By Dr. Hanish Gupta, Internal Medicine
The human body is controlled by chemicals known as hormones, which are secreted by small internal organs known as endocrine glands. These hormones act as catalysts and control the body’s metabolism. One of the most important endocrine organs is the thyroid gland which secretes two hormones T3 and T4.
The major disorders of the thyroid gland are related to increased or decreased amounts of secretion – causing hyperthyroidism or hypothyroidism.
- Graves’ disease, which is an autoimmune condition.
- Toxic nodules which are localized areas of increased production of the hormone.
- The pituitary gland, which is the master endocrine gland, can malfunction and affect thyroid function.
Symptoms: These symptoms relate to increased metabolism, and include:
- Increased heart rate and palpitations
- Severe fatigue
- Excessive perspiration
- Bulging of the eyes
- Intolerance for heat
- Increased frequency of bowel movement
- Weight loss
- Nervousness and anxiety
Hypothyroidism: This is a condition where there is reduced amounts of thyroid hormone in circulation.
- Autoimmune Hashimoto’s thyroiditis
- Surgical removal of the thyroid gland
- Iodine deficiency which affects adequate production of the hormone
- Lithium-containing drugs which are used in treating neurologic conditions also can affect thyroid hormone production.
- Lump in front of the neck, shaped like a butterfly
- Intolerance to cold and feeling cold all the time
- Extreme fatigue
- Drying of skin and mucous membranes
- Chronic constipation
- Weight gain
- Fluid retention leading to swollen joints and muscles
- Hair loss
- Poor concentration and feeling lost
- Menstrual disorders and infertility in women
Thyroid nodules and cancer: Nodules are extra growths within the gland which can be benign cysts, tumours, or cancers. While small ones can be harmless and present with no symptoms, larger ones can press on the surrounding organs and cause symptoms accordingly, including hoarse voice and breathing difficulty.
Diagnosis: Most thyroid disorders are diagnosed by a combination of presenting signs, physical exam, clinical testing, and radioactive imaging including x-rays and CT scans or ultrasound.
In very rare cases, biopsy and fine needle aspiration may be required, if tumours are suspected.
- Hypothyroidism: Hypothyroidism is very common in women, and the presenting symptoms are very characteristic of the condition. Thyroid supplementation is usually the preferred treatment of choice, and the dosage would depend on the severity of the symptoms. The treatment needs to be continued for a lifetime, and dosage adjusted if required. Because there is iodine deficiency linked to the condition, common salt is fortified with iodine in many countries to help prevent the condition.
- Hyperthyroidism: Small areas of hyperproduction can be surgically removed to control the amount of hormone produced. Radioactive iodine is also used to control hormone production. Beta-blockers are useful in controlling symptoms of increased heart rate and high blood pressure.