Thyroid Problems?
By Marcos Otero, Gulf Coast Immediate Care Center, Fort Walton Beach
What is the Thyroid? The thyroid is a butterfly shaped gland found in the neck below the Adam’s; apple wrapped around the trachea. The thyroid has two lobes and a thin section of thyroid connect the lobes. Iodine is used by the thyroid to produce hormones. These hormones regulate several metabolic processes in the body. Thyroids disorders affect the gland. The thyroid regulates numerous metabolic body processes.
What are thyroid disorders? The thyroid works via a feedback mechanism. It sends out thyroxin (T4), the primary hormone produced by the gland. Once delivered to the body it converts to triiodothyronine (T3), which is the most active hormone. 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. There are specific kinds of thyroid disorders that includes: hypothyroidism, hypothyroidism, goiter, thyroid nodules, and thyroid cancer. Thyroid disease is a common problem that can cause symptoms because of over- or under-function of the thyroid gland. We will discuss the most common; hypothyroidism, hyperthyroidism, and goiter.
Hypothyroidism – Hypothyroidism results from the thyroid gland producing an insufficient amount of thyroid hormone. It can develop from problems within the thyroid gland, pituitary gland, or hypothalamus. Symptoms of hypothyroidism can include:
- Fatigue
- Poor concentration or feeling mentally “foggy”
- Dry skin
- Constipation
- Feeling cold
- Fluid retention
- Muscle and joint aches
- Depression
- Prolonged or excessive menstrual bleeding in women
Some common causes of hypothyroidism include:
- Hashimoto’s thyroiditis (an autoimmune condition that causes inflammation of the thyroid gland)
- Thyroid hormone resistance
- Other types of thyroiditis (inflammation of the thyroid), such as acute thyroiditis and postpartum thyroiditis
Hyperthyroidism – Hyperthyroidism describes excessive production of thyroid hormone, a less common condition than hypothyroidism. Symptoms of hypothyroidism usually relate to increased metabolism. In mild cases, there may not be apparent symptoms. Symptoms and signs of hyperthyroidism can include:
- Tremor
- Nervousness
- Fast heart rate
- Fatigue
- Intolerance for heat
- Increase in bowel movements
- Increased sweating
- Concentration problems
- Unintentional weight loss
Some of the most common causes of hyperthyroidism are:
- Graves’ disease
- Toxic multinodular goiter
- Thyroid nodules that overexpress thyroid hormone (known as “hot” nodules)
- Excessive iodine consumption
Goiter – A goiter simply describes enlargement of the thyroid gland, regardless of cause. A goiter is not a specific disease per se. A goiter may be associated with hypothyroidism, hyperthyroidism, or normal thyroid function.
How are thyroid disorders diagnosed?
In addition to thorough medical history and physical exam, specialized tests are used to diagnose thyroid disorders.
Blood tests are typically done to measure levels of thyroid hormones and TSH. Blood tests to identify antibodies against thyroid tissue may also be ordered by your doctor, such as titers of anti-thyroglobulin, anti-thyroperoxidase, or TSH receptor stimulating antibodies.
What is the treatment for thyroid disorders? Thyroid disorders can be treated by medications or, in some cases, surgery. Treatment will depend on the particular disease of the thyroid.
Medications can be given to replace the missing thyroid hormone in hypothyroidism. Synthetic thyroid hormone is given in pill form by mouth. When hyperthyroidism is present, medications can be used to decrease production of thyroid hormone or prevent its release from the gland. Other medications can be given to help manage the symptoms of hyperthyroidism, such as increased heart rate. If hyperthyroidism is not controlled with medications, radioactive ablation can be performed. Ablation involves giving doses of iodine labeled with radioactivity that selectively destroys the thyroid tissue.
