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Thyroid Disorders – Hyperthyroidism & Hypothyroidism

  • What are thyroid disorders?

    Thyroid disorder

    The thyroid is a gland located at the front of the neck. It produces 2 hormones, thyroxine and triiodothyronine, which regulates many important metabolic processes in the body.

    The thyroid can stop working properly and become overactive or underactive. This leads to thyroid disorders called hyperthyroidism and hypothyroidism. Another common thyroid disorder is thyroid nodules, growths that develop on the thyroid gland.

    Women are more prone to thyroid disorders than men. According to the American Thyroid Association, women are 5 – 8 times more likely to have thyroid problems than men. During her lifetime, 1 in 8 women will develop a thyroid disorder.

    Types of thyroid disorders

    • Hypothyroidism – It is a developed condition that stems from an underproduction of thyroid hormones.
    • Hyperthyroidism – It is a condition that resulted due to an overproduction of thyroid hormones.
    • Thyroid nodules – These are either solid or fluid-filled growths that form on the thyroid gland.
  • Several causes lead to thyroid disorders:

    • Graves’ disease – A common cause is Graves’ disease. This occurs when the immune system produces antibodies that cause the uncontrollable production of thyroxine. This leads to eye irritation, swelling and vision problems. The causes of Graves’ disease are unclear but genetics might be a factor.
    • Hyperactive thyroid nodules – Hyperthyroidism is caused by hyperactive thyroid nodules that produce excessive thyroxine. The excess thyroxine is a hormone secreted by the thyroid gland.
    • Thyroiditis – It is caused by inflammation or swelling of the thyroid gland that makes thyroid hormone leak out into the bloodstream. This disorder can either be painful or not felt at all and can last for a few weeks or months.
    • Iodine deficiency – Iodine is used by the thyroid to generate hormones. Iodine deficiency can cause your thyroid gland to develop thyroid nodules.
    • Excessive iodine – Having excessive iodine inside the body can make the thyroid create more thyroid hormones than what it needs. This can be found in some medications such as cold and sinus medicines, and the heart medicine amiodarone.
    • Nodules – Nodules are growths that form in or on the thyroid gland.

    Risk factors for thyroid disorders

    • Pre-existing condition – People with autoimmune diseases such as type 1 diabetes or celiac are more likely to get disorders affecting the thyroid.
    • Pituitary gland disorder – It is a condition caused by too little or too much of one or more of the hormones produced by the pituitary gland.
    • Pregnancy – Women who are pregnant or who have had a recent pregnancy in the past 6 months are at high risk.
    • Injury to thyroid gland – An injury of the thyroid causes the gland to leak excess hormones that may result in temporary hyperthyroidism that may last for a few weeks to months.
    • Smoking – People who smoke and are exposed to second-hand smoke are at great risk of thyroid disorders.
    • Radiation exposure – The thyroid gland is vulnerable to radiation. A wide dose of radiation may induce thyroid diseases like benign thyroid nodules, Graves’ disease, thyroiditis, and hypothyroidism.

    Preventing thyroid disorders

    While there is no sure way to prevent thyroid disorders, there are ways to reduce your risk of developing the disease. One is to request for a thyroid collar before you undergo X-rays to protect your thyroid gland from radiation exposure. Another vital step to reduce thyroid disorder risk is to quit smoking as cigarette smoke has a variety of toxins that may affect your thyroid. It is also important to undergo the thyroid neck check that can detect lumps, bumps, and swelling on your thyroid. Seeing your doctor regularly is crucial for your thyroid health, especially if you have a high risk of developing thyroid disease.

  • Common symptoms of thyroid disorders include:

    Symptoms of hyperthyroidism

    • Anxiety, nervousness and irritability
    • Bulging eyes
    • Changes in menstruation cycle
    • Diarrhoea
    • Fast heartrate and palpitations (fast, strong and irregular heartbeat)
    • Tiredness
    • Muscle weakness and trembling
    • Sensitivity to heat
    • Insomnia
    • Weight loss

    Symptoms of hypothyroidism

    • Changes in menstruation cycle
    • Constipation
    • Depression
    • Tiredness
    • Brittle fingernails and hair
    • Muscle pain and weakness
    • Pale skin and puffy face
    • Sensitivity to cold
    • Slow heart rate
    • Weight gain

    Consult a doctor immediately if you encounter unexplained weight loss, a rapid heartbeat, swelling at the base of your neck, unusual sweating or other signs and symptoms associated with hyperthyroidism. Similarly, if you are feeling tired for no reason, have dry skin, a pale, puffy face, constipation, a hoarse voice or any of the signs and symptoms of hypothyroidism, visit your doctor immediately.

    Moreover, see your doctor regularly for him to monitor your condition if you have been treated for hyperthyroidism or hypothyroidism or if you are currently being treated.

  • If you experience symptoms of thyroid disorder, your doctor will require you to undergo the following tests:

    Physical exam

    Your doctor may try to detect a slight tremor in your fingers when they are extended. Your thyroid gland will also be assessed as you swallow to see if it is enlarged, tender or bumpy. Your pulse will also be checked. Other signs your doctor may be looking for are overactive reflexes and warm and moist skin. Likewise, your doctor will also observe eye changes that may be symptoms of thyroid eye disease such as watery or dry eyes, eye redness, bulging eyes, double vision, difficulty in closing your eyes, and vision problems.

    Blood tests

    Blood tests are done to measure thyroxine and thyroid-stimulating hormone (TSH) that can confirm the thyroid disorder diagnosis. High levels of thyroxine and nonexistent or low amounts of TSH reflect an overactive thyroid. The amount of TSH is significant because it is the hormone that prompts your thyroid gland to produce more thyroxine.

    Imaging tests

    Your doctor may recommend a thyroid scan, which illustrates how iodine collects in your thyroid. During the scan, a radioactive isotope will be injected into the vein on the inside of your elbow or sometimes into a vein in your hand. A thyroid ultrasound may also be used to help diagnose thyroid problems. It uses high-frequency sound waves to view images of the thyroid and discover thyroid nodules without exposure to any radiation.

  • The treatment of thyroid disorders depends on the patient's age and general health, as well as the cause and severity of the condition. There are several treatment options:

    For hyperthyroidism

    Anti-thyroid medicine

    Anti-thyroid medicine is the first-line of treatment that blocks the production of thyroid hormones and slowly reduces the symptoms of hyperthyroidism.

    Hormone replacement therapy

    This therapy aims at controlling thyroid hormone levels by using a man-made thyroid hormone pill.

    Radioactive iodine treatment

    This treatment is used if anti-thyroid medications do not work. Radioactive iodine is taken orally and can reduce thyroid activity significantly and even permanently.

    Thyroidectomy

    Total or partial thyroid removal is a surgical procedure used to treat diseases of the thyroid gland including thyroid cancer. This is a last-resort option as you may need to take life-long medication to maintain normal thyroid hormone levels.

    For hypothyroidism

    Oral medication

    To restore hormone levels and reverse hypothyroidism symptoms, the standard treatment includes an oral medication that contains synthetic thyroid hormone levothyroxine. This treatment also helps lower cholesterol levels elevated by hypothyroidism.

    For thyroid nodules

    Thyroid hormone therapy

    To reduce the size of the nodule, you may be given a thyroid hormone treatment.

    Surgery

    If the thyroid nodules are causing problems like difficulty in breathing or swallowing, your doctor may recommend surgery. Surgery may also be considered for those with large multinodular goiters (abnormal enlargement of your thyroid gland). The goiters may constrict airways, the esophagus or the blood vessels. Moreover, if the biopsy result states that the nodules are suspicious, a surgical removal may be necessary to evaluate the nodules for signs of cancer.

    Proper diagnosis is crucial to determine the most suitable hearing loss treatment. Consult a specialist at Parkway East Hospital. With the aid of medical equipment, our team of experienced specialists and nurses will work together to come up with an accurate diagnosis and an effective treatment plan for your condition.

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    • Eye problems, such as bulging eyes and blurry vision (caused by Graves’ disease)
    • Fever and hallucinations
    • Irregular heart beat and heart failure
    • Osteoporosis (weakening of bones)
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