Thyroid disorders

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Thyroid gland

Thyroid gland

Thyroid gland

The thyroid gland is butterfly shaped, ductless, endocrine gland in the neck, consisting of two lobes connected by a middle part called an isthmus. It is present in front of the neck, below the Adam’s apple. Through the hormones it produces and stores, the thyroid gland control metabolism – the way our body uses energy. The thyroid hormones regulate vital body functions, like – breathing, heart rate, blood pressure, body temperature and the rate at which food is converted into energy. These hormones  also help children grow and develop.

The thyroid uses iodine, a mineral found in some foods and in iodized salt, to make its hormones. The two most important thyroid hormones are thyroxine (T4) and triiodothyronine (T3). The thyroid gland also makes the hormone calcitonin, which is involved in calcium metabolism and stimulating bone cells to add calcium to bone. Thyroid stimulating hormone (TSH), which is produced by the pituitary gland, acts to stimulate hormone production by the thyroid gland.

Thyroid disorders

These disorders are conditions that affect the thyroid gland, either its structure or function.

Thyroxine, also known as T4, is the primary hormone produced by the gland. After delivery via the bloodstream to the body’s tissues, a small portion of the T4 released from the gland is converted to triiodothyronine (T3), which is the most active hormone.

Thyroid Hormones

Thyroid Hormones

The function of the thyroid gland is regulated by a feedback mechanism involving the brain. When thyroid hormone levels are low, the hypothalamus in the brain produces a hormone known as thyrotropin releasing hormone (TRH) that causes the pituitary gland (located at the base of the brain) to release thyroid stimulating hormone (TSH). TSH stimulates the thyroid gland to release more T4.

Since the thyroid gland is controlled by the pituitary gland and hypothalamus, disorders of these tissues can also affect thyroid function and cause thyroid problems.

Types of Thyroid disorders

1. Hyperthyroidism

2. Hypothyroidism

3. Thyroid cancer

Today we will discuss hyperthyroidism and hypothyroidism only in this post.

Hyperthyroidism (↓TSH,↑T3, T4)

The condition caused by the excessive quantities of thyroid hormones. It may be due to overproduction by the thyroid gland, overproduction originating outside the thyroid, or loss of storage function and leakage from the gland. Thyrotoxicosis implies a state of hyperthyroidism in which the thyroid hormone is toxic to the tissues producing clinical features; while hyperthyroidism simply implies excessive thyroid function. However both are not the synonymous, yet are used interchangeably.

Symptoms of Hyperthyroidism

  • Weight loss
  • Restlessness
  • Increase in appetite
  • Frequent bowel movement or diarrhoea
  • Nervousness and irritability
  • Palpitations and tachycardia
  • Heat intolerance or increased sweating
  • Tremulousness (characterized by or affected with trembling or tremors)
  • Lower leg swelling
  • Shortness of breath with exertion
  • Decreased menstural flow (oligomenorrhoea)
  • Impaired fertility
  • Loss of libido
  • Gynaecomastia (enlargement of a man’s breasts)
  • Onycholysis (is a common medical condition characterized by the painless detachment of the nail from the nail bed, usually starting at the tip and/or sides. On the hands, it occurs particularly on the ring finger but can occur on any of the fingernails. It may also happen to toenails)
  • Sleep disturbance (including insomnia)
  • Changes in vision -Photo-phobia, eye irritation with excess tears, diplopia or double vision, exopthalmos (forward protrusion of eye balls)
  • Fatigue and muscle weakness

 Hypothyroidism (↑ TSH, ↓T3, T4)

Hypothyroidism is clinical condition reflecting hypo-functioning thyroid gland, characterised by low levels of circulating thyroid hormones.

It is called primary when the cause of it lies in the thyroid gland itself. It becomes secondary when it occurs due to disease of anterior pituitary or hypothalamus.

Goitrous hypothyroidism means enlargement of thyroid gland associated with hypothyroidism

Subclinical hypothyroidism means biochemical evidence of hypothyroidism (normal T3 and T4 but raised TSH) without any symptoms of hypothyroidism (asymptomatic hypothyroidism). It may persist for many years.

Transient hypothyroidism refers to a state of reversible thyroid function, often observed

  • during the first 6 months after subtotal thyroidectomy.
  • Post- thyrotoxic phase of sub acute thyroiditis.
  • Postpartum thyroiditis
  • In some neonates, trans-placental passage of TSH receptors-binding antibodies from the mother with Grave’s disease or auto-immune thyroid disease may cause transient hypothyroidism.

Symptoms of hypothyroidism

  • Fatigue
  • Weakness
  • Intolerance to cold
  • Bradycardia
  • Muscle aching and cramps
  • Constipation
  • Weight gain or difficulty loosing weight
  • Poor appetite
  • Goiter (enlarged thyroid gland) in some cases
  • Dry, rough skin
  • Coarse, dry, brittle hair or hair loss
  • Eye and face swelling
  • Deafness
  • Deeper and/or hoarse voice
  • Enlarged tongue
  • Irregular/heavy menstrual periods
  • Poor libido/ loss of libido
  • Depression
  • Psychosis
  • Coma
  • Memory loss/ poor memory
  • Slowed thinking and mental activity
  • Increased blood cholesterol levels
  • Symptoms of other autoimmune disease may be present

Diagnosis of thyroid disorders

  1. Blood tests are typically done to measure levels of thyroid hormones and TSH.
  2. Imaging tests (ultrasound) are commonly used when thyroid nodules or enlargement are present.
  3. Thyroid scans using radioactive iodine are often performed to evaluate the function of thyroid nodules.
  4. Fine needle aspiration and biopsy techniques are used to take a sample of cells or tissue from the thyroid gland for examination.

Treatment of thyroid disorders

The basic aim of treatment of thyroid disorders is to restore the hormone levels to their proper balance. These disorders can be treated both medically and surgically, according to the disease. Hyperthyroidism needs treatment that will slow down the making of thyroid hormone, while hypothyroidism needs hormone replacement.

Surgery can be used to remove a large goiter or a hyper-functioning nodule within the gland. Surgery is necessary when there is a possibility of thyroid cancer. If the thyroid gland is removed entirely, the individual will need to take synthetic thyroid hormone for life.

Drugs and surgery are usually effective ways to adjust hormone levels. Other treatments, including diet supplements and diet changes, herbal remedies, and special exercises including Yoga asanas, may relieve some of the discomfort and help the thyroid gland work better.

Yoga asanas for thyroid problems

 

(P.S. – Coming soon is the post regarding hyperthyroidism diet, hypothyroidism diet, and later yoga asanas and pranayam to control thyroid disorders. Till then be happy and stay healthy.)

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Comments

  1. Anil Kumar on August 11, 2018 at 1:09 pm said:

    Pls reple

  2. Pritam yadav on August 11, 2018 at 12:33 pm said:

    Very informative. Nice description.looking forward for the next part regarding treatment part

    • Anil Kumar on August 11, 2018 at 1:07 pm said:

      Tsh 15.7

      • Hi Anil.
        the TSH level is quiet high. I want to ask a few questions…. Do you have a family history of Thyroid and secondly have you started with any medicines yet.
        Anil ji hypothyroidism , as in ur case is mostly a lifestyle disease. It can easily be controlled with maintaining a proper lifestyle, that includes, proper diet, regular exercise, good sleep and most importantly learn to handle the daily stress in an effective manner.
        I’m working on a post for thyroid diet and exercises. It will be posted soon. Please do check it. Hope it helps you out. Take care

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