Your thyroid creates and produces hormones that play a role in many different systems throughout your body. When your thyroid makes either too much or too little of these important hormones, it’s called a thyroid disease.
Your thyroid has an important job to do within your body — releasing and controlling thyroid hormones that control metabolism. Metabolism is a process where the food you take into your body is transformed into energy. This energy is used throughout your entire body to keep many of your body’s systems working correctly.
The thyroid controls your metabolism with a few specific hormones — T4 (thyroxine, contains four iodide atoms) and T3 (triiodothyronine, contains three iodide atoms). These two hormones are created by the thyroid and they tell the body’s cells how much energy to use. When your thyroid works properly, it will maintain the right amount of hormones to keep your metabolism working at the right rate. As the hormones are used, the thyroid creates replacements.
Common Thyroid Problems
The thyroid gland is prone to several very distinct problems, some of which are extremely common. These problems can be broken down into
- Those concerning the production of hormone (too much, or too little),
- Those due to increased growth of the thyroid, causing compression of important neck structures or simply appearing as a mass in the neck,
- The formation of nodules or lumps within the thyroid which are worrisome for the presence of thyroid cancer, and
- Those which are cancerous.
- Goiters: A thyroid goiter is a significantly enlarged thyroid gland that is usually noticed as a bump on the neck. Goiters are often removed for cosmetic reasons as well as to prevent the growth from causes problems such as compressing vital structures of the neck including the trachea and the esophagus. when a goiter grows inward, it may cause a sense of pressure or make it difficult and uncomfortable to breathe and even to swallow. Sometimes thyroid goiters will actually grow into the chest where they can cause trouble as well. Several x-rays will help uncover the cause of any goiter.
- Thyroid Cancer: Thyroid cancer is a fairly common malignancy, however, the vast majority have excellent long term survival.
- Solitary Thyroid Nodules: There are several characteristics of solitary nodules of the thyroid which make them suspicious for malignancy. Although as many as 50% of the population will have a nodule somewhere in their thyroid, the overwhelming majority of these are benign. Occasionally, thyroid nodules can take on characteristics of malignancy and require either a needle biopsy or surgical excision.
- Hyperthyroidism : Hyperthyroidism means too much thyroid hormone. Current methods used for treating a hyperthyroid patient are radioactive iodine, anti-thyroid drugs, or surgery. Each method has advantages and disadvantages and is selected for individual patients. Many times the situation will suggest that all three methods are appropriate, while other circumstances will dictate a single best therapeutic option. Surgery is the least common treatment selected for hyperthyroidism.
- Hypothyroidism: Hypothyroidism means too little thyroid hormone and is a common problem. In fact, hypothyroidism is often present for a number of years before it is recognized and treated. Hypothyroidism can even be associated with pregnancy. Treatment for all types of hypothyroidism is usually straightforward.
- Thyroiditis : Thyroiditis is an inflammatory process ongoing within the thyroid gland. Thyroiditis can present with a number of symptoms such as fever and pain, but it can also present as subtle findings of hypo or hyperthyroidism. There are a number of causes, some more common than others.
Causes of Thyroid Disease
The two main types of thyroid disease are hypothyroidism and hyperthyroidism. Both conditions can be caused by other diseases that impact the way the thyroid gland works.
Conditions that can cause hypothyroidism include:
- Thyroiditis: This condition is an inflammation (swelling) of the thyroid gland. Thyroiditis can lower the amount of hormones your thyroid produces.
- Hashimoto’s thyroiditis: A painless disease, Hashimoto’s thyroiditis is an autoimmune condition where the body’s cells attack and damage the thyroid. This is an inherited condition.
- Postpartum thyroiditis: This condition occurs in 5% to 9% of women after childbirth. It’s usually a temporary condition.
- Iodine deficiency: Iodine is used by the thyroid to produce hormones. An iodine deficiency is an issue that affects several million people around the world..
- A non-functioning thyroid gland: Sometimes, the thyroid gland doesn’t work correctly from birth. This affects about 1 in 4,000 newborns. If left untreated, the child could have both physical and mental issues in the future. All newborns are given a screening blood test in the hospital to check their thyroid function.
Conditions that can cause hyperthyroidism include:
- Graves’ disease: In this condition the entire thyroid gland might be overactive and produce too much hormone. This problem is also called diffuse toxic goiter (enlarged thyroid gland).
- Nodules: Hyperthyroidism can be caused by nodules that are overactive within the thyroid. A single nodule is called toxic autonomously functioning thyroid nodule, while a gland with several nodules is called a toxic multi-nodular goiter.
- Thyroiditis: This disorder can be either painful or not felt at all. In thyroiditis, the thyroid releases hormones that were stored there. This can last for a few weeks or months.
- Excessive iodine: When you have too much iodine (the mineral that is used to make thyroid hormones) in your body, the thyroid makes more thyroid hormones than it needs. Excessive iodine can be found in some medications (amiodarone, a heart medication) and cough syrups.
Common Symptoms of Thyroid Disease
Symptoms of an overactive thyroid (hyperthyroidism) can include:
- Experiencing anxiety, irritability and nervousness.
- Trouble sleeping.
- Losing weight.
- Enlarged thyroid gland or a goiter.
- Muscle weakness and tremors.
- Irregular menstrual periods or Cessation of menstrual cycle.
- Feeling sensitive to heat.
- Vision problems or eye irritation.
Symptoms of an underactive thyroid (hypothyroidism) can include:
- Fatigue or feeling tired.
- weight gain.
- Episodes of frequent and heavy menstrual periods.
- Dry and coarse hair.
- Hoarse voice.
- Intolerance to cold temperatures.
Diagnosis of Thyroid Disease
Sometimes, thyroid disease can be difficult to diagnose because the symptoms are easily confused with those of other conditions. You may experience similar symptoms when you are pregnant or aging and you would when developing a thyroid disease. Fortunately, there are tests that can help determine if your symptoms are being caused by a thyroid issue. These tests include:
- Blood tests.
- Imaging tests.
- Physical exams.
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.
In many cases, taking a look at the thyroid itself can answer a lot of questions. Your healthcare provider might do an imaging test called a thyroid scan. This allows your provider to look at your thyroid to check for an increased size, shape or growths (nodules).
Your provider could also use an imaging test called an Ultrasound.
Another way to quickly check the thyroid is with a physical exam in your healthcare provider’s office. This is a very simple and painless test where your provider feels your neck for any growths or enlargement of the thyroid.
Treatment of Thyroid Disease
Your healthcare provider’s goal at our clinic in Dubai is to return your thyroid hormone levels to normal. This can be done in a variety of ways and each specific treatment will depend on the cause of your thyroid condition.
If you have high levels of thyroid hormones (hyperthyroidism), treatment options can include:
- Anti-thyroid drugs (methimazole and propylthioracil): These are medications that stop your thyroid from making hormones.
- Radioactive iodine: This treatment damages the cells of your thyroid, preventing it from making high levels of thyroid hormones.
- Beta blockers: These medications don’t change the amount of hormones in your body, but they help control your symptoms.
- Surgery: A more permanent form of treatment, your healthcare provider may surgically remove your thyroid (thyroidectomy). This will stop it from creating hormones. However, you will need to take thyroid replacement hormones for the rest of your life.
If you have low levels of thyroid hormones (hypothyroidism), the main treatment option is:
- Thyroid replacement medication: This drug is a synthetic (man-made) way to add thyroid hormones back into your body. One drug that’s commonly used is called levothyroxine. By using a medication, you can control thyroid disease and live a normal life.
Thyroid Removal Surgeries
If your healthcare provider, Dr. Majid Bassuni determines that your thyroid needs to be removed, there are a couple of ways that can be done. Your thyroid may need to be completely removed or just partially. This will depend on the severity of your condition. Also, if your thyroid is very big (enlarged) or has a lot of growths on it, that could prevent you from being eligible for some types of surgery.
The surgery to remove your thyroid is called a thyroidectomy. There are two main ways this surgery can be done:
- With an incision on the front of your neck.
- With an incision in your armpit.
Talk to your about all of your treatment options and the best type of surgery for you.
How long does it take to recover from thyroid surgery (thyroidectomy)?
It will take your body a few weeks to recover after your thyroid is surgically removed (thyroidectomy). During this time you should avoid a few things, including:
- Submerging your incision under water.
- Lifting an object that’s heavier than 15 pounds.
- Doing more than light exercise.
This generally lasts for about two weeks. After that, you can return to your normal activities as per your doctors advise.
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