Thyroid disorders-All you need to know
Thyroid disorders are one of the most common disease affecting more than 42 million alone in India. The thyroid gland is an endocrine organ that is located at the base of your neck, on either side and anteriorly to the trachea (Airway). Its posterior surface gives attachment to the tiny parathyroid glands. Synthesis of thyroid hormone (thyroxine) is the main function of the thyroid gland. The hormone is mostly produced as T4 hormone while the rest is formed as T3.
The thyroid hormone level in the body is called the thyroid status of a person. Having the thyroid hormone level over the normal range is hyperthyroidism. On the other hand, low hormone level is hypothyroidism. Most thyroid diseases manifest as either hyperthyroidism or hypothyroidism.
The thyroid hormone virtually affects all the body cells. It stimulates cell metabolism, growth, and maturation, cognitive development. Therefore, hypothyroidism and hyperthyroidism both have a characteristic set of symptoms that aids in their recognition.
Symptoms of hypothyroidism
- Lethargy, malaise
- Excessive sleepiness
- Low body temperature and reduces sweating
- Weight gain and obesity
- Dry skin
- Reduced memory
- Reduced pulse rate
- Psychological changes like depression
Symptoms of hyperthyroidism
- High body temperature and excessive sweating
- Weight loss and thin body
- Frequent diarrhea
- Shaking/ Tremors of fingers
- Rapid pulse rate
- Feeling own heart contractions
- Thin skin
The common pathologies of thyroid gland include,
- Autoimmune thyroid diseases
- Cancers/ malignancies
A goiter is a benign enlargement of the thyroid gland. This appears as a swelling at the base of the neck. The size usually increases with time. Initially, on examination, the goiter may feel smooth. But with progression fine nodules are felt on the enlarged area.
The commonest cause for goiters is iodine deficiency. Iodine is essential for the thyroid hormone synthesis. Deficiency of Iodine leads to a compensatory enlargement of the thyroid gland which manifests as a goiter. These people may have hypothyroidism occurring concurrently with the goiter.
Autoimmune thyroid diseases
Autoimmune diseases are disorders of the immune system where the immune system attacks the own body cells. Regarding the thyroid gland, 3 main autoimmune diseases are frequently seen.
Hashimoto’s disease typically affects women in the adult age group, over 40 years. Here the immune system destroys the thyroid gland. Therefore, the patient presents with hypothyroidism.
Grave’s disease is one of the commonest autoimmune thyroid diseases. It classically affects the women at their age of 20-30 years. Surprisingly, here the immune system stimulates the thyroid gland. This causes hyperthyroidism. Marked bulging of the eyes is a characteristic feature of Grave’s disease in addition to hyperthyroid features.
De Quervain’s thyroiditis
De Quervain’s thyroiditis is a transient autoimmune thyroid disease that typically occurs after a viral illness. This is also common among the female population.
Cancers of the thyroid gland
Thyroid cancers appear as a goiter or as a nodular enlargement. Despite having an enlarged gland, the patient usually has hypothyroid features. Recent voice change, difficulty in swallowing may indicate thyroid cancer over a benign goiter.
Hypothyroidism in pregnancy
Maternal hypothyroidism during pregnancy can severely affect the fetus, especially if the fetus is also having a low thyroid status. This results in profound mental retardation, poor growth, bone malformations and neurological defects including deafness of the infant.
Tests to diagnose thyroid disorders
Classically T4, T3, and TSH hormone levels are measured to evaluate the thyroid function. TSH is a hormone that is secreted by the pituitary gland and it acts on thy thyroid to stimulate thyroxine production. T4 hormone is converted to T3 hormone, which is the biologically active form, by the peripheral circulation.
Ultrasound scans of the thyroid gland are done in cases of goiters or enlargements. If it’s suggestive of a malignancy, ultrasound-guided fine-needle aspiration is done to collect a cell sample for further investigations.
Treatment of Thyroid disorders
The treatment modality depends on the type of thyroid disorder. In the case of a malignancy, the thyroid gland is completely or partially removed by surgery. This is then followed up by radiolabeled Iodine therapy. Goiters can be removed if the person is having cosmetic issues, otherwise, no treatment is needed.
Grave’s disease is initially managed with anti-thyroid medications and radiolabeled Iodine therapy. If not responding to them the gland is removed by surgical excision.
Treatment for hypothyroidism is the thyroxine hormone. It’s given in oral form as T3 or T4 hormone depending on patient factors.
Hyperthyroidism is treated by anti-thyroid medications. These medications include Carbimazole, Methimazole, and Propylthiouracil. β blockers are given in some instances to relieve the symptoms like rapid heart rate and palpitations.
Diet in hypothyroidism
The commonest cause of hypothyroidism is iodine deficiency. Therefore, people should include foods rich in iodine irrespective of their thyroid status to prevent hypothyroidism.
- The best option is Iodinated salt
- Avoid certain vegetables including broccoli, cabbage, and spinach.
- Consume seafood more
- Do not use Iodine supplements since high levels of iodine can inhibit the thyroid function
Diet in hyperthyroidism
- A low Iodine diet is suitable for hyperthyroid patients.
- Use non-Iodized salt
- Consume vegetables and fiber-rich foods
- Reduce consumption of seafood
- Consume iron-rich food like dark green vegetables and meat.
Hope this post helps you to know everything you need to know about this disease. For the benefits of others, kindly share with others.