Let us speak about common thyroid disorders

Dr Ajit Lukram *

Overview of the thyroid system :: Pix - Wikipedia/Mikael Haggstrom

The thyroid is a small, butterfly-shaped gland located at the base of the neck in the front. It is an endocrine gland responsible for coordinating many of the body's activities. The thyroid gland manufactures hormones that regulate the body's metabolism (the process of creating and using energy).

Disorders can arise when the thyroid produces too much hormone (hyperthyroidism) or not enough (hypothyroidism). Common thyroid disorders include Hashimoto's disease, Graves' disease, colloid goiter, and thyroid nodules. Thyroid cancer is also increasingly diagnosed in patients presenting with thyroid nodules with the increased use of tissue biopsy (FNAC) now.

Hashimoto's Disease

Hashimoto's disease is also known as chronic lymphocytic thyroiditis or autoimmune thyroiditis. It's a very common cause of hypothyroidism in Manipur. It can occur at any age, but it's most common in middle-aged women. The disease occurs when the body's immune system mistakenly attacks and slowly destroys the thyroid gland and its ability to produce hormones. Hashimoto's disease is an autoimmune disorder, so the blood test would also show abnormal antibodies that might be attacking the thyroid.

Treatment includes hormone-replacing medication to raise thyroid hormone levels or lower TSH levels. It can also help relieve the symptoms of the disease. Surgery might be necessary to remove part or all of the thyroid gland in rare advanced cases of Hashimoto's when compression in the neck by the enlarged thyroid occurs causing- neck discomfort, difficulty in swallowing, difficulty in breathing..

Symptoms include:

o fatigue
o depression
o constipation
o mild weight gain
o dry skin
o dry, thinning hair
o pale, puffy face
o heavy and irregular menstruation
o intolerance to cold
o enlarged thyroid (goiter)

Graves' Disease

It's the most common cause of hyperthyroidism (overactive thyroid). It's an autoimmune disorder and occurs when the body's immune system mistakenly attacks the thyroid gland. This can cause the gland to overproduce the hormone responsible for regulating metabolism. The body's systems speed up and cause symptoms that are common to hyperthyroidism when there's a high level of thyroid hormone in the bloodstream.

Treatment can be Beta blockers to control rapid heart rate, anxiety, and sweating;Anti-thyroid medications to prevent the thyroid from producing excessive amounts of hormone; Radioactive iodine to destroy all or part of the thyroid; Surgery to remove the thyroid gland, a permanent option for patients who cannot tolerate anti-thyroid drugs or radioactive iodine. Successful hyperthyroidism treatment usually results in hypothyroidism.

Symptoms include:
o anxiety
o irritability
o fatigue
o hand tremors
o increased or irregular heartbeat
o excessive sweating
o difficulty sleeping
o diarrhoea or frequent bowel movements
o altered menstrual cycle
o enlarged thyroid (goiter)
o bulging eyes and vision problems

Goiter

Goiter is a noncancerous enlargement of the thyroid gland. The most common cause of goiter worldwide is iodine deficiency in the diet. There might not be any symptoms if the goiter is not severe. Goiters are often associated with highly treatable thyroid disorders, such as Graves' disease, and aren't usually a cause for concern. However, they can cause serious complications if they're left untreated. These complications can include difficulty breathing and swallowing.

The goiter may cause one or more of the following symptoms if it grows large enough, depending on the size:
o swelling/tightness in the neck
o breathing and/or swallowing difficulties
o coughing or wheezing
o hoarseness of voice

Thyroid Nodules

Thyroid nodules are growths that form on or in the thyroid gland. The nodules can be solid or fluid-filled. Most are benign, but they can also be cancerous in a small percentage of cases. Most thyroid nodules do not cause any symptoms. However, if they grow large enough, they can cause swelling in the neck and lead to breathing and swallowing difficulties, pain, and goiter.

Most nodules are detected during a normal physical exam. They can also be detected during an ultrasound, CT scan, or an MRI. Once a nodule is detected, other procedures — TSH test and a thyroid scan — can check for hyperthyroidism or hypothyroidism. A fine-needle aspiration (FNA) biopsy is used to take a sample of cells from the nodule and determine whether the nodule is cancerous.