Thyroid

The thyroid gland is a butterfly-shaped gland located at the front of the neck. It produces hormones that control the speed of metabolism — the system that helps the body use energy. Thyroid disorders can either slow down (hypothyroid) or over increase the metabolism (hyperthyroid) by disrupting the production of thyroid hormones.
The thyroid gland produces two important hormones which are Thyroxin (T4) and Triiodothyronine (T3). Of these two hormones, the T3 hormone is considered to be crucial in maintaining the metabolism and other bodily functions.

SymptomsCausesTypesDiagnosisTreatmentPrevention

Thyroid disorder symptoms can range from a small, harmless goiter (enlarged gland) that needs no treatment to life-threatening cancer. Too much thyroid hormone results in a condition known as hyperthyroidism. Insufficient hormone production leads to hypothyroidism. Following are the symptoms for both of the conditions:

Hypothyroidism – Also known as underactive thyroid, this condition can lead to excessive fatigue, tiredness, mood swings, depression, prolonged menstrual bleeding, repeated bouts of constipation, dry skin, bloating or fluid retention in the body, stiffness in joints and muscles along with aches and pains and hair loss. There is also a possibility that the person suffering from this condition feels colder than compared to others.

Hyperthyroidism – Also known as overactive thyroid, this condition leads to unexpected weight loss, irregular heartbeat, intolerance to heat, sweating and irritability, increased bowel movements, slight tremor in the limbs, unexplained weight loss, excessive fatigue, concentration problem, irregular menstrual cycle. It can lead to irregular heart rhythms and even hear
t failure in the elderly. Untreated hyperthyroidism may result in condition called thyroid storm, where a person can suffer from high blood pressure, fever leading to a heart failure.

Although the effects can be unpleasant or uncomfortable, most thyroid problems can be managed well if properly diagnosed and treated.

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  1. Hyperthyroidism is caused by overproduction of hormones by the thyroid gland in the neck. Some of the causes of this condition include:
  • Graves’ disease: An immune system disorder that results in the overproduction of thyroid hormones.
  • Toxic adenomas: Nodules develop in the thyroid gland and begin to secrete thyroid hormones, upsetting the body’s chemical balance; some goiter may contain several of these nodules.
  • Sub-acute thyroiditis: Inflammation of the thyroid that causes the gland to “leak” excess hormones resulting in temporary hyperthyroidism that generally lasts a few weeks but may persist for months.
  • Pituitary gland malfunctions or cancerous growths in the thyroid gland: Although rare, hyperthyroidism can also develop from these causes.
  1. Hypothyroidism stems from underproduction of thyroid hormones. Since the body’s energy production requires certain amount of thyroid hormones, a drop in hormone production leads to lower energy levels. If untreated for a long period of time, it can lead to myxedema coma, a rare but potentially fatal condition that requires immediate hormone treatment. Causes of hypothyroidism include:
  • Hashimoto’s thyroiditis: In this autoimmune disorder, the body attacks thyroid tissue. The tissue eventually dies and stops producing hormones.
  • Removal of the thyroid gland: The thyroid may have been surgically removed or chemically destroyed.
  • Exposure to excessive amounts of iodine: Cold and sinus medicines, heart medicine amiodarone, or certain contrast dyes given before some X-rays may expose the body to too much iodine.
  • Lithium: This drug has also been implicated as a cause of hypothyroidism.

Thyroid diseases can be broadly classified into three main categories namely –

  • Hypothyroidism: This condition is denoted by a dip in the thyroid hormones in the blood. It happens if one has an underactive thyroid or the glands that control the thyroid malfunctions, though there are other causes also that can lead to this condition. It is usually noticed that hypothyroidism affects women more than men and gets worse as one ages.
  • Hyperthyroidism: In this condition, there is an overdrive of the thyroid hormone in the blood due to an over active thyroid gland that secretes the hormones in abundance. Thyroid enlargement: thyroid disease occurs due to the structural changes in the gland like an enlargement or nodules appearing on the gland. There can be benign cysts developed or cancerous ones in form of nodules. Enlargement of the thyroid gland is often termed as goiter. Goiter can at times be unnoticeable and at other times, it can lead to abnormal enlargement that might need surgical removal of the organ.

 

Diagnosis of hypothyroidism is based on the symptoms experienced and the results of blood tests that measure the level of TSH and sometimes the level of the thyroid hormone thyroxin in the body.

Hypothyroidism can be treated by replacing the missing hormone that is essential to the body’s key functions. This can be accomplished by taking thyroid hormone replacement medicine prescribed by the physician. The other types of treatments are:

  • Antithyroid drugsalso known as thionamides are most often used to treat an overactive thyroid (hyperthyroidism) caused by Graves’ disease.
  • Radioactive iodine treatment (RAI) also known as radioiodine ablation is a type of internal radiotherapy for thyroid cancer.
  • Surgical removal of the whole thyroid gland or part of the gland known as thyroidectomy.

Some controversial, cutting-edge therapies for treatment include block/replace therapy (BRT), and thyroid arterial embolization. Generally the approach used for treatment depends on the severity of the condition, whether or not the patient is a child or a pregnant woman, and in some cases, the preference or perspective of the treating physician.

Most cases of hypothyroidism are caused by Hashimoto’s thyroiditis, which cannot be prevented. Doctors aren’t sure what causes most cases of thyroid cancer, so there is no way to prevent thyroid cancer in people who have an average risk of the disease. Although it can’t be prevented, one can watch for signs of the disease so it can be treated promptly.

Individuals with symptoms and signs potentially attributable to thyroid dysfunction and those with risk factors for its development may require more frequent serum thyrotropin testing.

Iodized salt is perhaps the most common source of iodine and can provide enough iodine to avoid low thyroid activity. Since an adult only requires around one teaspoonful of iodine over a lifetime, eating fish once a week is enough to fulfill the average iodine requirement.

The value of dietary iodine in the body can be reduced by the intake of vegetables from the brassica family which includes cabbage, brussels sprouts, raw turnip, broccoli, and cauliflower. Hence, such vegetables should be avoided or cut down upon. In circumstances where these foods are eaten in high numbers and the levels of dietary iodine are already low, goiter may develop.

Exercise is important for maintaining healthy hormone levels. Exercise 30 minutes daily, five days a week if possible. A doctor can help design an exercise program that is right for each individual.

 

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