Thyroid Disease
What is thyroid disease? Thyroid disease is a medical disorder that affects thyroid gland functions. The thyroid gland, located at the front of the neck, is responsible for the production of thyroid hormones which travel through the blood to help regulate many other organs. Read More
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Thyroid Disease
Table of contents
What is thyroid disease?
While thyroid disease is quite common and can be easily seen around, many people are not aware of what thyroid disease is. Thyroid disease is a medical disorder that affects thyroid gland functions. The thyroid gland, located at the front of the neck, is responsible for the production of thyroid hormones which travel through the blood to help regulate many other organs. These hormones generally act in the body to regulate energy use, infant development, and childhood development.
What are the types of thyroid disease?
There are five common types of thyroid diseases, each having its peculiar symptoms. One person could have a variety of types at the same time. The five groups are:
- Hypothyroidism: this means the thyroid gland is underactive and is caused by insufficient free thyroid hormones. Common symptoms include dry skin, intolerance to colds, fatigue, low energy, slow heart rate, weight gain, and constipation.
- Hyperthyroidism: this means the thyroid is hyperactive, and it is caused as a result of too many free thyroid hormones. Common symptoms include weight loss, irritability, diarrhea, anxiety, rapid heart rate, intolerance to heat, and enlargement of the thyroid gland.
- Structural abnormalities are mostly known as goiter: this is an enlargement of the thyroid gland. This may not produce symptoms. However, some people may have symptoms related to hyperthyroid or hypothyroid or notice neck swelling. On rare occasions, goiters can cause airway compression, difficulty swallowing, or compression of the vessels in the neck.
- Tumors or thyroid nodules as it is often called, can either be benign (that is, non-cancerous) or cancerous. This may also have several different symptoms ranging from those of hyperthyroidism to that hypothyroidism, to compression of the structures in the neck and swelling in the neck.
- An abnormal thyroid function test devoid of any clinical symptoms.
For some types of thyroid disease, like sub-acute thyroiditis or postpartum thyroiditis, symptoms may go away on their own after a few months, and results from laboratory tests may return to average values. However, this does not happen in most types of thyroid disease.
Causes
- Hyperthyroidism
In hyperthyroidism, the thyroid gland becomes hyperactive and, as a result, produces too much of its hormone, thyroxine hormone. This manifests as
Graves’ disease: This condition is characterized by the production of too much thyroid hormone as a result of over-activeness of the entire thyroid gland. This condition is also known as diffuse toxic goiter (that is, enlarged thyroid gland).
- Toxic adenomas: in this condition, nodules develop in the thyroid gland, become overactive and begin to secrete thyroid hormones. This secretion upsets the body’s chemical balance. Some goiters contain many of these nodules. A single nodule is referred to as a toxic autonomously functioning thyroid nodule, while a gland with numerous nodules is referred to as a toxic multi-nodular goiter.
- Sub-acute thyroiditis: This is an inflammation of the thyroid gland. The thyroid is afflicted by inflammation which causes it to release excess hormones, which can cause temporary hyperthyroidism, which typically lasts for a few weeks. However, it can last for several months. This can be uncomfortable or not even experienced in any way.
Pituitary gland dysfunction or tumor growth of the thyroid gland: While it is not common, the condition (hyperthyroidism) can develop from the mentioned causes.
Iodine excess: Excessive Iodine (the mineral involved in the production of thyroid hormones) within the body could stimulate the thyroid gland to produce excess thyroid hormones than is required.
Symptoms
Some of the thyroid disease symptoms associated with hyperthyroidism include – Rapid and irregular heartbeat; weight loss; nervousness, anxiety, and irritability; tremors (usually a fine trembling in the hands and fingers); fatigue and muscle weakness; difficulty in sleeping; profuse sweating; changes in menstrual patterns; and increased sensitivity to heat.
Hypothyroidism
This is the direct opposite of hyperthyroidism. In hypothyroidism, the thyroid gland becomes underactive and, as a result, produces less sufficient hormones.
The thyroid disease symptoms exhibited by hypothyroidism may not be noticeable in the early stages and, as a result, may lead to a number of health complications, such as obesity, infertility, joint pain, and heart disease.
Hypothyroidism manifests as
- Thyroiditis: This is characterized by an inflammation of the thyroid gland. It lowers the number of hormones produced by the thyroid gland.
- Hashimoto’s thyroiditis: Hashimoto’s thyroiditis is an autoimmune thyroid disease. In this type of hypothyroidism, the body’s cells attack and damage the thyroid tissue, which eventually dies and stops producing the necessary hormones. The painless disease is an inherited condition.
- Postpartum thyroiditis: This is usually a temporary condition that occurs in about 5% to 9% of women after childbirth.
- A non-functioning thyroid gland: At times, the thyroid gland doesn’t function correctly from birth. This occurs in about 1 in 4,000 newborns; if left untreated, the child could suffer from physical and mental issues.
Symptoms
The thyroid disease symptoms of hypothyroidism depend on the severity of the hormone deficiency.
Some of the thyroid disease symptoms associated with hypothyroidism include – Fatigue, increased cold sensitivity, dry skin, constipation, an elevated blood cholesterol level, slow heart rate, depression, impaired memory, heavier than usual or irregular menstrual periods, muscle weakness, and muscle aches, tenderness, and stiffness
Thyroid nodules
Thyroid nodules are benign (not cancerous) or cancerous growths that form in or on the thyroid gland. The causes are always unknown but may result from iodine deficiency and Hashimoto’s thyroiditis.
Thyroid nodules can be solid or fluid-filled and don’t cause any symptoms. However, if they are large, they can cause swelling around the neck, which is painful and can lead to breathing and swallowing difficulties and goiter. Most of these nodules are benign, but they can be cancerous, also.
Thyroid disease symptoms displayed may be similar to that of hyperthyroidism and hypothyroidism.
Goiter
Goiter, or structural abnormality as it is also known, is a non-cancerous enlargement of the thyroid gland, commonly caused is an iodine deficiency in the diet. According to research, goiter affects about 200 million of the 800 million people worldwide who are iodine-deficient.
Symptoms
In mild cases of goiter, there might not be any thyroid disease symptoms displayed. However, if it grows big enough, depending on the size, it may cause one or more of the following symptoms:
- Swelling or tightness in the neck
- Difficulty in breathing or swallowing
- Cough or wheezing
- Hoarseness of the voice
How is thyroid disease diagnosed?
Two factors are considered to diagnose thyroid disease – symptoms exhibited and the presence of thyroid nodules. Hence the patient is advised to do a blood test, an ultrasound, or a radioiodine scan. A blood test measures certain hormones, such as the thyroid hormones triiodothyronine (known as T3) and its precursor, thyroxine (known as T4), and the thyroid-stimulating hormone (TSH).
The ultrasound is requested to know the nature of a thyroid nodule. That is, whether it is cancerous.
A radioiodine scan is requested to know if there is even uptake and activity throughout the gland.
Nuclear scan and radioactive iodine uptake- are done to identify the signs of Grave’s disease, toxic multi-nodular goiter, and thyroiditis. This test is contraindicated (not advised) during pregnancy.
CT and MRI scans of the thyroid gland can help evaluate the thyroid gland’s size and shape.
FNAC- fine needle aspiration biopsy. During this procedure, a small tissue sample is taken from the abnormal gland and sent for pathological studies [1].
How is thyroid disease treated?
The treatment plan for thyroid disease includes the following:
- Medications- They include anti-thyroid medications such as methimazole and propylthiouracil. These drugs stop the thyroid gland from producing hormones.
- Beta-blockers- These medications help in controlling the symptoms caused by the thyroid gland.
- Radioactive iodine therapy- It is also known as radioiodine ablation therapy. This treatment helps damage the thyroid gland’s cells, preventing it from making high levels of thyroid hormones.
- Thyroidectomy surgery- A portion or an entire abnormal thyroid gland is removed during this procedure. Later the patient is advised to take thyroid replacement hormones for the rest of their lives [2].
FAQ
Yes, it can. The loss of hair is a sign of thyroid illness that is seen in many cases of hypothyroidism. If the patient starts to experience loss of hair and is worried about it, talk to the doctor.
Usually, thyroid disease doesn’t cause seizures. However, there’s an increased risk of developing low serum sodium in severe cases of hypothyroidism that are yet to be diagnosed or treated. This may lead to seizures.
Thyroid disease does not discriminate and can affect anyone — men, women, infants, teenagers, and the elderly.
The patient may, however, be at a higher risk of developing thyroid disease if –
1) There’s a family history of thyroid disease.
2) The patient may have certain medical conditions such as type 1 diabetes, pernicious anemia, primary adrenal insufficiency, lupus, rheumatoid arthritis, and Turner syndrome.
3) The patient is on a medication that’s high in iodine.
4) The patient is above the age of 60, especially women.
5) The patient has been previously treated for a thyroid condition or cancer.
Diabetic people are at a higher risk of developing thyroid disease than people without diabetes. Those with type 1 diabetes have a much higher risk because it is an autoimmune disorder, and having one autoimmune disorder predisposes one to develop another. For those with type 2 diabetes, the risk is lower.
Any of the following could predispose the patient to develop thyroid disease
1) A family history of thyroid disease, in particular, Graves’ disease
2) Female gender
3) Autoimmune diseases like type 1 diabetes or celiac disease
4) Previous treatment with radioactive iodine or anti-thyroid medications
5) Previous exposure to radiation around the neck or upper chest
Some of the complications that may occur as a result of thyroid disease include
1) Heart problems: low thyroid hormone levels may be associated with an increased risk of heart disease and heart failure, mainly because of high levels of low-density lipoprotein (LDL) cholesterol (that is, bad cholesterol) that can occur in people with an underactive thyroid.
2) Mental health issues. There’s the likelihood of depression occurring early in hypothyroidism. This may become more severe over time. There’s also the possibility of slowed mental functioning in hypothyroidism.
3) Myxedema: a rare, life-threatening condition that may result from long-term, undiagnosed hypothyroidism. It’s characterized by an intense cold intolerance and drowsiness, followed by profound lethargy and unconsciousness.
4) Infertility: Low levels of thyroid hormone in the body system can interfere with the ovulation period, which impairs fertility. Also, some of the causes of hypothyroidism, like an autoimmune disorder, can impair fertility.
5) Birth defects: when left untreated, thyroid disease may cause birth defects in babies born to women with thyroid disease. These children are also highly prone to develop severe intellectual and developmental problems.
The risk of developing thyroid disease can be prevented by following the below-mentioned ways.
1) Stop smoking
2) Exercise regularly
3) Have regular check-ups and follow-ups with the doctor
4) Have a balanced meal
5) Take supplements if required
6) Manage stress levels.
Picture courtesy: Verywell Health
Thyroid disease is often a life-long medical condition that must be treated by taking medications for the rest of their lives. A person can live an everyday life with thyroid disease [3]. Change in lifestyle habits and maintaining a healthy life will result in a good prognosis and prevent the further worsening of the condition.
References
- https://www.verywellhealth.com/thyroid-disease-diagnosis-4013578
- https://my.clevelandclinic.org/health/diseases/8541-thyroid-disease#management-and-treatment
- https://my.clevelandclinic.org/health/diseases/8541-thyroid-disease#management-and-treatment
