The Thyroid

March 13, 2020

What is thyroid?

The thyroid, or thyroid gland, is an endocrine gland in the neck consisting of two connected lobes. The thyroid is located at the front of the neck, below the Adam’s apple.

It makes two hormones that are secreted into the blood: thyroxine (T4) and triiodothyronine (T3). These hormones are necessary for all the cells in your body to work normally.

What is the function of the thyroid gland?

Thyroid hormones control your metabolism, which is the rate at which every part of your body works. When your thyroid gland is working the way it should, your metabolism stays at a steady pace—not too fast or not too slow.

The thyroid gland is controlled by the pituitary gland (a gland in your brain). The pituitary gland makes thyroid- stimulating hormone (TSH). TSH tells the thyroid gland to make more hormone if needed.

What are the disorders of the thyroid gland?

Thyroid disorders vary from, abnormality in its function to malignancy. Hence early diagnosis and management of the disease improves the quality of life.

Here are the list of commonly seen thyroid disorders and their symptoms.

     1.Hypothyroidism : Hypothyroidism occurs when the thyroid gland does not make enough of the thyroid hormones to maintain your normal body metabolism.

  • What causes hypothyroidism?

The most common cause of hypothyroidism is a disorder known as thyroiditis—an inflammation of the thyroid gland. The most common type of thyroiditis is called Hashimoto disease. In this disease, the immune system— your body’s natural defense against disease— mistakes cells in the thyroid gland for harmful invaders. Your body sends out white blood cells to destroy the thyroid gland. The pituitary gland then releases TSH to tell the thyroid gland to make more thyroid hormone. This demand on the thyroid gland can cause it to enlarge. This enlargement is called a goiter. Hypothyroidism also can result from a diet that does not have enough iodine.

Who is more likely to develop hypothyroidism?

Women are much more likely than men to develop hypothyroidism. The disease is also more common among people older than age 60.

You are more likely to have hypothyroidism if you

  • have had a thyroid problem before, such as a goiter.
  • have had surgery to correct a thyroid problem
  • have received radiation treatment to the thyroid, neck, or chest
  • have a family history of thyroid disease
  • were pregnant in the past 6 months
  • has Turner syndrome, a genetic disorder that affects females
  • have other health problems, including sjogrens syndrome a disease that causes dry eyes and mouth
  • pernicious anemia a disease caused by a vitamin B12 deficiency
  • lupus- an autoimmune condition.

What are the symptoms of hypothyroidism?

Hypothyroidism has many symptoms that can vary from person to person. Some common symptoms of hypothyroidism include

  • fatigue
  • weight gain
  • a puffy face
  • trouble tolerating cold
  • joint and muscle pain
  • constipation
  • dry skin
  • dry, thinning hair
  • decreased sweating
  • heavy or irregular menstrual periods
  • fertility problems
  • depression
  • slowed heart rate
  • goiter

Because hypothyroidism develops slowly, many people don’t notice symptoms of the disease for months or even years.

Many of these symptoms, especially fatigue and weight gain, are common and don’t always mean that someone has a thyroid problem.

  • What treatment is available for hypothyroidism?

The treatment is to supplement with thyroid hormones till a steady level is obtained.

      2.Hyperthyroidism : Hyperthyroidism results when the thyroid gland makes too much thyroid hormone, resulting in an increased basal metabolism.

  • What are the causes of hyperthyroidism?

Hyperthyroidism has several causes, including Graves’ disease, thyroid nodules including malignant, and thyroiditis—inflammationof the thyroid. Rarely, hyperthyroidism is caused by a noncancerous tumor of the pituitary gland located at the base of the brain. Consuming too much iodine or taking too much thyroid hormone medicine also may raise your thyroid hormone levels.

Who is more likely to develop hyperthyroidism?

Women are 2 to 10 times more likely than men to develop hyperthyroidism. You are more likely to have hyperthyroidism if you

  • have a family history of thyroid disease
  • have other health problems, including
    • pernicious anemia, a condition caused by a vitamin B12 deficiency
    • type i diabetes
    • primary adrenal deficiency, a hormonal disorder
  • eat large amounts of food containing iodine, such as kelp, or use medicines that contain iodine, such as amiodarone, a heart medicine
  • are older than age 60, especially if you are a woman
  • were pregnant within the past 6 months
  • What are the symptoms of hyperthyroidism?

Symptoms of hyperthyroidism can vary from person to person and may include

  • nervousness or irritability
  • fatigue or muscle weakness
  • trouble tolerating heat
  • trouble sleeping
  • shaky hands
  • rapid and irregular heartbeat
  • frequent bowel movements and diarrhea
  • weight loss
  • mood swings
  • goitre
  • What treatment is available for hyperthyroidism?

You may receive medicines, radioiodine therapy, or thyroid surgery to treat your hyperthyroidism. The aim of treatment is to bring thyroid hormone levels back to normal to prevent long-term health problems and to relieve uncomfortable symptoms. No single treatment works for everyone.

Treatment depends on the cause of your hyperthyroidism and how severe it is. When recommending a treatment, your doctor will consider your age, possible allergies to or side effects of the medicines, other conditions such as pregnancy or heart disease, and whether you have access to an experienced thyroid surgeon.

  • Is hyperthyroidism during pregnancy a problem?

Thyroid hormone levels that are just a little high are usually not a problem in pregnancy. However, more severe hyperthyroidism that isn’t treated can affect both the mother and the baby. If you have hyperthyroidism, be sure your disease is under control before becoming pregnant.

  • Thyroid nodules

What are thyroid nodules?

A nodule is a lump in the thyroid gland. When a thyroid nodule is found, it will be checked to see if it is benign (not cancer) or malignant (cancer). 
Your health care professional may use an ultrasound exam to examine the nodule.

Nodules may be further examined by a procedure known as fine-needle aspiration or biopsy. 
If no cancer cells are found, your health care professional may either prescribe medication to decrease the size of your nodule or suggest surgery to remove it. If cancer cells are found, further treatment will be needed. Thyroid cancer usually can be treated with success.

  • Can I be treated for thyroid disease if I am pregnant?

Yes, it is important to be treated for thyroid disease when you are pregnant. Untreated thyroid disease can pose serious risks to a woman and her fetus during pregnancy. With treatment, most pregnant women with thyroid disease can have healthy babies.

  • What is postpartum thyroiditis?

Some women may not have thyroid problems during pregnancy, but develop problems after childbirth. This condition is called postpartum thyroiditis. It often is a short-term problem and hormone levels quickly return to normal.

Dr. Rahul Abbas.
MBBS, DNB
Consultant Physician
Al-Hilal Hospital
Manama

If you have any symptoms mentioned above, visit your nearest Al Hilal Branch and get yourself checked.