Understanding Thyroid Disease
Words by Katherine Castillo Eustaquio
Published in Action & Fitness Magazine June 2010
Statistics around the world show that thyroid disease is more prevalent in women. In the Philippines, thyroid cancer is the most common type of cancer in women 15 to 24 years of age. As the number of thyroid cases continues to rise, more and more hospitals offer screenings and nonprofit organizations hold public awareness seminars about the disease.
Here are the things that you need to know:
What is thyroid and what does it do?
It is a small, butterfly-shaped gland located right below the Adam’s apple. It converts the iodine from food into two main hormones—triiodothyronine (T3) and thyroxine (T4)—that controls heart rate, body temperature, blood pressure, and the body’s metabolism.
In essence, each and every cell in the human body relies on these two hormones in order to function effectively. A healthy thyroid gland supplies the body with 20% T3 and 80% T4, with T3 four times more powerful than T4.
1. Goiter
It is an inflated thyroid gland that causes coughing, breathing and/or swallowing difficulties, and a tight sensation in the throat area. Iodine deficiency is one cause of goiters because the thyroid gland can’t produce enough hormones if the iodine supply is low. Other causes include thryroiditis, thyroid nodules, Graves’ disease, Hashimoto’s thyroiditis, and thyroid cancer.
2. Hyperthyroidism, or Overactive Thyroid
The leading cause of hyperthyroidism is Graves’ disease, an auto-immune disorder that attacks the immune system making it produce excess antibodies that fight infection. In turn, these antibodies make the thyroid gland produce more hormones, leading to an overactive thyroid. If hyperthyroidism remains untreated, it can lead to an abnormally fast heart rate and other complications.
Other causes of hyperthyroidism:
• Hyperactive lumps or nodules (tissue mass) in the thyroid gland
• Excessive medication for T3 and T4
• Thyroiditis (inflamed thyroid gland)
• Physical and emotional stress
• Hyperactive lumps or nodules (tissue mass) in the thyroid gland
• Excessive medication for T3 and T4
• Thyroiditis (inflamed thyroid gland)
• Physical and emotional stress
3. Hypothyroidism, or Underactive Thyroid
In this case, the thyroid gland fails to produce enough hormones to help the body function effectively. The leading case is another auto-immune disease called Hashimoto’s Thyroiditis, which is named after Dr. Hakaru Hashimoto who first diagnosed the condition in 1912. In this auto-immune disorder, the immune system fails to recognize the thyroid gland and attacks it, resulting in the thyroid glands underactivity.
Other causes of hypothyroidism:
- Thyroid removal due to benign tumors, cyst, overactivity, or excessive swelling
- Treatment for hyperthyroidism
- Inflammation of the thyroid gland
- Other surgeries that include goiter removal and/or other thyroid conditions, particularly the ones that make use of radioactive iodine therapy, which leaves the thyroid underactive for a long period of time because of damaged cells.
4. Thyroid Nodules
A thyroid nodule is an inflammation of a section in the thyroid gland that could be benign or malignant. While most thyroid nodules do not have symptoms, it is quite common especially for people who are 50 yeas old and above.
When thyroid nodules get big or hyperactive enough, they can get in the way of breathing and swallowing, while some cause the thyroid to produce excess hormones and lead to hyperthyroidism.
5. Thyroiditis
Simply put, this is a condition where the thyroid gland is inflamed. There are different kinds of thyroiditis:
- Hashimoto's thyroiditis
- Silent or painless thyroiditis – a person with this thyroid disorder experience hyperthyroidism and hypothyroidism simultaneously.
- Postpartum thyroiditis – common among women who recently gave birth, particularly those who have history of thyroid disorders and type 1 diabetes.
- Subacute thyroiditis – this may be due to an infection. It usually causes pain in the ear, jaw, and neck area.
6. Thyroid Cancer
People with thyroid nodules are advised to undergo a clinical test to see if the nodule is cancerous. Malignant thyroid nodules may cause swelling and lead to breathing and/or swallowing difficulties and worse conditions.
Top Symptoms of Thyroid Disorder
- Neck swelling and/or enlargement, hoarse voice
- Panic attacks, depression, anxiety
- Fatigue
- Unusual hair loss, brittle and dry hair.
- Dry, flaky skin
- Loss of hair in the upper part of the eyebrows
- Muscle cramps and joints pain, tendonitis
- Painful and heavy menstrual periods (hypothyroidism); short and intermittent cycles (hyperthyroidism)
- Long-term constipation (hypothyroidism) and/ or diarrhea (hyperthyroidism)
- High and low cholesterol levels that do not respond to medication or exercise
- Weight issues – inability to lose pounds and/or unexplained weight gain
How to Detect a Thyroid Disorder
The main reason why nearly half of thyroid disease cases remain undiagnosed is that its symptoms are similar to conditions. In the Philippines, thyroid disease scans are available for early detection, correct diagnosis, and proper treatment.
Here are some of the tests your doctors can do in order to help detect thyroid disorders:
Here are some of the tests your doctors can do in order to help detect thyroid disorders:
- Radioactive Iodine Uptake Test. This is done by swallowing a small dosage of radioactive iodine in capsule or liquid form. Since the thyroid gland uses iodine to produce the hormones, a probing tool determines how your thyroid gland reacts to the iodine whether it produces too much or too little thyroid hormones.
- Thyroid Scan. Makes use of the same radioactive iodine but in this test, a person is asked to lie on a table while a camera produces an image of his thyroid on the computer screen. This procedure can help detect malignant thyroid nodules.
- Thyroid Ultrasound. Sound waves are used to produce an image of your thyroid. This can help determine the size of a nodule.
- Thyroid Fine Needle Biopsy. This is a minor procedure wherein a very fine needle is inserted in the area to collect a small amount of fluid and cells. The sample is then examined by a pathologist to see if it contains abnormal cells.
- Blood Test. The level of thyroid stimulating hormone (TSH) in your blood can tell whether your thyroid gland is underactive or hyperactive.
How to Treat Thyroid Disorders
Depending on the kind of thyroid disorder you have, they can be treated using medication and surgery.
Goiter
Treatment: Radioactive iodine, potassium iodine solution, thyroid hormone supplements, surgery
Hyperthyroidism
Treatment: Radioiodine, anti-thyroid medicine (causes the thyroid gland to stop producing new hormones), surgery,
beta-blockers (medications that block the thyroid hormones’ effect on the body)
Hypothyroidism
Treatment: Medication that supply the body with thyroid hormones: levothyroxine and liothyronine
Thyroid Nodules
Treatment: Radioiodine, surgery, close observation
Thyroid Cancer
Treatment: Radioiodine, surgery
