Understanding thyroid functioning and ailments better
Thyroid uses iodine for production of vital hormones called Thyroxine (T4) and Tri iodothyronine (T3). After delivery of T4 to the bloodstream it is converted into T3 or triiodothyronine, the most-active hormone.
A feedback system covering the brain ensures regulation of thyroid gland functions. Whenever the levels of thyroid hormones are lower, the brain’s hypothalamus produces the TRH (thyrotropin-releasing hormone) that makes the pituitary gland release TSH (thyroid-stimulating hormone). This stimulates your thyroid gland for the release of T4 in higher amounts. The pituitary gland and hypothalamus control the thyroid gland and disorders in such tissues may impact overall functioning and lead to significant issues in the future.
Ailments related to the thyroid gland may lead to lower production known as Hypothyroidism or underactive thyroid disease or over-production known as hyperthyroidism or overactive thyroid disease. There may also be issues with the thyroid hormone, goitre and thyroid nodules. Problems with thyroid are more common in women as compared to men.
Here are some of the significant thyroid conditions:
- Thyroiditis- Inflammation of thyroid in this case is mostly due to a viral infection or even autoimmune disease. Thyroiditis can be very painful or come without any symptoms whatsoever.
- Goitre- This is a term used to describe swelling of the thyroid. Goitres may usually be harmless, or they may indicate a deficiency in iodine. There may also be conditions linked with inflammation of the thyroid called Hashimoto’s thyroiditis.
- Hypothyroidism- This equates to lower production of thyroid hormone. The damage from autoimmune diseases is the most typical reason behind hypothyroidism.
- Hyperthyroidism- This is indicative of excessive production of thyroid hormones and is commonly caused due to the overactive thyroid nodule or Graves’ disease as per doctors.
- Thyroid nodules: -Any small lump/mass in the thyroid gland, which seems abnormal has to be treated. Nodules are quite common, and few of them may even be cancerous. They may enable secretion of excessive hormones leading to hyperthyroidism.
- hyroid cancer- This is anuncommon type of cancer and is mostly curable as per medical experts. Hormone treatments, radiation and surgeries may be necessary for the treatment of thyroid cancer.
- Thyroid storm- This is a rare type of hyperthyroidism where considerably high levels of thyroid hormones cause severe ailments.
Understanding Key Thyroid Issues in More Detail
This usually happens due to insufficient production of thyroid hormone in the thyroid gland. This may develop due to issues with your pituitary gland, thyroid gland or even the hypothalamus. Some of the other common reasons include inflammation of thyroid or thyroiditis in various types like postpartum and acute varieties. An autoimmune condition like Hashimoto’s thyroiditis may also lead to inflammation in the thyroid gland. Thyroid hormone resistance may also cause hypothyroidism
Some of the key symptoms of Hypothyroidism may include
- Weight gain
- dry skin
- mental tiredness
- reduced concentration levels
- feeling cold frequently
- muscle and joint pains and aches
- retention of fluids
- excessive/prolonged menstrual bleeding in case of women
This indicates excessive thyroid hormone production, which is not as common a condition as compared to hypothyroidism. Some common causes include the following:
- Toxic multinodular goitre
- Graves’ Disease
- Excessive consumption of iodine
- Thyroid nodules which overexpress the hormone
Some symptoms can include the following:
- Intolerance to heat
- Protruding eyes
- Fast heart rate associated with palpitations
- Excessive sweating
- Increased bowel movements
- Unintentional weight loss
- Low Concentration
- Muscle weakness
Goitre is enlargement of your thyroid gland irrespective of any particular cause. This is not any specific ailment or disease and may be linked with normal thyroid functioning. Goitre can be seen with normal thyroid functions (known as euthyroid); it can also be associated with hypothyroidism or hyperthyroidism.
The nodules in question are abnormal masses or lumps placed within the thyroid. These nodules may be created through tumours which are benign, cysts or thyroid cancers, although the latter is less common. Nodules can be multiple or single and may have varying sizes. In case they are big, they may lead to compression of structures nearby.
Thyroid cancer is common among adult women as compared to young men or adult men. Two third of such cases usually take place in people lower than 55 years of age. There are various types of thyroid cancer based on the particular cell type, which becomes cancerous within your thyroid. Most cases can be cured with higher rates of survival when diagnosed early.
Diagnosis of thyroid ailments
Along with physical check-ups/examinations and review of one’s medical history, there are specialized tests conducted for diagnosing thyroid ailments. Blood tests are usually done for measurement of TSH levels and thyroid hormones. The doctor may recommend blood tests for identification of antibodies against thyroid tissue. Also, There are various investigations for thyroid which help in diagnosis of thyroid ailments.
- Thyroid ultrasound- A probe is positioned on your neck and the sound waves reflected are diagnosed. The sound waves enable detection of abnormal zones in your thyroid tissue. Ultrasound will help in proper visualization of the tissue consistency within the thyroid gland and may end up revealing calcifications or cysts
- Anti-TPO antibodies- In the case of autoimmune thyroid ailments, the proteins attack the thyroid peroxidase enzyme mistakenly. The thyroid uses the proteins for the production of thyroid hormonesThyroid Scan- In thyroid scan, a small portion of radioactive iodine is transmitted through your mouth to source images of thyroid gland. The thyroid is the sole location in your body which will take up iodine and hence whenever you get iodine which is radioactively labelled, it will be taken up by the thyroid gland. The imaging test usually depicts the radioactive iodine uptake by normal thyroid tissue. Nodules/zones which make excessive hormones will indicate higher iodine uptake. These are called hot nodules or zones. In comparison, cold nodules are zones where iodine uptake has decreased in recent times. These nodules do not enable the production of extra hormones and can also indicate cancer at times.
- Thyroid function test:TSH (Thyroid Stimulating Hormone)- Blood tests showing higher TSH levels indicate hypothyroidism and lower TSH levels indicate hyperthyroidism. T4 and T3- The primary types of thyroid hormones, T4 and T3 are checked via blood tests.
- Thyroid Biopsy- A smaller amount of tissue is removed, majorly for ascertaining chances of thyroid cancer.. FNAC (fine needle aspiration Cytology) is a technique where a thin and long needle is used for withdrawing cell samples from thyroid for cytological examination. Ultrasound imaging is used at times for conducting this FNA process. Biopsies are surgical
- Imaging Tests- In case of any rapid spread of thyroid cancer, tests like MRIs, CT scans or PET scans may help in identifying its extent.
- Thyroglobulin- This is a substance which is secreted by the thyroid and can be used as a marker for thyroid cancer. This is measured when follow up is done for patients suffering from the disease. Higher levels indicate recurrence and should be addressed immediately.
- Thyrogen Stimulation test using Recombinant human TSH- This involves the injection of a thyroid-stimulating agent for getting a clearer picture on recurrence of thyroid cancer through imaging tests after completion of treatment.
Treatments for Thyroid
- Thyroidectomy or Thyroid Surgery- The surgeon will be removing a portion of the thyroid or all of it via an operation. This is done in case of goitre, thyroid cancer or hyperthyroidism.
- Anti-thyroid medication- Medicines may help in reducing the pace of production of thyroid hormones in case of hyperthyroidism. Two of the most prevalent medicines in this regard are propylthiouracil and methimazole.
- Radioactive Iodine- Iodine with a high level of radioactivity can be used in lower doses for testing your thyroid gland or eliminating an overactive gland. Higher doses may come in handy for removing cancerous tissues.
- Thyroid hormone pills- Essentially a artificial substitute of the natural hormone given in deficit conditions. These pills are used for the treatment of hypothyroidismand also, after removal of the thyroid gland surgically or by radioactive iodine.
- External Radiation- A radiation beam will be directed at the thyroid gland several times with the rays being used for eliminating thyroid cancer affected cells.
Thyroid ailments can be well-managed in most situations with suitable medical procedures and treatments. They are not fatal in most cases, although a few diseases may necessitate surgery and treatment. Thyroid cancer is deemed as mostly curable, although, the thyroid cancer that spreads throughout body is more dangerous.
Pregnancy and Hypothyroidism/Hyperthyroidism
The symptoms and indications of hypothyroidism in pregnancy are similar to that of normal pregnancies. Hypothyroidism, which has not been diagnosed during the pregnancy scales up chances of growth retardation of the foetus which is born. Also, it scales up chances of stillbirth and complications such as eclampsia, anaemia and placental abruption.
The most prominent female group with hypothyroidism during the time of pregnancy are the ones who are presently on thyroid hormone replacement. The requirement of increases in thyroid hormones in the pregnancy stage goes with the delivery of the new-born as per medical studies. Hyperthyroidism in pregnant women is rare, and it occurs only in 1 out of 2,000 such cases.Graves’ disease is the main factor here, and the reason behind 95% instances of hyperthyroidism diagnosed freshly during pregnancy in women. Many symptoms of this ailment are similar to those during pregnancy. However, significant weight loss, higher blood pressure, vomiting or continually fast heart rates should necessitate blood tests for ascertaining any hyperthyroidism. In cases where women have hyperthyroidism due to Hashimoto’s thyroiditis or Grave disease, the condition may steadily improve with progress of pregnancy.
Complications of thyroid diseases:
- ▪ Myxedema and myxedema coma: most severe complications of a hypothyroid state when generalised swelling happens, most prominent on the front of the legs combined with swelling of the eyes, and sometimes associated with a generalized debilitated state.
- ▪ Lipid disorders/Dyslipidemia
- ▪ Carpal Tunnel Syndrome: Entrapment of a nerve of hand in the wrist
- ▪ Obesity
- ▪ Heart Diseases;
- ▪ Menstrual irregularities and infertility in females
- ▪ Heart diseases: mostly associated with hyperthyroidism, rapid or irregular heart rates, palpitations.
- ▪ Osteoporosis: Seen in hyperthyroidism
- ▪ Eye problems: Grave’s Ophthalmopathy, protruding eye balls with photosensitivity and double vision
- ▪ Thyrotoxic crisis: Fever, rapid heart rate, associated with disorientation and delirium.
Disclaimer : The details provided herein is meant for informative purposes only. For detailed information related to the disease and its treatment please consult a relevant qualified specialist.
Living with Thyroid Disease:
Most of the thyroid diseases including Thyroid cancer, if treated on time respond very well to treatment. Hypothyroidism and other conditions with total or near total ablation of the thyroid gland need to take daily dose of the replacement thyroid hormone and that’s about it. Periodic evaluation through thyroid function tests is all that is required to monitor control of the state of hypo or hyperthyroidism. Please get in touch with an endocrinologist or a thyroid surgeon if you have suspected thyroid disease for proper diagnosis and management plan.
Some of the key symptoms of Hypothyroidism may include