What Is Thyroid Disorders - Types, Risk Factors and FAQ

Thyroid disorder:

Thyroid disorder is a condition related to the thyroid gland, a butterfly-shaped gland located in the neck below the larynx, i.e. the voice box .The thyroid gland secretes thyroid hormones, which are released into the blood and transferred to every tissue in the body.The thyroid hormones are responsible for regulating the metabolism of our body and assist in the normal functioning of our body organs. The thyroid gland needs iodine to produce these essential hormones. This gland produces Thyroxine hormones, T3 (also called Tri-iodo Thyronine) and T4 (also called Tetraiodo Thyronine). Both these hormones are controlled by TSH (Thyroid Stimulating hormone), which is released by the pituitary gland situated in the brain.

An increase in the secretion of the thyroid hormones causes Thyrotoxicosis, a condition popularly known as Hyperthyroidism; while an insufficient secretion of the above thyroid hormones in the blood leads to Myxoedema, commonly referred to as Hypothyroidism. A condition where the thyroid gland increases in size than normal is generally known as Goitre (reference size for normal condition is 2 x 2 cm).

Types of Thyroid Disorders:

1. Thyrotoxicosis/Hyperthyroidism

This is a condition where the concentration of thyroid hormones T3 & T4 increases in the blood and the TSH levels go low.

Symptoms:

The symptoms of Thyrotoxicosis/hyperthyroidism are swelling in the neck (goitre), sudden weight loss, amplified appetite, swelling in the legs, extreme sweating, shivering, high blood pressure, skin pigmentation, heart failure or atrial fibrillation (also called Thyrocardiac disease), hair fall, rough skin, protruding eyes, sometimes double vision and reduction of vision (very rare). Other visible symptoms are extreme fatigue, muscle and body pain, breathlessness on physical activity, frequent diarrhoea, anxiety insomnia, etc. Sometimes, (in about one percent of patients), the weakness gets so severe that the patient develops thyrotoxic periodic paralysis; a condition where the patient is incapable of standing up from any sitting posture for a constant period of time. All these symptoms occur due to an increase in the metabolic rate of the body.

The patients diagnosed with hyperthyroidism may turn anemic and may develop osteoporosis, due to weakened bones; he/she may pass excessive urine. This condition also results in lack of beard & moustache and Gynecomastia (breast development in boys). Females suffer with miscarriages and conceiving problems.

Diagnosis:

To determine the condition of hyperthyroidism in a patient, the below tests are done: primarily T3, T4, and TSH; Antimicrosomal & Antithyroglobulin antibodies; and Free T3 and Free T4. Many times, a thyroid scan, Thyroglabulin test, TBG (thyroid binding globulin), along with radioactive iodine uptake are also undertaken depending on the severity and history of the disease.

Causes and Treatment:

1)    Graves’ disease: This is a condition of hyperthyroidism caused due to excess of thyroid hormone in blood. This happens due to an over-active Thyroid gland. It can be treated effectively in 2 years with drugs like neomercazol, antithyrox, or PTU. Sometimes, radioiodine therapy may be necessary.

2)    Toxic adenoma: it is a condition where a single inflamed nodule produces excess thyroid hormone. It requires a surgery or radio-iodine treatment/clero therapy.

3)    Thyroiditis is a common cause of thyrotoxicosis. There are three types of this condition:

a.    Subacute Thyroiditis: caused by an inflammation i.e. swelling in thyroid gland. Symptoms are swelling and pain in neck and throat and fever. Proper diagnosis includes tests of thyroid functioning, ESR, thyrod antibody test & thyroid scan. Can be easily treated in 2 months with effective drugs.

b.    Silent Thyroiditis:In this condition, there is a leakage of excess thyroid hormone in blood due to inflammation in thyroid gland.  Silent thyroiditis exhibits signs & symptoms of hyperthyroidism but without any no pain or fever.

c.    Hashimoto Thyroiditis: It occurs due to swelling of thyroid and excess deposition of inflammatory tissues in the thyroid gland. Symptoms are enlarged thyroid i.e. goiter & other similar signs indicating thyrotoxicosis.  

4)    Thyrotoxicosis (Thyroid) during pregnancy caused due to increased levels of thyroid hormone in blood. If not controlled, can lead to thyroid disorders in mother and child in future.

2. Hypothyroidism:

This condition is due to deficiency of thyroid hormone in the body.

Symptoms of Hypothyroidism:

Weight gain, dry and itchy skin, less or no sweating, hair loss, constipation, hot and cold chills, nervousness, irritability, depression, extreme fatigue & body pain, swelling of face & body, hypertension, anemia, hair fall, dry & brittle nails, itching of eyebrow hair, loss of appetite, excessive sleepiness, memory loss, muscle and body pain, puffy eyes, irregular menstrual periods in women infertility in men, etc. All these symptoms are due to decreased metabolism in the body.

Diagnosis:

The following tests are required for proper diagnosis and treatment of hypothyroidism.Free T3, Free T4 & TSH / or T3, T 4 & TSH

Other tests like Thyroid microsomal antibody, Urinary iodine, Thyroglobulin, Anti-thyroglobulin antibody, Thyroid scan, etc. may be done to know if the condition is temporary or permanent hypothyroidism.

Causes & treatment of Hypothyroidism

Permanent hypothyroidism is treated with drugs like Eltroxin, Thyrox, and Thyronorm in optimum doses depending on the severity of the condition. Thyroid tests are conducted at regular intervals. Medicines are to be taken regularly to lead a healthy life.

In many cases, the condition of hypothyroidism is temporary. It does not require lifelong medication. Proper diagnosis and treatment by a thyroid specialist can permanently cure the patient with hypothyroid condition.

Risk Factors:

Hyperthyroidism, especially Graves’ disease, may usually run in families. Therefore, tests and examinations of your entire family could reveal other persons in the family with underlying thyroid disorders.

Myths:

1. Intake of 4 spoons of coconut oil daily can cure hypothyroidism!

There is no evidence related to the benefits of coconut oil in curing thyroid. Please consult your physician before relying on such myths.

2. Thyroid disorder occurs due to the trauma suffered by a person while passing through the birth canal!

Absolutely rubbish!  This myth has unknown origin and evidence.

3. Toothpaste or water fluoride causes thyroid disorder!

There is no medical or scientific evidence to prove this fact.

FAQs:

Commonly asked questions about Thyroid disorders:

1. How can I know if I have thyroid disorder?

Answer: Check for symptoms like fatigue, anxiety, irregularity in sleep pattern, sudden changes in weight, sensitivity to hot or cold temperature, hair loss, dry itchy skin, muscles and body pain, or menstrual problems. You should even check any swelling in the neck or throat area. Immediately go for testing your thyroid function and consult a doctor if T3, T4 and TSH levels are not within the normal range.

2. How do I keep my thyroid healthy?

Answer: A well balanced diet and an active lifestyle can keep your thyroid functioning properly.  In addition, check for optimum iodineintake in your diet. Insufficient iodine in food causes thyroid while excess of iodine can also interfere in the normal thyroid functioning. Also the Iron levels in your blood should be sufficient enough to support the thyroid function. Iron helps to convert T4 to T3, the most active hormone in blood, and also binds T3. Another important ingredient in your diet is Trace Minerals like Zinc, chromium, and selenium that convert inactive T4 to active T3.

3. What does it mean if my thyroid tests show an increased TSH level?

Answer: Thyroid stimulating hormone or TSH is produced by the pituitary gland in the brain. It stimulates the thyroid gland to produce thyroid hormone. When the thyroid gland is underactive and produces less hormone in the body, the pituitary gland triggers more TSH production, signaling the thyroid gland to secrete more thyroid hormone. Thus if you have a higher TSH level, it means you are hypothyroid and your thyroid is underactive.

4. Can the mother with hypothyroidism breastfeed her baby?

Answer: Yes! But do consult your doctor for thyroid disorders in pregnancy.

5. What are the risks of hyperthyroidism during pregnancy?

Answer: Hyperthyroidism in mothers, if untreated, may lead to augmented heart rate and in some cases, still births. It is therefore very important to treat hyperthyroidism in an expecting mother.