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Unpacking Thyroid Disease: Treatment Strategies for Optimal Management

Unravelling Thyroid Disease: Symptoms, Diagnosis, and Management Strategies


How do you understand thyroid disease and prevent it?

Your thyroid is a butterfly-shaped gland in your neck, just above your collarbone, and controls the rate of many activities. The activities include how fast you burn calories. The thyroid is one of your endocrine glands that makes hormones. Thyroid disease occurs when your thyroid makes too much or not enough of these vital hormones. There are several types of thyroid disease, including hyperthyroidism, hypothyroidism, thyroiditis, and Hashimoto's thyroiditis. If your thyroid does not work correctly, it can affect your entire body. 


You can get hyperthyroidism if your body develops excess thyroid hormones. Concurrently, you can experience hypothyroidism if your body produces inadequate thyroid hormones. Your endocrinologist will treat and correct the conditions.


Why Women are More prone to Thyroid Disease
Why Women are More Prone to Thyroid Disease

 

What is thyroid disease?

Thyroid disease is a general medical condition that keeps your thyroid from making the right amount of hormones. Your thyroid typically produces hormones that manage your functions accurately. When the thyroid produces too much thyroid hormone, your body uses energy too quickly. We call this hyperthyroidism. Using vitality or energy too quickly will do more than make you tired; it can make your heart beat faster, cause you to lose weight without trying, and even make you feel nervous. Your thyroid can produce too little thyroid hormone. We call this hypothyroidism. Too little thyroid hormone in your body can make you feel tired and gain excess weight, and you may not even be able to tolerate cold temperatures. It can also pass them on from generation to generation (inherited).

 

What does the thyroid do?

Your thyroid has a vital job within your body, releasing and controlling thyroid hormones that force metabolism. The body uses this energy throughout to keep many body systems working correctly. It takes in raw energy and uses it to power something bigger.


  • The thyroid controls metabolism with a few specific hormones, T4 and T3.
  • The thyroid creates these two hormones, and they share the message with the body cells about how much energy to use.
  • When your thyroid works accurately, it produces a precise amount of hormones to keep your metabolism working.
  • The thyroid produces replacement hormones as the hormones get depleted.
  • The pituitary gland supervises these activities.
  • The pituitary gland monitors and controls the number of thyroid hormones in your bloodstream.
  • The pituitary gland location is below the brain.
  • The pituitary gland tastes thyroid hormones or a high level of hormones in your body and may adjust the amounts with its hormones.
  • Thyroid-stimulating hormone, or TSH, is the name of the hormone.
  • It will send TSH to the thyroid, and it may share with the thyroid what it needs to do to get the body back to normal.

 

Who could be more affected by thyroid disease?

Thyroid disease can affect anyone: men, women, infants, and teenagers. It is a condition that can develop at birth or with age (typically hypothyroidism). Thyroid disease is prevalent, with about 18 million people in India having thyroid disorders. A woman is about five to eight times more likely to be diagnosed with a thyroid condition than a man.


Who is at high risk of developing thyroid disease?

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

  • If you have a history of thyroid illness in your family,
  • If you have a medical disease like pernicious anaemia, type 1 diabetes, primary adrenal insufficiency, lupus, rheumatoid arthritis, Sjogren syndrome, or Turner syndrome,
  • If you consume medicines that are high in iodine, such as amiodarone,
  • If you are older than 60, especially women,
  • If you have had treatment for a past thyroid condition or cancer, such as a thyroidectomy or radiation,

 

What causes a thyroid issue?

The two main types of thyroid disease are hypothyroidism and hyperthyroidism. As the thyroid gland works, other contaminants can cause both conditions.

Medical conditions that can cause hypothyroidism include:

  1. An inflammation (swelling) of the thyroid gland is called thyroiditis. It can lower the number of hormones your thyroid produces.
  2. Hashimoto's thyroiditis: a painless disease Hashimoto thyroiditis is an autoimmune condition where the cells attack and damage the thyroid. Hashimoto's thyroiditis is an inherited condition.
  3. Postpartum thyroiditis: This condition affects 5–9% of new mothers. It is usually a temporary condition.
  4. Iodine deficiency: We know the thyroid uses iodine to produce hormones. Iodine deficiency is an issue that affects several million people around the world.
  5. A non-functioning thyroid gland:
  6. The thyroid gland does not function properly at birth. If left untreated, the child could have both physical and mental issues in future. Doctors give all newborns a screening blood test in the hospital to check their thyroid function.

 

 

Medical conditions that can cause hyperthyroidism include:

Graves' disease: 

  1. In this disease, the entire thyroid gland is hyperactive. It generates an excessive number of hormones. We also know this condition as "diffuse toxic goitre" (enlarged thyroid gland).
  2. Nodules: nodules that are overactive in the thyroid can cause hyperthyroidism. A toxic multi-nodular goitre is a gland that has many nodules.
  3. Thyroiditis disorders can be painful or not felt at all. In thyroiditis, the thyroid releases hormones that accumulate there. Thyroiditis can last for a few weeks or months.
  4. Excessive iodine: When you have too much iodine in your body, the thyroid produces more hormones than it needs. We can find excessive iodine in some medications (amiodarone, a heart medication) and cough syrups.

 

What common symptoms can happen with thyroid disease?

There are a variety of symptoms you could experience if you have thyroid disease. Unfortunately, the acute symptoms of a thyroid condition are often very similar to those of other medical conditions and stages of life. It can be tough to know if your symptoms are related to a thyroid condition or something entirely different.

 

Most symptoms of thyroid disease fall into two groups: those linked to excess thyroid hormone and those shared with too little thyroid hormone (hypothyroidism).


Thyroid Issue Signs and Symptoms in Women
Thyroid Issue, Signs and Symptoms in Women

Symptoms of an overactive thyroid (hyperthyroidism) can include:

  1. Experiencing anxiety, irritability, and nervousness.
  2. Have trouble sleeping?
  3. Sudden loss of weight.
  4. Having a swollen thyroid gland or a goitre
  5. having muscle weakness or tremors
  6. having irregular menstrual periods
  7. Feeling conscious of the heat
  8. Have you had vision problems or eye inflammation?

Symptoms of an underactive thyroid (hypothyroidism) can include:

  1. Feeling tired (fatigue).
  2. Weight gain
  3. experiencing a blackout.
  4. Having frequent and heavy menstrual periods
  5. and having dry and raw hair.
  6. Having a harsh voice
  7. Having a cold intolerance

 

Can a thyroid problem make me lose my hair?

Hair loss is a symptom of thyroid disease, particularly hypothyroidism. If you experience hair loss, talk to your endocrinologist.

 

Can thyroid problems cause seizures?

In most cases, thyroid issues do not cause seizures. If you have untreated hypothyroidism, you may have a chance of having low serum sodium levels. This situation could lead to a stroke.

 

How is thyroid disease diagnosed?

Thyroid illness can be the hardest to identify since the symptoms are similar to those of other diseases. You may experience similar symptoms when pregnant.

Fortunately, several tests can help you identify whether your symptoms result from a thyroid problem.


These tests include:

  • Blood tests
  • Imaging tests
  • Physical exams 


Pathologists perform specific blood tests to understand your thyroid gland:

  • Thyroid-stimulating hormone (TSH)
  • T4 or thyroxine tests
  • FT4, free T4, or free thyroxine?
  • T3, or triiodothyronine,
  • FT3 (free triiodothyronine) or free T3 (free triiodothyronine)

These tests can diagnose thyroid illness, but your endocrinologist may perform new testing to evaluate a possible thyroid disorder.

 

Other blood tests might include

  • Thyroid antibodies
  • Calcitonin
  • Thyroglobulin


Talk to your endocrinologist about the ranges for these thyroid blood tests. They can answer several questions. Your healthcare provider might do an imaging test called a thyroid scan. Scanning allows your endocrinologist to look at your thyroid to check for enlarged size, shape, or growth (nodules). You may go for an imaging test called an ultrasound. An ultrasound usually takes between 20 and 30 minutes to complete. Your doctor may conduct a simple and bland physical investigation to check for thyroid growth or enlargement in the neck.

 

How does an endocrinologist treat thyroid disease?

Your endocrinologist aims to return your thyroid hormone levels to normal. An endocrinologist can do this, and the specific treatment will depend on the cause of your thyroid condition.

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

  • Antithyroid drugs are medications that stop your thyroid from making hormones.
  • Radiation damages thyroid cells and prevents them from producing thyroid hormones in high amounts.
  • Beta-blockers hardly change the number of hormones in your body, but they help control your symptoms.
  • Surgery is a more permanent form of treatment. Your surgeon may surgically remove your thyroid (thyroidectomy). Surgery will stop it from creating hormones. However, you can take thyroid replacement hormones for the rest of your life.

If you have low levels of thyroid hormones (hypothyroidism), the main treatment options are:

 

Thyroid replacement medication:

  • This drug offers synthetic thyroid hormones to add back into your body. The doctors use levothyroxine to treat it.


Are there different thyroid removal surgeries?

If your endocrinologist thinks you should remove your thyroid, there are a few options. Your doctor may remove the thyroid fully or partially. This action will depend on the severity of your condition. Thyroidectomy is the name of the surgery.

 

Surgeons perform thyroidectomy surgery in two ways:

  • With the help of an incision on the front of your neck.
  • With the incision in your armpit


The incision on the front of your neck is more of a traditional version of a thyroidectomy. This action allows your surgeon to go straight in and remove the thyroid. Most of the time, this might be your best option. You may need this medication if your thyroid is large or has a lot of larger nodules.


First, there is a variant of thyroid removal surgery where your surgeon makes an incision in your armpit and then creates a tunnel to your thyroid. They make this tunnel with a specific tool called an elevated retractor. It creates an opening that connects the incision in your armpit with your neck. The surgeon will use an electronic arm to move through the tunnel to get to the thyroid. Once there, it can remove the thyroid back through the tunnel and out of the incision in your armpit.

We often call this procedure "scarless" because the incision is under your armpit and out of sight. However, it is more complicated for the surgeon, and the tunnel is more invasive for you.

You may not be a candidate for this type of thyroid removal if you:

 

You are not at a healthy body weight.

  •  Thyroid nodules.
  •  Graves’ disease.

You can discuss this with your endocrinologist or surgeon. 

 

How long does it take to recover from a thyroidectomy?

It will take a few weeks to recover after your thyroidectomy.

During this time, avoid a few things, including:

  • Submerge your incision underwater.
  • It is not advisable to lift an object weighing more than 30 kg.
  • Perform more than light exercise.

This action lasts for about two weeks. After that, you can return to your normal activities.

 

How long after I remove my thyroid issue will my tiredness go away?

Your surgeon will provide medication to help with your symptoms right after surgery. The hormones can still be in your body for two to three weeks. Medication will reintroduce new hormones into your body after thyroid removal. It takes time for your body to heal. You can talk to your endocrinologist if you are still experiencing fatigue and other symptoms after surgery.

 

Can I stop taking medications after having a piece of my thyroid removed during surgery?

Sometimes, your surgeon may remove part of your thyroid and leave the other portion so that it can continue to create and release thyroid hormones. This action is most likely necessary in situations where you have a nodule causing your thyroid problem. In about 75% of patients, only one side of the thyroid removed can make enough thyroid hormone after surgery without hormone replacement therapy.

 

Can I check my thyroid at home?

You can do an active and easy self-exam of your thyroid at home. The only tools you need to do this self-exam are a mirror and a glass of water.


To do the thyroid self-exam, follow these steps:

  • Locate your thyroid by identifying its location. You will find the thyroid on the front of your neck, between your collarbone and Adam’s apple. Adam's apple is much more visible in men. For women, it is usually easiest to look from the collarbone up.
  • Edge your head back while looking in a mirror. Look at your neck and try to make it sharp in the space you will look at once you start the exam.
  • Once you are ready, drink water while tilting your head back. Watch your thyroid as you drink. During this test, you are looking for lumps or bumps. You may see them when you drink the water.


Can I live a routine life with thyroid disease?

Thyroid disease is often a lifelong medical condition. This disease often involves daily medication. Your healthcare provider will monitor your treatment and make adjustments. However, you can usually live a healthy work-life with thyroid disease.

 


 

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