Thyroid Problems: Hyperthyroidism & Hypothyroidism
Thyroid is a small gland situated in front of the neck that fits around the esophagus and windpipe and is quite visible when enlarged, especially during swallowing. It is an endocrine gland that produces thyroid hormones, the principal ones being triiodothyronine (T3) and thyroxine (T4). The thyroid gland is controlled by thyroid-stimulating hormone (TSH) produced by the pituitary gland. The thyroid hormones regulate cellular metabolism throughout the body.
Two thyroid related disorders, hyperthyroidism and hypothyroidism, are very common and can play havoc with your health, but timely treatment can be helpful. We will discuss them one by one.
This is a condition when the gland becomes over-active, and produces more thyroid hormones.
- Heat intolerance
Diagnosis of Hyperthyroidism:
Hyperthyroidism is diagnosed with tests that evaluate the blood levels of both the hormones the thyroid grand produces (T3 and T4) and hormones that control the thyroid like TSH. Your physician may also run a 24-hour radioiodine uptake test that finds out how much iodine your thyroid is using.
Causes of Hyperthyroidism:
- It is often associated with Graves’ disease which is an autoimmune disease.
- Formation of toxic diffuse goiter.
- Infection or inflammation of the thyroid gland.
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Treatments of Hyperthyroidism:
Possible treatments of hyperthyroidism include anti-thyroid drugs, radioactive iodine, and surgery. Anti-thyroid drugs halt or reduce thyroid activity by interrupting a step in hormone synthesis in the gland. Because the thyroid can store a large amount of already made hormone, it takes 6 to 8 weeks of drug therapy before blood hormone levels are reduced to normal. After several months some patients may go into remission and need no drugs for a long time. But relapses are common in hyperthyroidism. Some patients are given potassium iodine supplements in addition to the anti-thyroid drugs.
Radioactive iodine therapy is administered in order to destroy a proportion of or the entire thyroid gland. Radioactive iodine is selectively taken up by the gland and gradually destroys the cells of the gland. It is a safe procedure for most of the patients but can not be used for children or pregnant women. After radioactive iodine therapy the patient usually has an under-active thyroid, or hypothyroidism – and must take iodine or thyroid supplements.
Surgical removal of the thyroid gland is rarely used now and done only for patients who can not take anti-thyroid drugs or radioactive iodine.
In some cases, hyperthyroidism is treated by treating the cause of the over-activity rather than the gland itself. Hyperthyroidism symptoms can be treated with drugs called beta blockers that are most commonly used to treat heart problems or hypertension.
Decreased secretion of thyroid hormones is called hypothyroidism, which is a highly prevalent disorder. In hypothyroidism the symptoms are almost opposite.
- Slow heart rate
- Dry skin
- Hoarse voice, slowed speech
- Goiter (caused by swollen thyroid gland)
- Cold intolerance
- Weight gain
- Dry, scaly, thick, coarse hair
- Numbness in fingers or hands
- Confusion, depression, dementia
- Menstrual problems
- In children, slowed growth, delayed teething, and slow mental development
Diagnosis of Hypothyroidism:
Diagnosis is confirmed by doing estimation of thyroid hormone concentration (T3, T4, and TSH) in the blood. A low T3, T4 and high TSH confirm a diagnosis of hypothyroidism. At times in many thyroid diseases, an ultrasound and radioactive scan of the thyroid are required. Thyroid nodules occasionally require a fine needle aspiration biopsy. The procedure is safe and virtually painless.
Causes of Hypothyroidism:
- Shrunken and scarred thyroid gland with little ability to function normally.
- Congenital thyroid abnormalities.
- Iodine deficiency is the most common cause of hypothyroidism.
- Autoimmune disorders such as Hashimoto's thyroiditis.
- Therapy of hyperthyroidism.
Treatments of Hypothyroidism:
Treatment of hypothyroidism is simple as thyroxin tablets can be given my mouth daily morning in appropriate dosage. This is a replacement therapy, hence in correct dosage it is entirely devoid of side-effects. Most patients require doses of 50 – 150 microgram orally, which should be taken before breakfast. In most patients, it needs to continue throughout the life, but occasionally, the disease reverses, allowing discontinuation of the medication.
The most important preventive measure of hypothyroidism has been iodination of salt. It prevents goiter and hypothyroidism in iodine deficient areas. It has been one of the most effective preventive measures.