Over 200 million people in the world have some form of thyroid disease which if left untreated can have a pronounced impact on the body as a whole. Some common complications such as increased cholesterol levels, heart diseases, infertility, muscle weaknesses and osteoporosis are often associated with untreated thyroid disorders. Therefore, it’s important to be aware and well-informed about the disorders of thyroid as their diagnosis is challenging. It is often based on vague symptoms and general clinical manifestations which may not be obvious for a person to seek any medical advice.
The Thyroid gland located in the neck produces two hormones, namely:
- Thyroxine (T4)
- Tri-iodothyroxine (T3).
These hormones play a crucial role in regulating the metabolism in all the cells of the body. Thyroid stimulating hormone (TSH) that is secreted from the pituitary gland in the brain, regulate the production of these hormones from the thyroid gland.
Disorders of the thyroid gland manifest in two forms:
- Hyperthyroidism – The condition is classified as hyperthyroidism when the serum Thyroxine (T4) levels have increased beyond the normal range.
- Hypothyroidism – The disease is known as ‘hypo’ when the serum Tri-iodothyroxine (T3) levels have decreased.
Hyperthyroidism is characterized by high levels of circulating thyroid hormones. It can occur due to thyroid gland over-activity on its own or due to causes other then over-activity of the gland. Some common symptoms of hyperthyroidism are weakness and fatigue, heat intolerance, nervousness, irritability, weight loss or gain, hair loss etc. Hypothyroidism on the other hand is characterized by decreased thyroid hormone synthesis with resulting low levels of thyroid hormones. In hypothyroidism, you may experience general fatigue, cold intolerance, loss of taste or smell, hoarseness, lack of sweating etc. Some common physical findings include thin and brittle nails, puffiness of face and eyelids, goiter, thickening of the tongue etc.
Gender and age primarily influence the prevalence and incidence of thyroid associated diseases. It’s more common in women than in men and in younger individuals than the older age groups. One should consider testing for problems associated with thyroid while taking certain medications or herbal products (both drugs and food).
AACE recommends getting your thyroid tested during the following years.
1) Birth through adolescence
2) Reproductive years
3) Menopausal age
4) Senior years during aging.
The basic management lies in the screening of thyroid during different stages of growth. One of the most sensitive tests is the thyroid-stimulating hormone test also known as TSH which clearly defines thyroid disease. It also allows for a precise calculation of a dose for thyroid replacement therapy. To assess the T3 and T4, radioimmunoassay is used to measure both bound and unbound hormone directly or indirectly.
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Medical management of thyroid disorders:
Management of hypothyroidism requires replacement of thyroid hormones. The most preferred way is therapy with L-thyroxine which is administered orally. Besides, drugs such as Beta-blockers, anti-thyroid drugs, treatment through radioiodine are also recommended as a line of treatment option for hyperthyroidism. The Beta-blocker group of drugs improve the symptoms and manifestations of the disease. However, a patient who has asthma or wheezing should avoid these drugs. Anti-thyroid drugs such as neomercazole and propylthiouracil help in regulating the production of thyroid hormones. To definitively treat thyroid over activity doctors may also prescribe a surgery to remove most or all of the thyroid gland.