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Thyroid Problems:
Symptoms, Causes, Risk Factors, Diagnosis & Treatment

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1.Thyroid: An Overview

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.

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2.What are Thyroid problems

Thyroid problems occur when there are abnormal secretions of thyroid hormones in the bloodstream. When the patient is suffering hyperthyroidism, the body secretes excess amounts of thyroid glands into the bloodstream. And, when the thyroid hormones are released in a deficit, that is known as hypothyroidism. While these are the most prominent forms of classifying the thyroid problems, there are further classifications that can be made based on the root cause and effect.

While most cases of thyroid can be easily managed or treated with medication, there are few cases when left untreated can be fatal and result in death.

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3.Types of Thyroid problems

Thyroid Problems

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.

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4.Symptoms of Thyroid issues in Men & Women

Thyroid problem persists and shows different symptoms in men and women. While most recorded cases of thyroid are from women either below the age of 40 or over the age of 50.
The number of recorded cases in men is significantly low. The thyroid affects men differently and the effects are mostly around fertility, libido, and erectile dysfunction.

The symptoms of thyroid problems in women are:

  • Fatigue
  • Weakness in muscles
  • Respiratory distress
  • Difficulty in swallowing
  • Irritability
  • Intolerance towards heat
  • Intolerance towards cold
  • Palpitations
  • Swelling in the legs
  • Red spots on the shin
  • Effects on the sex drive
  • Excessive eating
  • Decline in appetite
  • Weariness
  • Dry hair
  • Hair loss
  • Fever
  • Few menstrual cycles
  • Lighter menstrual cycles
  • Diarrhoea
  • Sleeping disorders
  • Oversleeping

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5.Causes of Thyroid issues

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.

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6.Risk factors

Although anyone can be affected by thyroid, the risk is significantly higher if you are:

  1. A woman under 40 years of age or are over 50 years
  2. A pregnant woman
  3. You have undergone radiation treatment to your neck or upper chest
  4. You have Type 1 diabetes
  5. You have delivered a baby in the last 6 months

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7.Steps to prevent Thyroid issues

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.

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8.Diagnosis

The thyroid can be diagnosed with its symptoms like dry skin, irregular heartbeats, chest pains, loss of appetite, overeating, red spots on the shin etc. However, for a confirmed diagnosis, doctors generally test the blood for excess amounts of thyroid glands or acute levels of the same.

The thyroid can also be diagnosed physically, by using imaging tests like CT Scans, ultrasound imaging, and MRI scans.

In a few cases where the diagnosis is not accurate from the other tests, the doctor then makes a small incision of the thyroid tissue to study its nature to make an accurate diagnosis.

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9.Treatment and management of Thyroid

Thyroid Management

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.

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10.Road to Recovery and Aftercare

The road to recovery for hypothyroidism and hyperthyroidism is pretty normal. As long as the patient follows the medication regime, there should not be any complications.

People who have undergone a thyroid surgery should refrain from driving for 1-2 and weeks and should get as much rest as possible as they might experience muscle pain in the area of the incision, the neck and the shoulder. Depending on the amount of excess tissue that had to be removed during the surgery, doctors either prescribe cytomel or synthroid.

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11.Thyroid FAQs: All your concerns addressed

Q.  Is thyroid 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.  Is thyroid 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.  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.

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