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Thyroid Problems

The thyroid is a small gland present in the neck right below the adam’s apple in the shape of a butterfly. When the thyroid is functioning normally, it can’t be felt under the skin. The thyroid gland is placed around the windpipe and it produces hormones that regulate metabolism, growth, and development activities of the body. Thyroid releases hormones are regularly released into the bloodstream depending on the situation and surroundings. Few instances where thyroid hormones are released at a variable degree is when it is too cold outside or when a female is going through pregnancy. Thyroid hormones help in digestion, producing the adrenaline rush, growth, maturity of the brain, digesting food, and regulating pulse of the body.
Thyroid relies on the pituitary gland to receive signals on when thyroid hormones should be released into the bloodstream and the quantity required.

In fight or flight situations, the body breaks down the thyroid in the blood for quick utilization.

The thyroid gland requires digestible iodine to function systematically and hence maintaining a balanced diet with adequate amounts of Iodine is essential.

The most prominent and common forms of thyroid problems are:

• Graves disease
• Plummer Disease
• Toxic Adenoma
• Hypothyroidism
• Thyroid nodules and
• Thyroid cancer

Graves’ Disease:

Graves’ disease is the most common form of hyperthyroidism that mostly affects women under the age of 40. Though many other forms of hyperthyroidism are prominent, Graves’ disease is the most common.

Graves’ disease is an auto-immune condition that causes the body to secrete excess hormones in the blood.

The symptoms of Graves’ disease include anxiety and irritability, tremors in the limbs, weight loss even when maintaining regular eating habits, fluctuations in the menstrual cycle, fatigue, irregular heartbeat, bulging in the eyes and throat, and irregular bowel movements.

Graves’ disease is treatable and depending on the severity of the condition, doctors either administer beta blocker, antithyroid drugs, radioactive iodine therapy or surgery.

Plummer’s disease:

Toxic multinodular goitre or Plummer’s disease occurs when there is a slightly elevated presence of thyroid hormones in the blood. Plummer’s disease often occurs in men and women who are over 50 years of age. The slightly elevated levels of thyroid glands can increase significantly after the patient is treated with high iodine intake.

The symptoms of Plummer’s disease include intolerance towards heat, weakening in muscles, hyperactivity, weight loss, irritability, osteoporosis, increase in appetite, increase in the heartbeat rate (tachycardia) and fatigue among others.

The treatment options for Plummer’s disease include the use of radioactive iodine, antithyroid drugs and surgery.

Toxic Adenoma:

Toxic adenoma is a condition where the thyroid gland has a benign tumour growing in the thyroid gland making it secrete more than required thyroid hormones into the bloodstream. When there is a deficiency of Iodine in the body, the thyroid glands become bigger and work much harder to absorb iodine to secrete thyroid glands.

In this condition, the body secretes higher levels of thyroid glands into the bloodstream.
When there is a single benign growth is called an adenoma, while the presence of multiple tumours is referred to as a goitre. 3-5% of the total recorded cases of hyperthyroidism is caused by toxic adenoma.

The patients suffering from this condition experience weight loss, increase in appetite, irritability, palpitations, muscle weakness, diarrhoea, irregular bowel movements, poor sleep and tremors.

Depending on the nature of the disease and the physical conditions of the patient, the treatment options vary between the use of radioiodine, antithyroid drugs and surgery.

Hypothyroidism:

Hypothyroidism is a condition where the thyroid glands do not secrete adequate levels of thyroid hormones into the blood. Hypothyroidism is caused due to Hashimoto’s thyroiditis, or the destruction of the thyroid gland, or as a result of lymphocytic thyroiditis, or radioactive iodine, or as a result of an injury to the pituitary glands.

The major symptoms of Hypothyroidism include excessive sleep, muscle cramps, constipation, muscle cramps, dry skin, red spots on the shins, fatigue, swelling in the legs, intolerance towards cold, and hair loss among others.

The treatment options for hypothyroidism vary on a case to case basis. However, the most commonly used treatment option is the use of thyroid hormone replacement drug. This comes in the form of a pill and the patient is advised to have 1 pill a day for the rest of their life to regulate the level of thyroid hormones in the blood.

Thyroid nodules:

A thyroid nodule is a lump that occurs in the thyroid due to irregular growth of thyroid tissue. Sometimes these nodules present themselves in the form of an adenoma, or goitre or cysts. Often these nodules in the thyroid gland are not cancerous, but in a few cases, the fluid in the cysts have small amounts of cancerous cells.

Thyroid nodules are caused as a by-product of Hashimoto’s disease or due to overgrowth of the thyroid tissue or due to iodine deficiency, or due to the presence of thyroid cancer or due to severe inflammation of the thyroid gland.

Patients with thyroid nodules present symptoms which include sudden weight loss, fatigue, weakness in the muscle, irritability, dry skin, memory problems, constipation, irregular heartbeat and intolerance towards cold.

Thyroid nodules can lead to hypothyroidism, cause complications during the surgery of the thyroid glands, and make it difficult for people to swallow food and water.

The treatment for nodules in the thyroid gland include surgery, thyroid hormone therapy and waiting. Waiting is advised when the GP analyses the nodule and confirms that it is non-cancerous. In these cases, the patient is advised to wait until the nodule disintegrates on its own without any intervention.

Thyroid cancer:

The root cause of thyroid cancer is not known. However, it happens due to genetic mutation when the thyroid cells grow rapidly and do not die. This forms an irregular cluster of thyroid tissue around the windpipe. Thyroid cancer is often not fatal and can be treated with medication and surgery. However, there are a few forms of thyroid cancer that are very aggressive and result in a quick death.

The symptoms of thyroid cancer are:

• Swelling in the throat
• Difficulty in swallowing food and water
• swelling the lymph nodes in the neck
• Chronic pain in the neck

The prominent forms of thyroid cancer are papillary thyroid cancer, follicular thyroid cancer, Anaplastic thyroid cancer, medullary thyroid cancer and a few other rare forms of thyroid cancer. Anaplastic and medullary thyroid cancers are relatively aggressive and can cause fatal damage when left untreated.

The major causes of thyroid are:

Autoimmune diseases:

Certain autoimmune conditions like the Hashimoto’s Disease and Graves’ Disease causes the thyroid glands to act abnormally and alter the level of thyroid hormones in the body.

Iodine deficiency:

The thyroid gland requires iodine to carry out its routine functions. When the body faces a deficit of Iodine, more thyroid tissue is formed in an attempt to absorb more iodine. This abnormal growth can cause an adenoma, cysts, or nodules, thereby causing complications that could lead to thyroid issues.

Viral and bacterial infections:

Some bacteria and viruses could cause thyroid issues in the human body. If caught in the early stages, these conditions are curable.

Nodules:

Nodules in the thyroid gland occur when there is excessive growth of the thyroid tissue. This occurs when the thyroid glands grow excessively to absorb more iodine. While most nodules are benign, they can still cause discomfort to the patient in the form of pain in the neck, stiffness in the neck, and difficulty in swallowing.

Cancerous tumours:

Few nodules and cysts formed in the thyroid gland become cancerous and attack the host aggressively. Removing the cancerous cells with surgery is the best option to eliminate this root cause of thyroid problems.

Surgery and certain treatments:

Surgically removing the thyroid gland can cause hypothyroidism and sometimes the usage of radioiodine can also result in fluctuations in the secretion of thyroid hormones.

Pregnancy:

Sometimes the onset of thyroid in a few women occurs during the pregnancy. These onsets when left untreated can cause a lot of thyroid problems to the mother and the fetus and can cause death to both in certain unattended cases.

There are no measures that can help you prevent thyroid problems in life. However, following a few regimes can significantly reduce the risk of getting a thyroid problem. They are:

Quit smoking:

Smoking does a lot of damage to the body and tobacco fluctuates the thyroxine levels in the body.

Maintain a healthy diet:

Ensure that you take every meal with a pinch of salt to ensure that your body does not run out of iodine as the thyroid glands require iodine and they tend to swell and clog the throat when the amount of iodine in the body is less.

Thyroid is a manageable and treatable disease which does not require any forms of medication. Hypothyroidism can be treated with artificial synthetic pills that can be used as an alternative to maintain normal levels of thyroid hormones in the blood.

Likewise, for hyperthyroidism, radioactive iodine can be used to selectively destroy certain parts of the thyroid gland that is causing the presence of elevated levels of thyroid hormones in the blood.

Surgery or thyroid surgery is recommended by doctors when there is a risk of thyroid cancer due to the presence of a nodule, an adenoma or a goitre. The result of removing the thyroid gland is that the patient would have to take synthetic thyroid pills throughout his/her life.

Q.  Is thyroid disease a communicable disease?

1. No, thyroid is not a communicable disease. However, there have been instances that the disease has been passed on from mother to child through genetic mutation.

Q.  How Important is Thyroid in your well-being?

1. The thyroid gland is responsible for producing thyroid hormone that controls every cell, tissue, and organs in your body. If the thyroid gland stops operating at usual speed, it can produce a bulk amount of thyroid hormone, which causes the body system to speed up (a condition termed as hyperthyroidism) or can create too minimal thyroid hormone slowing down the body systems (a condition known as hypothyroidism).
   If you suffer from thyroid disease, leaving it untreated can lead to drastic effects like elevated cholesterol levels, subsequent heart disease, infertility, and osteoporosis. Some studies also claim that there’s a strong genetic connection between the thyroid disease and onset of other autoimmune diseases like diabetes, arthritis, and anemia.

Q.  How to determine if you’re suffering from thyroid disease?

1. Identifying the symptoms of the thyroid disorder isn’t an easy task as most symptoms are hidden and resemble the signs of other diseases and conditions. To check if you suffer from a thyroid problem, you can ask your doctor for a TSH (thyroid-stimulating-hormone) test - a simple blood test that helps you verify your thyroid gland’s condition.
   Since there have been cases of thyroid passing through genes, a thorough examination of your family and review of their medical history are two additional measures you must undertake to rule out the possibility of them suffering from thyroid.

Q.  Is thyroid disease fatal?

1. Most forms of thyroid problems are not deadly. However, sometimes benign cysts can contain cancerous cells in them that can affect the thyroid gland aggressively and turn fatal if left unattended.

Q.  Can thyroid cancer spread to other parts of the body?

1. Thyroid cancers are nothing, but slow-growing tumors, so yes, they can spread out to other parts and metastasize. In most cases, cancer can expand from the thyroid gland and affect the nearby regions like the neck (esophagus), nerves, or windpipe.
   If cancer spreads out to the lymph nodes in the neck, the doctors recommend you to undergo a lymph node surgery. In severe cases, thyroid tumors can even spread out to the lungs or bones.

Q.  Why are only women affected by thyroid?

1. Thyroid problems are most predominant in women, but men are also affected by it. In men, the effects of thyroid imbalance leads to erectile dysfunction, lack of sex drive, and fertility problems.

Q.  What are the alternative medication options for thyroid?

1. Maintaining a healthy diet and exercising regularly can help you balance your thyroid levels. However, we’d recommend you to consult your medical practitioner before exploring alternative medication in the form of coffee, soy, broccoli, and yoga.

Q.  What are the different types of thyroid problems?

1. The prominent types are hypothyroidism, hyperthyroidism, Plummer’s Disease, thyroid cancer, toxic adenomas and Graves' Disease.

Q.  What are the most common symptoms of hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid)?

1. Both hyperthyroidism and hypothyroidism are prominent thyroid diseases and show different symptoms in an individual. Symptoms of hyperthyroidism include:
   • Nervousness and Irritation
   • An abrupt increase in perspiration
   • Shaky hands and racing heart
   • Insomnia
   • Frequent bowel movements
   • Weight loss despite a good appetite
   • Lighter flow and less frequency of menstrual periods
   Hypothyroidism, on the contrary, shows the following symptoms:
   • Anxiety attacks
   • Fatigue and exhaustion
   • Depression
   • Poor concentration
   • Excessive weight gain becomes an issue
   • Muscle cramps
   • Increased menstrual flow leading to frequent periods

Q.  Should you get treated for Thyroid during pregnancy?

1. Yes, you must get yourself treated for Thyroid disease even if you’re expecting. Neglecting the symptoms of the thyroid during pregnancy can pose serious risks to you and your fetus. With proper diagnosis and treatment, you can ensure that you give birth to a healthy baby.
   In some cases, women might suffer from thyroid problems post-childbirth. It’s a short-term problem and with the right care, hormone levels quickly return to normal.

Q.  What are the probable chances of thyroid cancer recurring after surgery and treatment?

1. Thyroid cancer can return in some cases. Post-treatment or surgery, your doctor and endocrinologist will keep a tab on your health, monitor your signs of recurrent disease through blood tests or ultrasound examinations.