What Is Thyroid


Thyroid is a butterfly shaped gland situated in, front part of neck below larynx i.e. the voice box. This gland makes thyroxine hormone T3 & T4 which control many of the organ’s function.

These two hormones are under control of TSH (Thyroid Stimulating hormone) which is secreted from pituitary gland in brain.

Values of T3 and T4 in Blood Clinical Interpretation
Normal Euthyroidism
Increased Hyperthyroidism ( Thyrotoxicosis)
Decreased Hypothyroidism


WHAT IS GOITER


Abnormal enlargement Of Thyroid gland is called Goiter. It is very common condition and need Endocrinologist opinion. Not all Goiters cause symptoms. Symptoms can range from visible swelling , Coughing throat tightness or trouble breathing just to name a few. A small goitre that doesn't cause symptoms may not need treatment. In some cases, medication and/or surgery is required.

HYPOTHYROIDISM ( UNDERACTIVE THYROID/ HASHIMOTOSDISEASE DISEASE)


Hypothyroidism occurs when your body doesn’t produce enough thyroid hormones. (LOW T3 AND T4 WITH HIGH TSH) . Usually causesd by Autoimmune reasons. It may accompanied by other Autoimmune disease like Vitiligo , Type 1 Diabetes Mellitus , Rheumatoid Arthritis.

The most common signs and symptoms of hypothyroidism include:

•  fatigue
•  depression
•  constipation
•  feeling cold
•  dry skin
•  weight gain
•  muscle weakness
•  decreased sweating
•  slowed heart rate
•  elevated blood cholesterol
•  pain and stiffness in your joints
•  dry, thinning hair
•  impaired memory
•  fertility difficulties or menstrual changes
•  muscle stiffness, aches, and tenderness
•  hoarseness
•  puffy, sensitive face


HOW DO I KNOW IF I HAVE HYPOTHYROIDISM


If you have above symptoms and signs visit Endocrinologist . She will examine you and advise you investigation based on your case. You may need to do Blood test, Ultrasound of Thyroid gland or other scan .



TREATMENT AND MEDICATION FOR HYPOTHYROIDISM


Hypothyroidism is best treated by using levothyroxine (Thyronorm , Eltroxin , Thyroid ). This synthetic version of the T4 hormone is designed to return adequate levels of thyroid hormone to your blood. Once hormone levels are restored, symptoms of the condition are likely to disappear or at least become much more manageable.
Once you start treatment, it takes several weeks before you begin feeling relief. You’ll require follow-up blood tests to monitor your progress. You and your doctor will work together to find a dose and a treatment plan that best addresses your symptoms. This can take some time.
In most cases, people with hypothyroidism must remain on this medication their entire lives. However, it’s unlikely you’ll continue to take the same dose. To make sure your medication is still working properly, your doctor should test your TSH levels yearly.
If blood levels indicate the medicine isn’t working as well as it should, your doctor will adjust the dose until a balance is achieved.

Hyperthyroidism ( overactive thyroid / Thyrotoxicosis / Graves Disease )



Hyperthyroidism occurs when the thyroid gland makes too much T4, T3, or both.

What causes hyperthyroidism?


Graves' disease (autoimmune disorder )excess
iodine, a key ingredient in T4 and T3
thyroiditis, or inflammation of the thyroid, which causes T4 and T3 to leak out of the gland
tumors of the ovaries or testes
benign tumors of the thyroid or pituitary gland
large amounts of tetraiodothyronine taken through dietary supplements or medication

What are the symptoms of hyperthyroidism?



High amounts of T4, T3, or both can cause an excessively high metabolic rate which causes



  • increased appetite

  • nervousness

  • restlessness

  • inability to concentrate

  • weakness

  • irregular heartbeat

  • difficulty sleeping

  • fine, brittle hair

  • itching

  • hair loss

  • nausea and vomiting

  • breast development in men

  • Visibly, the thyroid gland itself can swell into a goiter, which can be either symmetrical or one-sided. Your eyes may also appear quite prominent, which is a sign of exophthalmos, a condition that’s related to Graves’ disease.



    HOW DO I KNOW IF I HAVE HYPOTHYROIDISM


    If you have above symptoms and signs visit Endocrinologist . She will examine you and advise you investigation based on your case. You may need to do Blood test, Ultrasound of Thyroid gland or other scan .

    How to treat hyperthyroidism


    1. Medication

    Antithyroid medications, such as methimazole , carbimazole to stop the thyroid from making hormones. They are a common treatment.

    Also, beta-blockers such as propranolol can help control your rapid pulse, sweating, anxiety, and high blood pressure. Most people respond well to this treatment.

    Your doctor can tell you how much vitamin D and calcium to take each day. Learn more about the health benefits of vitamin D.

    2. Radioactive iodine

    It effectively destroys the cells that produce hormones.Common side effects include dry mouth, dry eyes, sore throat, and changes in taste. Precautions may need to be taken for a short time after treatment to prevent radiation spread to others.

    3. Surgery
    A section or all of your thyroid gland may be surgically removed. You will then have to take thyroid hormone supplements to prevent hypothyroidism, which occurs when you have an underactive thyroid that secretes too little hormone.



    THYROIDITIS


    It is one of the common cause of thyrotoxicosis. This is of three type as follows :

    Subacute Thyroiditis: In this condition there occurs inflammation i.e. swelling in thyroid gland due to viral infection. Symptoms are swelling in neck, pain in neck, throat pain, fever, along with symptoms & signs suggestive of Thyrotoxicosis. Tests required for proper diagnosis are thyroid test, ESR,thyroid antibody test & thyroid scan. With appropriate treatment it is cured permanently in two months.

    Silent Thyroiditis : In thyroiditis there occurs leakage of preformed thyroid hormone from thyroid gland in blood due to inflammation in thyroid gland. In silent thyroiditis etiology is idiopathic with symptom & signs of thyrotoxicosis but no pain or fever.with proper diagnosis & treatment it is cured easily

    Hashimoto Thyroiditis: In this condition there occurs swelling of thyroid due to deposition of inflammatory cells in the thyroid. Symptoms are thyroid enlargement i.e. goiter & symptoms of thyrotoxicosis.

    Thyrotoxicosis (Thyroid) during pregnancy we keep thyroid hormone under tight control by every six weekly thyroid test & dose adjustment accordingly