most are benign, a small percentage of cases may have cancerous cells as well. The risk of these thyroid nodules may increase with age.
Mostly, thyroid nodules do not have any symptoms, but if they grow large enough, it may result in swelling in the neck or lead to breathing and swallowing difficulties or sometimes, goitre.
Some nodules produce the thyroid hormone that results in abnormally high levels in the bloodstream. In such a scenario, symptoms are the same as hyperthyroidism and include-
- Nervousness
- Tremors
- Weight loss
- High pulse rate
- Increased appetite
- Clammy skin
If the nodules are due to Hashimoto's disease, the symptoms tend to be similar to hypothyroidism. Some symptoms may include:
- Hair loss
- Dry skin
- Weight loss
- Cold intolerance
- Fatigue
Hashimoto’s Disease
Also known as chronic lymphocytic thyroiditis, it is the most common cause of hypothyroidism. The disease usually occurs when the body’s immune mistakenly attacks the thyroid gland, slowly destroying its ability to produce hormones.
A mild case of the disease may not have any apparent symptoms. However, the condition would remain stable for years in the end. Some of the symptoms include-
Graves’ Disease
The disease has been named after the doctor who first described it more than 150 years ago. The most common cause of hyperthyroidism, Graves’ is an autoimmune disorder that occurs when the body’s immune system attacks the thyroid gland by mistake. This leads to an overproduction of the hormone responsible for the regulation of metabolism. A hereditary disease may develop at any age. Some of the other risk factors of the disease include stress, pregnancy, and smoking.
When the blood has high levels of thyroid hormones, the body’s systems speed up and cause certain symptoms. Some of the symptoms include-
- Irritability
- Anxiety
- Fatigue
- Irregular/ increased heartbeat
- Difficulty sleeping
- Hand tremors
- Excessive sweating
- Frequent bowel movement or diarrhoea
- Alteration in the menstrual cycle
- Vision difficulties
- Goitre
Diagnosis of Thyroid Disorders
Besides a physical examination and thorough medical history checkup, the doctor would advise a specific test for the diagnosis of thyroid disorders.
Blood Tests-
The doctor may order a blood test to measure the levels of thyroid hormones and TSH. Blood tests also assist in the identification of antibodies against thyroid tissue.
Imaging Tests-
Imaging tests are used when the thyroid nodules or enlargement is present. Besides, ultrasound helps to visualise the consistency of the tissue within the gland and may often reveal calcifications or cysts. However, ultrasound examination cannot distinguish a benign tumour from a malignant tumour.
The doctor would perform thyroid scans using radioactive iodine for evaluation of the function of the thyroid nodules. This is done because the thyroid is the only location in the body that takes up iodine, hence when radioactively labelled iodine is given, the thyroid gland consumes it.
Sample Cell Removal-
Fine needle aspiration and biopsy are techniques that take a sample of the tissue or cells from the thyroid for the purpose of diagnosis.
Fine Needle Aspiration: It uses a long thin needle to withdraw a cell sample from the thyroid. Further, the doctor may use ultrasound imaging to guide the procedure.
Biopsy: A biopsy involves a surgical sampling of the tissue.
Treatment of Thyroid Disorders
With a timely diagnosis, thyroid disorders can be easily treated. Though sometimes the treatment procedure would involve medications, in extreme cases surgery. Also, the treatment solely depends on the type of disorder and how far it has spread.
Thyroid Medications-
The doctor may prescribe a few medications to replace the missing thyroid hormone in hypothyroidism. For hyperthyroidism, medicines may be prescribed for decreasing the production of thyroid hormone or stopping its release from the gland.
Eventually, the doctor may also prescribe other medications so that the symptoms of hyperthyroidism like an increase in heart rate are manageable. However, if hyperthyroidism is uncontrolled through drugs, the doctor may perform radioactive ablation. This involves giving doses of iodine fueled with radioactivity to destroy the thyroid tissue.
Thyroid surgery-
In case the gland is too large, or there is a large goitre or a hyperfunctioning nodule within the organ, the doctor may advise surgery. Surgery is unavoidable when a doctor identifies a risk of thyroid cancer.
In case of complications, the doctor may have to remove the thyroid gland entirely. In such a scenario, the individual would have to take synthetic thyroid hormone throughout his/her life.
Surgery may also be performed in Graves Disease (subtotal thyroidectomy) and was used as a treatment option prior to the RAI therapy.
Jun 01, 2019
May 30, 2018