Thyroid Disease Symptoms,Causes, Diagnosis,Treatments

Thyroid Disease

 

Thyroid disease is a group of disorders that affects the thyroid gland. The thyroid is a small butterfly-shaped gland, located at the front in the base of your neck that makes thyroid hormones.

Thyroid hormones regulate numerous functions of the body including

  • Breathing
  • Heart rate
  • Body temperature
  • Central nervous system developments, and
  • Body growth.




 

Thyroid Disease Symptoms

Types Of Thyroid Disease 

1. Hyperthyroidism

 

When the thyroid produces too many thyroid hormones.

Which causes a series of symptoms such as

  • Nervousness,
  • Anxiety,
  • Hyperactivity,
  • Weight loss,
  • Rapid or irregular heartbeat.

There are many possible causes, the most common being Basedow-Graves disease, an autoimmune disease that can strike at any age.

 

2. Hypothyroidism

 

If the thyroid does not produce enough thyroid hormones. In the early stages, hypothyroidism rarely causes disturbances. But, over time, if left untreated, it can cause a number of health problems, such as obesity, joint pain, infertility, and heart disease.

Both men and women may suffer, although it is more common among women, especially over 60 years of age.

If it affects the fetus, usually due to defects in thyroid development, it causes severe mental retardation and growth.

 

3. Nodules

 

It is solid or liquid formations that form inside the gland itself and that are the most frequent thyroid disease. They are almost always benign formations and in only 0.3% of the cases, they have characteristics of malignancy (thyroid tumors).

In most cases, they are not serious and do not cause problems (symptoms). So it is often discovered that they are completely random.

 

4. Goiter

 

Goiter means an increase in thyroid volume. The size of the goiter can be variable: in most cases, it is small and does not cause any symptoms but, if the volume of the thyroid gland increases significantly, breathing and swallowing disorders may occur.

 

There are two main types of goiter:

 

  1. Diffuse goiter: The entire thyroid is increased in volume and its surface is smooth when palpated.
  2. Nodular goiter: Solid nodules develop, or full of liquid inside the thyroid gland, making the surface irregular to palpation.

 

5. Thyroid Cancer

 

Rare are the cases of thyroid tumors, due to the abnormal growth of a group of cells, and can be either benign or malignant.

A thyroid nodule is not necessarily a tumor. Only about 1 in 20 is a tumor. Furthermore, thyroid tumors are slow-growing and not very aggressive, so much so that they often remain silent without showing signs for life.

 

5. Thyroiditis

 

When an inflammation process occurs in the thyroid that can cause abnormal (high or low) levels of thyroid hormones in the blood.

 

The origin of thyroiditis can be varied depending on the type:

  • Autoimmune origin (Hashimoto).
  • Viral origin (De Quervain thyroiditis).
  • Bacterial origin (acute thyroiditis).

 

According to current estimates, women are much more prone to thyroid diseases than men.


 

Symptoms Of Thyroid Disease

 

The symptoms that indicate a thyroid problem may be different.

 

In adults hypothyroidism rarely causes symptoms in the early stages of the disease but, if left untreated, it can cause various health problems over time.

Furthermore, the symptoms tend to develop slowly and, therefore, it is more difficult to recognize them. They include:

 

  • Fatigue
  • Increased sensitivity to cold
  • Constipation
  • Dry skin
  • Weight gain
  • Swollen face
  • hoarseness (lowering of the voice)
  • Muscle weakness and pain
  • Stiffness, swelling or pain in the joints
  • High blood cholesterol levels
  • Irregular menstrual cycle
  • Hair loss
  • Slowing of the heartbeat
  • Depression
  • Memory alterations

 




If hypothyroidism occurs in the fetus and/or the child in the first years of life, it causes a serious delay in the growth and development of the central nervous system.

 

In hyperthyroidism  the most frequent symptoms are:

 

  • Nervousness and anxiety
  • Hyperactivity, that is, the inability to a standstill
  • Unexplained weight loss despite increased appetite
  • Rapid or irregular heartbeat
  • Visible swelling of the thyroid gland
  • Menstrual irregularity
  • Sleep disorders

It is unlikely, however, that they all manifest together.

 

If the cause of hyperthyroidism is Basedow-Graves’ disease, these symptoms can be associated with others that affect the eyes such as:

 

  • Bulging eyes
  • Burning, redness, and swelling of the eyes
  • Excessive tearing, blurred or double vision
  • Sensitivity to light

 

In the case of goiter or nodules, there are usually no complaints. However, in more severe cases, the volume of goiter or nodules can be so large that it bothers breathing and swallowing.

In some cases, thyroid nodules also begin to produce thyroid hormone thereby causing the typical symptoms of hyperthyroidism.

 

Even with regard to thyroid cancer, the symptoms are minimal: the most common is a painless lump or a swelling that develops in the neck. Others tend to occur only when the disease has reached an advanced stage and may consist of unexplained hoarseness that lasts a few weeks, a sore throat or difficulty swallowing.

 

Causes Of Thyroid Disease

 

The causes that cause thyroid problems vary depending on the disorder that has occurred. However, there are some common factors that can increase the risk of developing thyroid malfunction.

 

Some of which are:

 

  • Women are more likely than men to develop thyroid dysfunction
  • The age over 50 increases the risk
  • Family or personal background: the risk increases if you have thyroid problems during pregnancy, or if some family members have suffered from it.
  • Smokers, or former smokers, have a higher risk of developing autoimmune thyroid dysfunction
  • Taking some medications or special treatments
  • If there is not enough iodine in the diet or, on the contrary, if you use excessive iodine or natural supplements.

In addition to these general causes, there are others specific to each disorder.

 

Diagnosis Of Thyroid Disease

 




When you feel the disorders related to the malfunction of the thyroid it is advisable to consult the doctor who, after a visit, will evaluate whether to prescribe some follow-up examinations.

 

Thyroid test

The tests available to ascertain (diagnose) a thyroid disorder are:

 

Blood tests

It assesses the levels of circulating thyroid hormones. Normally it is required to detect the value of the thyroid-stimulating hormone ( TSH ) and thyroxine (T4).

Sometimes triiodothyronine (T3) also measure. High levels of T4 and low, or non-existent amounts of TSH indicate a thyroid that produces too much hormone, therefore hyperthyroidism. In contrast, low levels of T4 and high TSH are indices of hypothyroidism.

You can also measure blood levels of antibodies against thyroid peroxidase (TPO) index of autoimmune thyroiditis (Hashimoto)

Ultrasound

Ultrasound examines the structure and size of the thyroid, therefore, it can highlight the presence of nodules within the gland and distinguish cysts (liquid) from solid nodules

 

Fine-needle aspiration and biopsy

Help to distinguish between benign and malignant thyroid nodules. The needle aspiration is performed using a thin needle to take, under the guidance of an ultrasound, the tissue to be examined.

They use to determine if cancerous cells are present in the thyroid and, possibly, to define which type they belong to.

 

Scintigraphy

Can provide useful information on the structure and function of the thyroid. The examination consists of introducing a small amount of radioactive iodine into a vein. Iodine accumulates in the thyroid which can, therefore, be studied using a special machine.

With this test, we can distinguish hot nodules (which produce an excess of hormone and are almost always non-cancerous) and cold nodules (which do not produce hormones but can be cancerous).

 

Treatments Of Thyroid Disease

 

Treatment for thyroid disease depends on the disorder that presents itself.

 

Hypothyroidism Treatments

 

The standard therapy for hypothyroidism is usually simple, safe and effective and involves the daily intake, by mouth, of the synthetic T4 thyroid hormone (levothyroxine).

It is important to find the right dosage.

This drug brings the hormone level back to normal, reversing the signs and disorders (symptoms) of hypothyroidism.

 



Levothyroxine is usually available in the form of tablets to be taken by mouth, on a completely empty stomach (for this reason it is advisable to take them in the morning).

It is essential to wait at least 30 minutes before having breakfast to prevent the food from affecting the absorption of the hormone.

 

The side effects of levothyroxine usually occur when an overdose has been taken and can be:

 

  • Irregular heartbeat
  • Muscle cramps
  • He retched
  • Diarrhea
  • Weight loss
  • Sleep problems
  • Headache
  • Sweating
  • This drug should be taken for life.




 

Hyperthyroidism Treatments

 

The cure in case of hyperthyroidism depends on the age, physical condition, cause and severity of the disease:

 

Radioactive iodine

It is a form of radiotherapy used to treat most cases of an overactive thyroid. The radioactivity dose of radioactive iodine is very low and is not harmful. Taken by mouth, iodine absorbs by the thyroid and, being radioactive, causes it to shrink and slow down the production of thyroid hormone.

The symptoms of hyperthyroidism subside within about three to six months. The risk of this therapy is that the production of thyroid hormone becomes too low causing hypothyroidism.

Anti-thyroid drugs (thionamides)

Gradually reduce the symptoms of hyperthyroidism by preventing the thyroid from producing too much hormone. Symptoms usually begin to improve six to twelve weeks after starting therapy. Treatment generally continues with lower doses for at least a year.



In some cases, this therapy resolves the problem definitively, in others a relapse can occur. However, these drugs can cause severe liver damage, so they are used with caution and regular checks

Beta-blockers

Drugs commonly used to treat hypertension. They do not reduce thyroid hormone levels, but they can limit cardiac symptoms ( rapid or irregular heartbeat ) by controlling the frequency of its heartbeat. Beta-blockers, not prescribed in cases of asthma, can cause some side effects, including feeling tired, cold hands and feet and difficulty sleeping

Surgery

Surgery (thyroidectomy) is used when other treatments are not possible, for example in the state of pregnancy, in the presence of a large goiter, for recurrence following treatment with anti-thyroid drugs or in the case of ocular disorders for Basedow-Graves disease.

With surgery, all or most of the thyroid is removed. The risk can be damage to the vocal cords or parathyroids, glands that help control calcium levels in the body. Furthermore, following the operation, it will be necessary to take synthetic thyroid hormone for life.

Most people respond well to care.

 

Goiter Treatments

 

The goiter therapy depends on its size, the disorders it causes and the causes. Small goiters that are not obvious and do not cause problems usually do not need treatment.

If the goiter is associated with hypothyroidism or hyperthyroidism, it is used for its treatment.

If the goiter interferes with breathing or swallowing and has not improved with other treatments, surgery may be required to remove part or all of the thyroid (thyroidectomy).

 

Thyroid Nodules Treatments

 

Treatment of nodules depends on the diagnosis. If a thyroid nodule is not carcinogenic, there are several treatment options.

A benign thyroid nodule keeps under control with tests for thyroid function and annual ultrasound. If it remains unchanged, no cure may be necessary.

 

Percutaneous alcoholization with ethanol is the first-line treatment of recurrent benign thyroid cysts.

Thermoablative treatment

In the event that symptoms are present in patients with solid or mixed nodules, benign but progressively increasing in size. A thermoablative treatment can be used to reduce local growth and symptoms.

This treatment consists of the “burning” of the tissue, obtained using an energy source to burn the thyroid nodule. The heat that is obtained inside the nodule (it reaches temperatures of around 100 ° C) causes destruction of the thyroid tissue which will be replaced over time by scar tissue, resulting in a considerable reduction in the size of the thyroid nodule.

 

Levothyroxine

A therapy with the synthetic thyroid hormone (levothyroxine) that will induce the pituitary gland to produce less TSH , a hormone that stimulates the growth of the thyroid tissue, thus counteracting the growth of the nodule, may also be prescribed , although the recent guidelines do not recommend the suppressive treatment with levothyroxine (LT4) in euthyroid patients. In iodine-deficient geographical areas, iodine supplementation may be useful and non-TSH-suppressive treatment with LT4 may be attempted in young patients with a small nodular goiter.

 

From time to time a lump, although benign, may require surgery, especially if it is so large that it is difficult to breathe or swallow.



In some cases, thyroid nodules also produce thyroxine. In this case, they are treated with therapies for hyperthyroidism, in particular with radioactive iodine, anti-thyroid drugs (thionamides) or with surgery, when other treatments are not possible.

 

Thyroidectomy Surgery

If a thyroid nodule is malignant, surgery (thyroidectomy) is normally used to eliminate all or most of the thyroid.

 

Finally, the recommended therapy for treating thyroid cancer is surgery (thyroidectomy) with the removal, generally, of the entire thyroid. After surgery, therefore, it is necessary to take the synthetic thyroid hormone (levothyroxine).

In the case of follicular or papillary carcinomas with the risk of metastasis, treatment with radioactive iodine also uses. This substance helps destroy any remaining cancer cells and prevent the recurrence of the tumor. Residual thyroid cells absorb radioactive iodine and the emitted radiation destroys them.

 

Thyroiditis Treatments

 

As far as thyroiditis is concerned, the therapy differs according to the type of inflammation.

For Hashimoto’s thyroiditis, the treatment based on thyroid hormone (levothyroxine) use which is usually prescribed for life.

Some thyroiditis cause pain that can treat with corticosteroid medicines. If, on the other hand, the origin of thyroiditis is infectious, the antibiotic is sufficient to resolve it.



 

Sources: 

  1. https://www.womenshealth.gov/a-z-topics/thyroid-disease
  2. https://www.niddk.nih.gov/health-information/diagnostic-tests/thyroid
  3. https://www.cancer.org/cancer/thyroid-cancer/detection-diagnosis-staging/how-diagnosed.html
  4. https://www.ncbi.nlm.nih.gov/books/NBK221541/

 


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Symptoms Of Thyroid Disease
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Symptoms Of Thyroid Disease
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The symptoms that indicate a thyroid problem may be different. In adults hypothyroidism rarely causes symptoms in the early stages of the disease but, if left untreated, it can cause various health problems over time. Furthermore, the symptoms tend to develop slowly and, therefore, it is more difficult to recognize them
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