INTRODUCTION:

The thyroid is a butterfly-shaped gland in front of the neck in your body that secrete certain hormones of great specifications. The thyroid has various important roles to play in the body, the most important of all is the regulation of metabolism. It takes up iodine from the body to produce its hormones. Thyroxine, also known as T4 is the primary hormone of this gland, a small proportion of which gets converted into T3 when the hormone enters the tissues from the bloodstream. T3 is yet the most active hormone in the body. The gland functions by a negative feedback mechanism which is when the hormone levels fall, a message is sent to the brain and hypothalamus starts producing Thyrotropin-releasing hormone (TRH) which causes the pituitary gland to start releasing thyroid stimulating hormone (TSH) which then acts on thyroid gland to release the thyroid hormones especially the T4.

Well, the thyroid disorders may be due to some structural or functional defects in the thyroid gland itself, the disorders due to the organ itself are categorized as “primary disorders”. And those due to hypothalamus or pituitary as they have their own role in releasing the hormone are categorized as “secondary disorders”.

Various Thyroid Disorders:

There are certain thyroid disorders you have heard of most commonly. They are all listed below:

• Hypothyroidism
• Hyperthyroidism
• Thyroid Nodules
• Thyroid cancer
• Goiter

What is Hypothyroidism?

It results from insufficient production of thyroid hormone from the gland. It could either be primary or secondary. The symptoms of the disease include:

• Fatigue
• Poor concentration or feeling mentally “foggy”
• Dry skin
• Constipation
• Feeling cold
• Fluid retention
• Muscle and joint aches
• Depression
• Prolonged or excessive menstrual bleeding in women

The causes of the disease include:

• Hashimoto’s thyroiditis (an autoimmune condition that causes inflammation of the thyroid gland)
• Thyroid hormone resistance
• Other types of thyroiditis (inflammation of the thyroid), such as acute thyroiditis and postpartum thyroiditis

Hyperthyroidism:

Contrary to hypothyroidism, the gland in this disease secretes an increased amount of the hormone. But it is a less common condition as compared to hypothyroidism. Sign and symptoms of the disease include:

• Tremor
• Nervousness
• Fast heart rate
• Fatigue
• Intolerance for heat
• Increase in bowel movements
• Increased sweating
• Concentration problems
• Unintentional weight loss

Some of the most common causes of hyperthyroidism are:

• Graves’ disease (an autoimmune disease that affects thyroid)
• Toxic multinodular goiter
• Thyroid nodules that overexpress thyroid hormone (known as “hot” nodules)
• Excessive iodine consumption

Goiter:

It is the enlargement of the thyroid gland and the cause is undetermined yet. It is not specified as a disease but a condition that may either be seen in hypothyroidism, hyperthyroidism or even normal thyroid function.

Thyroid Nodules:

These are the abnormal lumps or masses that form within the thyroid due to any cause, that could either be benign cysts, tumors or less commonly due to the cancer gland. The nodules may vary in size and could either be single or multiple. Well, if grown to a large size they may compress nearby structures.

Thyroid Cancer:

Thyroid disorders are yet more common in females than males. About 2/3rd of the cases have been reported in people under age 55. There are certain types of thyroid cancer depending upon the nature of cells it includes. But the good news is most of the cases of thyroid cancer have relatively a good prognosis and yet the high survival rates if diagnosed in early years.

Diagnosis of Thyroid Disorders:

No doubt, you need to consult your doctor as soon as you feel any of the above-mentioned symptoms. Apart from the physical examination and medical history, he may ask for specialized tests to confirm the diagnosis.

Blood tests are the utmost priority to rule out the levels of thyroid hormones and TSH. Hence, TSH is the most sensitive test among all. The doctor may request to go for the blood tests that determine if there are antibodies against your thyroid gland such as titers of anti-thyroglobulin, anti thyroperoxidase, or TSH receptor antiglobulin antibodies.

In case of nodules or lumps, imaging tests are usually the preference to see the enlargements and their consistency. It helps to visualize the gland and reveal if any cysts or calcifications. But unfortunately, it can’t distinguish a benign from a malignant. There are certain advanced techniques if a doctor rules out any malignancy.

Thyroid scans which make the use of radioactive iodine are often performed to determine the function of thyroid nodules. The part of the gland that misfunctions and takes the more amount of radioactive iodine is referred as “hot nodules” and known to be hyperactive while those who don’t are referred as “cold nodules” and sometimes may represent cancer.

Fine needle aspiration (FNAC) or biopsy are kinds of surgical techniques that aspirate the fluid/cells or takes off a small portion of the tissue for the examination by a pathologist. The FNA is often guided by an imaging technique and reveals more about the nature of cells.

Treatment of Thyroid Disorder:

A thyroid disorder can be treated medically or in some cases surgically. Treatment will obviously depend upon the nature of the disease and its severity though. But yet it is treatable and people have a high survival rate even if they are suffering from thyroid cancer. But if the cancer is malignant and spread out through the body the prognosis may not be that good.

Medication and Treatment:

For those suffering from thyroid disorders, the doctor often prescribes a synthetic hormone called levothyroxine. Other anti-thyroid drugs that block the production of thyroid hormone may also be prescribed. Other co-factors may include toxins, infection, diet, stress etc. Thus, thyroid needs certain key nutrients such as selenium and zinc to function properly. The supplements could also be a treatment along with hormones. Well, thyroid disorders are more common in adult females as compared to males who may acquire any in their old age. Your diet must contain a sufficient amount of iodine as it is the utmost nutrient required for its proper functioning. Otherwise, report the doctor as soon as you can if you feel any of the above symptoms.

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