Thyroid Disease

THYROID DISEASE

What is thyroid?

Thyroid gland is a butterfly-shaped tiny organ that is found around the region of the windpipe exactly in the front of the neck (trachea) and below the Adam’s apple cartilage. It has two side lobes that are joined in the center by an isthmus (bridge). And it weighs approximately 20 grams.


What are the functions of thyroid?

Your thyroid does an important job within your body by releasing and controlling thyroid hormones that control metabolism. Metabolism is a process where the taken food into your body is transformed into energy. This energy is used throughout your entire body to keep many of your body’s systems, such as heart rate, cholesterol level, bodyweight, mood and menstrual cycle in various organs and tissues of the body working correctly.


Thyroid gland secretes the hormones T3 (triiodothyronine, contains three iodide atoms) and T4 (thyroxine, contains four iodide atoms). These hormones control your metabolism and they tell the body’s cells how much energy to use. When your thyroid works properly, it will maintain the right amount of hormones to keep your metabolism working at the right rate. As the hormones are used, the thyroid creates replacements.


This is all supervised by something called the pituitary gland. Located in the center of the skull, below your brain, the pituitary gland monitors and controls the amount of thyroid hormones in your bloodstream. When the pituitary gland senses a lack of thyroid hormones or a high level of hormones in your body, it will adjust the amounts with its own hormone. This hormone is called thyroid stimulating hormone (TSH). The TSH will be sent to the thyroid and it will tell the thyroid what needs to be done to get the body back to normal.


What is thyroid disease?

Thyroid disease is a general term for a medical condition that keeps your thyroid from making the right amount of hormones.


When the thyroid makes too much thyroid hormone, your body uses energy too quickly. This is called hyperthyroidism and it can make you tired too quickly, make your heart beat faster, cause you to lose weight without trying and even make you feel nervous. On the other hand, when your thyroid makes too little thyroid hormone, this condition is called hypothyroidism. When you have too little thyroid hormone in your body, it can make you feel tired, you might gain weight and you may even be unable to tolerate cold temperatures.


Who can be affected by thyroid disease?

Thyroid disease can affect men, women, elders, teenagers and infants. Thyroid disease is very common. Approximately 20 millions people in the USA have some type of thyroid disorder. Thyroid gland diseases are more common in women.


You may be at a higher risk of developing a thyroid disease if you:

  Have a family history of thyroid disease such as goiter, thyroid nodule, thyroid cancer and thyroiditis

  Have a medical condition such as pernicious anemia, type 1 diabetes, primary adrenal insufficiency, lupus, rheumatoid arthritis, Sjögren’s syndrome and Turner syndrome

  Have a history of treatment for a past thyroid condition

  Have a history of radiotherapy for head or neck

  Have a history of surgery due to thyroid nodule

  Take a high iodine medication (amiodarone)

  Are post-menopausal woman


Causes of thyroid disease

Some of the common causes of the thyroid disease are:


Iodine usage:

  Iodine deficiency:Iodine is used by the thyroid to produce hormones. Severe iodine deficiency can cause Goiter and Hypothyroidism conditions. Sometimes, Nodules can form within a goiter. Swallowing and breathing difficulties may occur in patients with goiter.

  Excessive iodine:When you have too much iodine in your body, the thyroid makes more thyroid hormones than it needs. Excessive iodine can be found in some medications such as amiodarone (a heart medication) and cough syrups.


Autoimmune diseases:

  Hashimoto’s thyroiditis:Hashimoto’s thyroiditis is an autoimmune condition of hypothyroidism type and is a painless disease. Body’s cells attack and damage the thyroid gland as well as the area around the thyroid gland.

  Graves’ disease:Graves’ disease is an autoimmune condition of hyperthyroidism type. Entire thyroid gland might be overactive and produce too much hormone in this condition. This condition is also called diffuse toxic goiter (enlarged thyroid gland)


Autoimmune Thyroiditis:  Thyroiditis condition is an inflammation (swelling) of the thyroid gland. Thyroiditis can lower the amount of hormones your thyroid produces. Either the blood levels of thyroid hormones are excessively high or abnormally low.


Thyroid nodules:  Thyroid nodules are lumps or growths in the thyroid gland. They normally don’t show any indications or symptoms. They are frequently discovered during a doctor’s normal medical examination. They can become large if treatment is not given properly.


A non-functioning thyroid gland:   Sometimes, the thyroid gland doesn’t work correctly from birth. If left untreated, the child could have both physical and mental issues in the future. Nowadays, all newborns are given a screening blood test in the hospital to check their thyroid function.


Postpartum thyroiditis:  It’s usually a temporary condition which occurs in 5% to 10% of women after childbirth.


Cancerous tumors:  The thyroid gland is a region where thyroid cancer first develops. Even after thyroid surgery or other treatments, your body still needs thyroid hormones to function. You’ll need to take thyroid hormone replacement therapy for the rest of your life.


Thyroid surgery:  A thyroidectomy is the surgical removal of all or part of your thyroid gland. This may diminish or halt hormone production and you’ll need to take thyroid hormone for the rest of your life.


Radiation therapy:  Overactive thyroid (hyperthyroidism) and certain kinds of thyroid cancer are treated with radioactive iodine (RAI). Radiation therapy also used to treat cancers of the head and neck can affect your thyroid gland and may lead to hypothyroidism.


Genetic disorders:  Mutations in one of the several genes involved in thyroid hormone synthesis that cause thyroid dyshormonogenesis. Thyroid hormone synthesis is disrupted by mutations in each of these genes, resulting in abnormally low amounts of hormones.


Medications:  High iodine medications (amiodarone) or lithium based medications which are used to treat certain psychiatric disorders can cause the hypothyroidism condition.


Types and Symptoms of thyroid disease

There are a variety of symptoms you could experience if you have a thyroid disease. The symptoms of thyroid disease can be divided into groups below.


Symptoms of an overactive or too much thyroid hormone (hyperthyroidism) can include:

  Having an enlarged thyroid gland or a goiter

  Feeling of congestion in throat

  Rapid heartbeat (tachycardia)

  Irregular heartbeat (arrhythmia)

  Pounding heart (palpitations)

  Tremor in hands and fingers

  Increasing sensitivity to heat

  Increasing appetite and thirst

  Sudden weight loss

  Abnormal sweating

  Irregular menstrual periods or stopped menstrual cycle

  Experiencing anxiety, irritability and nervousness

  Muscle weakness and fatigue

  Hair loss

  Sleeping troubles


Symptoms of an underactive or too little thyroid hormone (hypothyroidism) can include:

  Having an enlarged thyroid gland or a goiter

  Muscle weakness and fatigue

  Weight gain

  Increased sensitivity to cold

  Slowed heart rate

  Having frequent and heavy menstrual periods.

  Having dry and coarse hair.

  Hoarseness

  Impaired memory

  Dry Skin

  Puffy face


How is thyroid disease diagnosed?

Sometimes, thyroid disease can be difficult to diagnose because the symptoms are easily confused with other medical conditions. Fortunately, there are tests that can help determine if your symptoms are being caused by a thyroid issue. These tests include:


Blood tests:

Blood tests are one of the most definitive ways to diagnose a thyroid disease. Thyroid blood tests are used to tell if your thyroid gland is functioning properly by measuring the amount of thyroid hormones in your blood. These tests are done by taking blood from a vein in your arm.

  Thyroid-stimulating hormone (TSH):  This test will check thyroid hormone imbalance in your body. Too low thyroid hormone (hypothyroidism) is associated with an elevated TSH level, while too much thyroid hormone (hyperthyroidism) is associated with a low TSH level. Normal TSH range for an adult is 0.40 - 4.50 mIU/mL (milli-international units per liter of blood).

  T4 (Thyroxine):  This test checks for hypothyroidism and hyperthyroidism and is used to monitor treatment of thyroid disorders. Low T4 levels may indicate hypothyroidism whereas high T4 levels may indicate hyperthyroidism. Normal T4 range for an adult is 5.0 - 11.0 ug/dL (micrograms per deciliter of blood).

  T3 (Triiodothyronine):  This test diagnoses hyperthyroidism or the severity of hyperthyroidism. Low T3 levels can be observed in hypothyroidism, where high T3 levels can be observed in hyperthyroidism. Normal T3 range for an adult is 100 - 200 ng/dL (nanograms per deciliter of blood).

  Thyroid antibodies:  These tests help identify different types of autoimmune thyroid conditions. Common thyroid antibody tests are:

  Microsomal antibodies (aka thyroid peroxidase antibodies or TPO antibodies)

  Thyroglobulin antibodies (aka TG antibodies)

  Thyroid receptor antibodies (includes thyroid stimulating immunoglobulins [TSI] and thyroid blocking immunoglobulins [TBI])

  Thyroglobulin:  This test diagnoses thyroiditis (thyroid inflammation) and to monitor treatment of thyroid cancer.

  Calcitonin:  This test diagnoses C-cell hyperplasia and medullary thyroid cancer, both of which are rare thyroid disorders.


Imaging tests:

These techniques can be used to evaluate the thyroid gland. They provide information on the structure of the thyroid gland as well as the location and size of thyroid nodules. Nuclear medicine scans also provide functional data about nodules. Common imaging tests are:

  Nuclear medicine scan

  Ultrasound

  Computed tomography

  Magnetic resonance imaging (MRI)


Physical exams:

Physical examination is performed in either a seated or standing position. This is a very simple and painless test where your doctor checks your neck for any growths or enlargement of the thyroid. Examination of the thyroid is done between the cricoid cartilage and the suprasternal notch to detect the presence of the thyroid isthmus.


Treatment & Prevention of thyroid disease

To normalize your thyroid hormone levels, a variety of ways and treatments are available. Each specific treatment will depend on the cause of your thyroid condition.


Medications:

If you have high levels of thyroid hormones (hyperthyroidism), treatment options can include:


Anti-thyroid drugs:  These medications stop your thyroid from making too many hormones.

  Methimazole

  Tapazole

  Carbimazole


Radioactive iodine:  In this treatment, the thyroid gland absorbs radioactive iodine which kills the cells in the thyroid gland to prevent it from making high levels of thyroid hormones. This has the effect of lowering the amount of thyroxine produced by the thyroid gland and shrinking the gland’s size.


Beta blockers:  These beta-blockers medications balance increased beta-adrenergic tone which causes hyperthyroidism symptoms. These medications don’t change the amount of hormones in your body, but they help control your symptoms.

  Propranolol

  Hemangeol


Surgery:  In this thyroidectomy surgery, either the entire or partial thyroid gland is surgically removed. This will stop it from creating hormones. However, you will need to take thyroid replacement hormones for the rest of your life.


If you have low levels of thyroid hormones (hypothyroidism), the main treatment option can include:


Thyroid replacement medication:  This drug is a synthetic (man-made) way to add thyroid hormones back into your body. By using this medication, you can control thyroid disease and live a normal life.

  Levothyroxine

  Synthroid

  Euthyrox

  Tirosint

  Unithroid

  Levoxyl

  Levo-T


Thyroid cannot be prevented. But you can prevent thyroid from developing severe symptoms by making some simple changes in your daily lifestyle and food habits.


Visit your doctor regularly:  If you have hypothyroidism, you should test your thyroid function once a year, and if you have hyperthyroidism, you should test it monthly. A thyroid neck check can detect lumps and swelling if they’re close to the surface.


Diet for patients with thyroid disease:  Your thyroid hormone levels can’t get back to normal by a healthy diet alone, but they certainly help to control hormone levels and also help your body to absorb these hormones more effectively.


What to take:

  Milk, Yogurt

  Selenium supplements (sunflower seeds or Brazil nuts)

  Antioxidant-rich fruits and vegetables

  Chicken, Fish, Eggs

  Seaweed


What to reduce:

  Salt

  Soy and soy products


What to avoid:

  Gluten

  Processed food

  Fast food

  Smoking

  Caffeine

  Alcohol


Yoga:  Yoga can be beneficial in various situations. These exercises should not be used to replace any existing therapies or medications, but rather as a complementary therapy. As stress is one of the leading causes of thyroid conditions, here are some 5 Yoga poses (asanas) to help you feel better by stimulating the pharynx, avoiding diseases, and acting as a complementary therapy for thyroid disease.


  Sarvangasana (Shoulder Stand Pose)

  Matsyasana (The Fish Pose)

  Ustrasana (Camel Pose)

  Bhujangasana (Cobra Pose)

  Savasana (Corpse Pose)


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