Overview
Thyroid disease occurs when the thyroid gland (a small, butterfly-shaped gland on the front of your neck) does not produce the correct amount of thyroid hormone. Or it occurs when an abnormal growth develops, giving rise to a nodule or lump. Thyroid hormones control how your body uses energy. If you feel fatigued, notice skin or hair changes, or have hoarseness or pain, your doctor may conduct a physical exam and order blood tests to assess thyroid function. If tests indicate a problem, your doctor may order a thyroid scan. Your doctor may find a lump or nodule in your thyroid. If so, they may use thyroid biopsy or ultrasound imaging to help assess your condition. Treatment will depend on the specific nature of your thyroid condition and its underlying cause.
The primary function of the thyroid gland is to release a hormone called thyroxine or T4, which is turned into a hormone called T3. Both hormones circulate in the bloodstream and help regulate your metabolism. The level of T4 produced by the thyroid gland is determined by a hormone produced by the pituitary gland called TSH or thyroid stimulating hormone. Depending on the levels of T4 in the body, the pituitary gland produces more or less TSH to encourage the thyroid gland to produce the proper amount of T4.
Facts
- Women are more likely than men to have thyroid issues.
- Stress and other factors can worsen thyroid disorders.
- It can occur in any age.
- Thyroid problems must be treated before – and during pregnancy.
- A lump or nodule in the thyroid does not means cancer.
Symptoms
If you have any of the following symptoms, see your doctor about getting your blood tested:
- Menstrual changes
- Chronic fatigue
- Unexplained weight gain and/or weight loss
- Excessive hair fall
- Palpitations or rapid heartbeat
- Enlarged thyroid gland leading to swelling of the neck (goiter)
- Sleep disorders
- Constipation
- Depression
- Reduced tolerance to cold
- Fertility problems in women of child-bearing age
- Nervousness and irritability
Sometimes we mistake thyroid symptoms for something else because its symptoms are similar to those of many other medical conditions. Some of the False conditions include:
- Polycystic ovarian disease (PCOD)
- Hypoglycemia
- Addison’s disease
- Anemia
- Cirrhosis
- Alzheimer’s disease
Lab Tests
Lab tests are a complete analysis of your whole body. Blood tests are done:
- To diagnose any kind of symptoms.
- To find out how well our organs are working.
- It can monitor chronic health conditions and diseases and find out problems in their early stages.
To Diagnose and monitor Thyroid some of the following tests are :
- Thyroid stimulating hormone (TSH)
- Thyroxine – T4 (Total)
- Thyroxine – T4 (Free)
- Triiodothyronine – T3 (Total)
- Triiodothyronine – T3 (Free)
- Anti thyroglobulin antibody
- Thyroxine binding globulin
- Anti Thyroperoxidase (Anti TPO)
Causes
Hypothyroidism
Hypothyroidism is a hormonal disorder where the thyroid gland does not produce sufficient quantities of thyroid hormone. Tsh and Free thyroxine concentrations are helpful in the diagnosis of Hypothyroidism. TSH levels are higher than the reference range while thyroxine levels are below the reference range.
The condition may be due to many factors
- Autoimmune diseases such as Hashimoto’s thyroiditis
- Iodine deficiency
- Medications such as lithium are helpful in treating certain psychiatric conditions
- Early radiotherapy of the neck
- Early radioiodine treatment is used to treat hyperthyroidism
- Pregnancy
- Pituitary gland damage
- Previous thyroid surgery
Hyperthyroidism
Primary hyperthyroidism, or thyrotoxicosis, happens when the disorder lies within the thyroid gland. It leads to producing large amounts of thyroxine.
It can be caused due to different conditions:- Graves’ disease
- Thyroid nodules
- Thyroiditis
- Iodine
Risk Factors
Hypothyroidism
You are at risk if :
- Older than 60 age
- Family history of thyroid disease
- Are a women
- An autoimmune disease
- Rheumatoid arthritis
- Type 1 or type 2 diabetes
- Down syndrome
- Thyroid surgery (partial thyroidectomy)
Hyperthyroidism
You are at risk if :
- Vitamin B12 deficiency
- Hypothyroidism that is overtreated (overdose of thyroxine medicine)
- Certain chronic illnesses, such as type 1 diabetes
- Older than 60 years
- Goiter
- Addison’s disease
- Pregnant or had a baby in the past 6 months
- High iodine intake
Diagnosis
One of the most definitive ways to diagnose a thyroid problem is through blood tests. Thyroid blood tests are used to tell if your thyroid gland is functioning properly by measuring the amount of thyroid hormones in your blood.
Thyroid Stimulating Hormone Test (TSH)
It is the most important and sensitive test to diagnose thyroid problems or disorders. This test measures TSH levels in the blood, which regulates the secretion of thyroid hormones (T3 and T4). It can also help doctors determine what dosage of medication is needed. A low TSH level in the blood means hyperthyroidism, and a high TSH level means hypothyroidism. TSH is a part of a thyroid profile, with other hormone tests produced by the thyroid gland. Another blood test is to be done if the TSH result is abnormal.
Triiodothyronine (T3)
Both free T3 and total T3 testing help us evaluate the thyroid gland. Free and Total T3 tests with TSH help us to diagnose thyroid disorders such as hypothyroidism (underactive) or hyperthyroidism (overactive), analyze the severity of thyroid problems, diagnose pituitary gland disorders, and monitor patients with known thyroid conditions. T3 testing may be used as a follow-up test if a patient has had an abnormal (TSH) test. A free or total T3 test is often part of a thyroid panel, a group of tests combined to evaluate thyroid health.
Thyroxine (T4)
Both free T4 and total T4 tests help us evaluate how well our thyroid gland works. This test follows an abnormal TSH test result and diagnoses hypothyroidism (underactive) and hyperthyroidism (overactive). It has been tested to monitor T4 levels in patients on thyroid replacement therapy.
Along with these three tests, further tests may also be ordered to evaluate and monitor the condition such as:
- Anti Thyroid Peroxidase Antibody (Anti TPO)
- Anti Thyroglobulin test
- Thyroxine binding globulin (TBG)
Treatments
Anti thyroid medications
Standard hypothyroidism treatment involves the daily use of the synthetic thyroid hormone levothyroxine (Levo-T, Synthroid, and others). This oral medication restores adequate hormone levels, reversing the signs and symptoms of hypothyroidism. You’ll likely start to feel better soon after you start treatment. The medication gradually lowers cholesterol levels elevated by the disease and may reverse any weight gain. Treatment with levothyroxine will likely be lifelong, but you may need to change the dosage. Your doctor will check your TSH level every three months and prescribe accordingly.
Thyroidectomy
It is a permanent treatment for the thyroid.
Removing your thyroid through surgery or destroying your thyroid through medication will cure hyperthyroidism. However, once your thyroid is removed or destroyed, you’ll need to take thyroid hormone replacement medications for the rest of your life.
Thyroidectomy is used to treat thyroid disorders such as cancer, a noncancerous enlargement of the thyroid (goiter), and overactive thyroid (hyperthyroidism).