Diseases of Thyroid Gland
This page provides information about thyroid gland diseases, including their symptoms, causes, diagnosis, and treatment options. The content on this page has been developed with the assistance of MACS Clinic and Dr. Sandeep Nayak, a prominent thyroid surgeon who operates out of leading hospitals in Bangalore, India. He is recognized for pioneering the RABIT technique of Robotic thyroidectomy.
About 200 million people worldwide suffer from some type of thyroid disease. In India, around 42 million individuals have thyroid-related problems. Diseases of thyroid gland include various conditions that affect its functioning.
The thyroid gland is an essential organ that produces vital hormones. It regulates metabolism and other body functions. Conditions such as hypothyroidism, hyperthyroidism, and thyroid nodules can lead to irregular hormone production. These conditions can affect metabolism and cause various health problems. Timely intervention and effective management of these conditions are critical to ensuring overall well-being. It is, therefore, essential to understand thyroid diseases thoroughly.
Let’s delve into the basics, underlying causes, symptoms, diagnosis, and efficient treatment options for thyroid disorders.
What is the thyroid gland?
Overproduction of thyroid hormone causes a condition known as Hyperthyroidism. When the thyroid gland fails to produce enough thyroid hormone, it results in Hypothyroidism. These conditions are severe and require proper treatment.
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Now, let’s understand the role of the thyroid gland in controlling metabolism.
What is the function of the thyroid gland?
The thyroid gland produces two essential hormones, T4 (thyroxine) and T3 (triiodothyronine). T4 has four iodide atoms, while T3 has three iodide atoms. These hormones regulate metabolism and interact with body cells. They instruct them on how much energy to use. When functioning correctly, the thyroid maintains hormone balance to sustain an optimal metabolic rate. The thyroid generates replacements to maintain balance as the body uses these hormones.
The process of regulating thyroid hormones in the body involves the pituitary gland. It is present at the centre of the skull beneath the brain. The gland monitors and controls the levels of thyroid hormones. Whenever it detects an excess or deficiency of these hormones, it releases thyroid-stimulating hormone (TSH). It then directs the thyroid to make necessary adjustments to restore balance in the body.
Explore the realm of thyroid disorders and how they affect your overall well-being.
What exactly are thyroid diseases?
fast heartbeat
unintentional weight loss
increased nervousness
On the other hand, the thyroid may not produce sufficient thyroid hormone, leading to Hypothyroidism. This condition can cause symptoms such as:
fatigue
weight gain
increased sensitivity to cold temperatures
These conditions may stem from diverse causes, including heredity.
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Discover whether you are at risk of thyroid diseases
Who is most susceptible to thyroid diseases?
Thyroid disease can affect anyone. It may be present at birth, commonly known as Hypothyroidism. It can also develop as you age, often after menopause. Thyroid conditions are prevalent in women, about five to eight times more often than in men.
You may be at risk of developing a thyroid condition if you:
Have a family history of thyroid disorder or a condition like:
Type 1 Diabetes
Turners’ syndrome
Pernicious anemia
Sjögren’s syndrome
Lupus
Rheumatoid arthritis
Primary Adrenal Insufficiency
Take a medication high in iodine, such as Amiodarone, may also increase your risk.
Are a woman over 60 who has had treatment for thyroid conditions or cancer, including thyroidectomy or radiation therapy.
Discover the potential triggers that can be the cause of thyroid disease.
Causes of Thyroid Disease
The thyroid gland is responsible for two types of diseases – Hypothyroidism and Hyperthyroidism. Other medical conditions can affect the thyroid gland’s function, leading to these disorders.
Hypothyroidism can be caused by various ailments, such as:
Thyroiditis
Thyroiditis is the inflammation of the thyroid gland, often caused by an autoimmune reaction, infections, or certain medications. This inflammation can damage thyroid cells. It can lead to reduced hormone production, causing hypothyroidism. Symptoms of thyroiditis include fatigue, weight gain, and cold intolerance. In some cases, steroids are prescribed to reduce the inflammation.
Thyroiditis
Thyroiditis is the inflammation of the thyroid gland, often caused by an autoimmune reaction, infections, or certain medications. This inflammation can damage thyroid cells. It can lead to reduced hormone production, causing hypothyroidism. Symptoms of thyroiditis include fatigue, weight gain, and cold intolerance. In some cases, steroids are prescribed to reduce the inflammation.
Hashimoto's thyroiditis
Hashimoto’s thyroiditis is an inherited autoimmune disorder. In this condition, the body cells attack and damage the thyroid.
Postpartum thyroiditis
Postpartum thyroiditis occurs temporarily in 5% to 9% of women after delivery.
Iodine deficiency
Iodine deficiency affects millions worldwide, as the thyroid gland requires iodine to produce hormones.
Non-functioning thyroid gland
Non-functioning thyroid gland is a rare condition. It affects approximately 1 in 4,000 infants from birth. If left untreated, it can cause mental and physical health problems later in life. Newborns receive a thyroid function screening test in the hospital after birth.
Hyperthyroidism can be caused by various conditions, such as:
Graves’ Disease
Graves’ Disease occurs when the entire thyroid gland becomes overactive and produces excess hormones, also known as diffuse toxic Goiter.
Overactive nodules
Overactive nodules within the thyroid gland can also cause Hyperthyroidism. An overactive nodule is referred to as a toxic autonomously functioning thyroid nodule. In contrast, a gland with numerous overactive nodules is termed a toxic multinodular Goiter.
Thyroiditis
Thyroiditis is inflammation of the thyroid gland, often leading to its dysfunction. It can cause hyperthyroidism when the inflamed gland releases excessive thyroid hormones into the bloodstream. Symptoms include weight loss, rapid heartbeat, and anxiety.
Excessive iodine
Excessive iodine in the body can also lead to Hyperthyroidism. Some medicines, such as Amiodarone, a heart drug, and cough syrups, contain excessive amounts of iodine. It triggers the thyroid gland to produce more hormones than necessary to regulate metabolism.
Does having diabetes increase the likelihood of developing thyroid disease?
Individuals with diabetes are at a higher risk of thyroid disease than those who do not have diabetes. This is because type 1 diabetes is an autoimmune disorder. Having one autoimmune disorder increases the risk of developing another. For those with type 2 diabetes, the risk of developing thyroid disease is relatively lower, but it is still present. This group of individuals may develop thyroid disease later in life.
Experts recommend to undergo regular testing to check for thyroid issues. For people with Type 1 diabetes, frequent testing may be required both immediately after diagnosis and yearly, as compared to those with Type 2 diabetes. In the case of Type 2 diabetes, there is no set schedule for testing. However, your doctor may suggest testing over time.
If you have been diagnosed with both diabetes and thyroid disease, there are specific steps you can take to ensure that you feel your best:
Make sure to get enough sleep.
Maintain a healthy diet.
Exercise regularly.
Get tested regularly as directed by your physician.
Take any prescribed medications.
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Does having diabetes increase the likelihood of developing thyroid disease?
Thyroid disease symptoms can be classified into two groups:
- those related to having too much thyroid hormone (hyperthyroidism)
- those related to having too little thyroid hormone (hypothyroidism)
Unfortunately, these symptoms can often be similar to those of other medical conditions or natural stages of life. Hence, it can be challenging to diagnose whether your symptoms are caused by a thyroid issue or something else.
Hyperthyroidism, or an overactive thyroid, can cause several symptoms, including:
Nervousness, irritability, and anxiety
Unintentional weight loss
Difficulty sleeping
An enlarged thyroid gland (also known as a goiter)
Irregular or absent menstrual periods
Muscle weakness and tremors
Vision problems or eye irritation
Increased sensitivity to heat
Symptoms may vary from person to person. If you experience any of these symptoms, seek medical advice from a healthcare expert.
Hypothyroidism or underactive thyroid can cause various symptoms, including:
Tiredness
Weight gain
Hoarse voice
Forgetfulness
Dry and coarse hair
Intolerance to cold temperatures
Frequent and heavy menstrual periods
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Let’s explore the methods used for diagnosing thyroid issues.
Diagnosis of Thyroid Diseases
Thyroid diseases can be challenging to diagnose as their symptoms may resemble those of other situations, such as pregnancy or ageing. Various tests are available to determine if a thyroid problem is causing your symptoms, including:
Physical examination
A physical exam in your doctor’s office is one way to check for thyroid issues easily. During this painless exam, your doctor will feel your neck for any enlargement or growth of the thyroid gland.
Blood tests
Blood tests are a reliable way to diagnose thyroid disorders. They measure the levels of thyroid hormones in your bloodstream. These tests reveal whether your thyroid gland is functioning correctly. These tests require taking a blood sample from a vein in the arm.
Thyroid blood tests help detect thyroid disorders that are associated with either hyperthyroidism or hypothyroidism:
Thyroiditis
Graves’ disease
Hashimoto’s disease
Goiter
Thyroid nodule
Thyroid cancer
To diagnose thyroid issues, doctors can order certain blood tests, including:
TSH test:
The pituitary gland produces thyroid-stimulating hormone (TSH). Its function is to regulate the levels of thyroid hormones T4 and T3 in the bloodstream. A TSH test is usually the first test done to check for a thyroid hormone imbalance.
Hypothyroidism is often associated with an elevated TSH level. On the other hand, low TSH levels indicate an excess of thyroid hormones (Hyperthyroidism).
If TSH levels are abnormal, your doctor may advise additional tests to evaluate thyroid hormones. These tests include thyroxine (T4) and triiodothyronine (T3) tests. In adults, normal TSH levels range from 0.40 to 4.50 mIU/mL.
T4 test:
Thyroxine tests can detect thyroid disorders. Low T4 indicates hypothyroidism, while high T4 levels may signal hyperthyroidism. The normal T4 range for adults is between 5.0-11.0 ug/dL.
FT4 test:
Free T4 measures the level of unbound T4 in the blood. The normal range for adults is 0.9 to 1.7 ng/dL.
T3 test:
Triiodothyronine (T3) tests are used to diagnose and assess the severity of Hyperthyroidism. These tests also help identify low T3 levels in people with Hypothyroidism. They help manage Hyperthyroidism, where T3 levels are often elevated. The normal T3 range for an individual is between 100 to 200 ng/dL.
FT3 test:
Free T3 or free triiodothyronine measures T3 binding proteins and provides accurate results. The normal range is 2.3 to 4.1 pg/mL.
Additional blood tests that may be required are:
Thyroid Antibodies Test:
These tests aim to identify a particular kind of autoimmune thyroid disorder. The standard tests for thyroid antibodies include:
- Microsomal antibodies, also known as thyroid peroxidase (TPO) antibodies
- Thyroglobulin (TG) antibodies and thyroid receptor antibodies
The thyroid receptor antibodies have:
- Thyroid-stimulating immunoglobulins [TSI]
- Thyroid-blocking immunoglobulins [TBI]
Calcitonin test:
The calcitonin test is used to diagnose two rare thyroid disorders:
- Medullary thyroid cancer
- C-cell hyperplasia
- Thyroglobulin test:
This test helps diagnose thyroiditis. It is inflammation of the thyroid gland. The thyroglobulin test is also used to monitor thyroid cancer treatment.
Discussing the ranges for your thyroid blood tests with your physician is essential. It is normal for your ranges to differ from others. However, if you have concerns about your test results, speak with your doctor.
Imaging tests
Your doctor may recommend a thyroid scan to examine your thyroid gland. This imaging test helps visually inspect the gland for any signs of enlargement, abnormal shape, or nodules.
Your doctor may suggest an ultrasound. It is a safe diagnostic test that uses high-frequency sound waves to create images of internal organs. Unlike X-rays, it doesn’t use radiation. The test doesn’t require any special preparation and is painless.
During the test, you will lie on a padded table while a small handheld device is moved over the examined area. The echoes created during the test produce images that help diagnose medical issues. The test usually lasts 20 to 30 minutes.
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How are thyroid diseases treated?
The treatment for thyroid disease depends on the underlying cause. If you are diagnosed with Hyperthyroidism, there are several treatments available, such as:
Anti-thyroid medications work by inhibiting the production of hormones by your thyroid.
Radioactive iodine therapy damages the thyroid cells. This prevents thyroid hormone production.
Beta-blockers help manage the symptoms of hyperthyroidism. But they do not change the hormone levels in your body.
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Let’s explore different treatments for managing thyroid disorders.
Types of Surgeries for Thyroid Gland Removal
If your thyroid needs to be removed, the surgeon may remove it entirely or partially. The surgical option depends on the severity of your condition. Enlarged or multiple growths may make certain surgeries unsuitable.
The surgical procedure to remove the thyroid gland is known as a Thyroidectomy. This surgery can be performed through two primary methods:
The incision on the front of the neck
It is the conventional method of thyroidectomy. It involves making an incision on the front of the neck. This method provides the surgeon with direct access to remove the thyroid gland. In some instances, this may be the most appropriate option. This approach may be necessary if the thyroid gland is significantly enlarged or has many larger nodules.
The incision in the armpit
It is a scarless alternative to thyroid removal surgery. It involves making an incision in the armpit and creating a tunnel to the thyroid. A robotic arm removes the thyroid through the tunnel and out of the armpit. This procedure is more complicated for the surgeon. Not everyone is eligible for this type of thyroid removal, especially those who:
- are not at a healthy body weight
- have large thyroid nodules
- have a condition like Thyroiditis or Graves’s disease
Talk to your medical team about the best treatment options and surgeries for thyroid disease.
If you are diagnosed with hypothyroidism, the main treatment option is thyroid replacement medication. It is a synthetic way to add thyroid hormones into your body. Levothyroxine is one drug that is commonly prescribed. You can manage thyroid disease using medication and continue living a normal life.
Outlook / Prognosis
After a thyroid removal surgery, how long does it take for tiredness to go away?
After thyroid surgery, your doctor will prescribe medication to help with symptoms. Hormones will circulate for 2-3 weeks, but medication will replace the gland’s function. Feeling tired is normal during recovery. Consult your doctor if you experience fatigue or other symptoms of thyroid disease after surgery.
If one part of the thyroid is removed, will the remaining part produce sufficient hormones to avoid medicine?
In certain situations, a surgeon may remove a portion of the thyroid gland while leaving the other part undisturbed. This procedure is typically performed when a nodule is causing issues with the thyroid. By doing so, the thyroid can still produce and release thyroid hormones. After removing one thyroid lobe, most patients can produce enough thyroid hormone without requiring hormone replacement medication.
Check out the FAQs section for answers to common queries about thyroid conditions.
Frequently Asked Questions
Is the recovery time longer after thyroid surgery?
After undergoing thyroid surgery, it typically takes a few weeks to recover fully. During the recovery period, you should avoid certain activities, including:
– Dipping the incision area under water.
– Engaging in intense exercises.
– Lifting heavy objects.
These restrictions generally last for about two weeks. After that, it is usually safe to return to normal activities.
Is it possible to lead a normal life with thyroid disease?
Thyroid disease is a long-term condition that requires ongoing management. This often involves taking medication daily. Your physician will monitor your treatment closely and make any necessary adjustments over time.
Finding the proper treatment and managing your hormone levels may take some trial and error. However, once you find a suitable treatment plan, it is possible to live a normal life with thyroid disease. People with this condition typically do not face many restrictions. They can carry out their daily activities easily.
Is it safe to exercise if I have thyroid problems?
Regular exercise is crucial for leading a healthy life. People with thyroid disease can maintain their usual exercise routine without any issues. Exercise doesn’t impact the levels of thyroid hormones or cause any pain. However, please consult a doctor before starting a new exercise routine. It will help ensure that it is suitable and safe for you.
Is it possible for thyroid disease to result in seizures?
Thyroid issues rarely cause seizures. However, if untreated, severe hypothyroidism can increase the risk of low serum sodium. It can cause seizures.
Can a thyroid check be performed at home?
Performing a thyroid self-exam at home is easy. You only need a mirror and a glass of water.
To perform a thyroid self-exam at home:
1. Locate your thyroid in the front of your neck, between your collarbone and Adam’s apple.
2. Tilt your head back and focus on the area of your neck where your thyroid is located.
3. Drink water and watch for lumps in your thyroid as you swallow.
4. Repeat the test multiple times.
Consult with your doctor if you find any abnormalities.
Can thyroid disease be prevented?
Prevention of thyroid disease involves:
A balanced diet
Regular exercise
Avoiding excessive iodine intake
However, not all thyroid conditions can be prevented. Early detection through regular check-ups is necessary for effective management.