Thyroid Diseases – types, symptoms, causes, diagnosis and treatment

The thyroid gland undoubtedly stands to be one of the most important glands of the human endocrine system. It secretes hormones that regulates metabolism and other important functions of the body and hence initiates growth and development of the same.

The thyroid gland produces two important hormones, namely, the thyroxine (T4) and the triiodothyronine (T3). Of these two hormones the T3 hormone is considered to be more crucial in maintaining the metabolism and other bodily functions. When released in the systems a large part of the T4 hormone is converted in to T3 hormone, which is a normal function of the system.

How does the thyroid gland work?

Present in the lower part of your neck, thyroid is one of the largest glands of the endocrine system. A lot of people may not have heard about the gland, and even fewer would know that it is the gland responsible for your body’s growth and development. Here are 10 facts about the gland that you should know.

1. The hormones secreted by the thyroid gland are responsible for a lot of things; the way in which you metabolize food, use energy, your sleep patterns, your temperature preferences, whether you gain or lose weight, etc. Some of the main hormones released by the gland are triiodothyronine and thyroxine also called T3 and T4.
2. Hyperthyroidism refers to an increase in production of hormones by the gland. Some of the symptoms that could signal hyperthyroidism are weight loss despite a good appetite, enlargement in your neck, an increase in heart rate, shorter menstrual periods, high blood pressure, increased sweating, frequent bowel movements, nervousness and trembling hands.
3. Hypothyroidism refers to a decrease in production of hormones by the gland. Some of the symptoms that could signal hypothyroidism are weight gain or failure to lose weight despite a proper weight loss regime, enlargement in the neck, reduced heart rate, increased cold sensitivity, lethargy, numbness in hands, dry skin and hair, heavy menstrual periods and constipation. 
4. For hypothyroidism, your doctor might prescribe you thyroid hormone pills which you’ll need to take for life. For hyperthyroidism, you may be prescribed anti-thyroid medications and/or radioactive iodine. You doctor may also prescribe drugs to reduce symptoms like increased heart rate and tremors.
5. A lump in the neck with pain and swollen lymph nodes, trouble in breathing and swallowing, hoarse voice are some of the symptoms that could signal thyroid cancer. In such cases, surgery is performed to remove the thyroid gland or a part of it along with radioactive iodine therapy. (Read: Thyroid – facts you need to know)
6. The factors that put you at an increased risk of thyroid disease are: family history of thyroid disease, type I diabetes, age, stress, thyroid surgery performed previously and Down’s or Turner’s syndrome. Women are more susceptible to thyroid problems than men especially during delivery and menopause, which are periods when there is a hormonal flux. 
7. Thyroid is diagnosed by tests like Thyroid profile which measure your Thyroid stimulating hormone or TSH. High TSH levels indicate hypothyroidism, and low TSH levels indicate hyperthyroidism.
8. After the age of 35, you should ideally get screened for thyroid dysfunction once every five years. If you exhibit any of the symptoms or risk factors mentioned above, then you should get yourself screened more often. 
9. If you are diagnosed with thyroid disease, it is important that you take it seriously and follow whatever instructions the doctor gives you. If left untreated, thyroid problems can lead to stroke, heart disease, infertility, Alzheimer’s and ultimately death. 
10. In order to keep your thyroid gland in mint condition, eat foods rich in nutrients like Iodine and Selenium. You can do so by eating iodized salt and seafood. Vegetarians can add spinach, garlic and sesame seeds in their diet instead. Foods like fish, meat, mushrooms, sunflower seeds and soybeans can fulfil your selenium requirement.

What is thyroid disease?

If the above mentioned equilibrium is disturbed due to any reasons resulting in increased or decreased production of thyroid hormone, it causes various thyroid diseases. In addition, structural abnormalities in the gland. 

Types and causes of thyroid disease:

Since the thyroid hormones play an important part in metabolism and growth it is necessary that an optimal amount of the hormones circulate within the human system for proper functioning and nourishment. But if there is a slight increase or decrease in the levels of the hormones in the system it could lead to a medical condition that might need attention.

If there is an excess amount of thyroid hormone produced it could lead to a condition called ad hyperthyroidism and a deficit of these hormones can give rise to a condition called as hypothyroidism.

The thyroid gland also produces another hormone called the calcitonin. This hormone regulates calcium by lowering calcium levels in the blood. Excess of calcium could again give rise to another condition called hypercalcemia.

Hypothyroidism: This condition is denoted by a dip in the thyroid hormones in the blood. It happens if one has an underactive thyroid or the glands that control the thyroid malfunctions, though there are other causes also that can lead to this condition. It is usually noticed that hypothyroidism affects women more than men and gets worse as one ages. Some of the causes that could lead to a low level of thyroid hormone in the system and give rise to hypothyroidism are:

• Hashimoto’s disease: An auto immune disease that attacks the tissues of the thyroid gland.
• Thyroiditis: Inflammation of the thyroid gland that can result in less production of the hormone. 
• Radioactive treatment for hyperthyroidism: If one is treated for hyperthyroidism with radioactive therapy, the treatment while correcting the condition can lead to an unpleasant outcome – underactive thyroid.
• Malfunctioning of the other important glands in the system:At times one might have a perfect healthy thyroid but can still suffer from the problem of hypothyroidism, if the glands that regulate the function of thyroid go haywire.
• Medications taken to treat hyperthyroidism: Sometimes medications that are prescribed to control hyperthyroidism can lead to hypothyroidism making the thyroid gland function sub-optimally.
• Iodine deficiency: A diet low in iodine has been seen to be a major cause of hypothyroidism in adults. It is noticed that areas that have low sources of iodine have more number of people suffering from this condition.

Hyperthyroidism: In this condition there is an overdrive of the thyroid hormone in the blood due to an over active thyroid gland that secretes the hormones in abundance. Some of the common causes that leads to hyperthyroidism are:

• Graves’s disease: This is the most common reason that causes hyperthyroidism in adults.
• Nodules in the gland: A single lump or multiple lumps growing on the thyroid can mimic its function and secrete more hormones than necessary.
• Excessive TSH secretion: Sometimes a medical condition like a tumor in the pituitary gland can initiate excess secretion of TSH that could lead to hyper secretion of the thyroid hormone leading to the condition.
• Medications taken to treat hypothyroidism: Excessive intake of medications that initiates thyroid to produce the hormones can lead to this condition.
• Thyroiditis: If the inflammation of the thyroid gland leads to abnormal amounts of hormones into the system, it can lead to hyperthyroidism.

Thyroid enlargement: In this condition thyroid disease occurs due to the structural changes in the gland like an enlargement or nodules appearing on the gland. There can be benign cysts developed or cancerous ones in form of nodules. Enlargement of the thyroid gland is often termed as goiter. Goiter can at times be unnoticeable and at other times, it can lead to abnormal enlargement that might need surgical removal of the organ.

Symptoms of a thyroid malfunction:

Both hypothyroidism and hyperthyroidism can have adverse affects on a person’s health. The symptoms and signs of the condition can vary from person to person depending on the severity of the condition.

Some of the common symptoms of hypothyroidism are:

• Extreme fatigue
• Forgetfulness and confusion in thought process
• Feeling cold all the time
• Repeated bouts of constipation
• Dry skin
• Bloating or fluid retention in the body
• Stiffness in joints and muscles along with aches and pains
• Menorrhagia, excessive or prolonged menstrual bleeding
• Depression

Some of the common symptoms of hyperthyroidism are:

• Sweating profusely
• Intolerance to heat
• Increased bowel movements
• Slight tremor in the limbs
• Rapid heart rate
• Unexplained weight loss
• Excessive fatigue
• Concentration problem
• Irregular menstrual cycle
• It can lead to irregular heart rhythms and even heart failure in the elderly.
• Untreated hyperthyroidism may result in condition called thyroid storm, where a person can suffer from high blood pressure, fever leading to a heart failure.
• In Graves’ disease, there may be eye changes and skin changes in addition to the other symptoms.

Diagnosis of thyroid disease:

The diagnosis of the disease often happens in the following ways:

Blood test: The first step of the diagnosis involves a blood test to check the levels of the TSH along with the levels of T3 and T4. Lower levels would indicate hypothyroidism and the higher values would be indicative of hyperthyroidism. If cancer is suspected, a thyroglobulin level check may be asked for. In rare circumstances, the blood calcitonin level may also be checked. Also read about five tests to check thyroid function. 

Imaging techniques: This is usually done if the doctor suspects any structural changes in the gland. An ultrasound or thyroid scan can detect the presence of cysts, their nature and also the extent of thyroid enlargement that has taken place.

Biopsy: This is usually done if a cancer is suspected to study the tissues taken from the gland and if any cyst or tumour is noted in the thyroid gland.

Treatment of thyroid disease:

Medication: In case of hyperthyroidism oral medication is the first line of treatment to reduce the hyperactivity of the gland and control the levels of hormone in the body.

To treat hypothyroidism synthetic thyroid hormone is given daily to make up for the deficit in the system.

A very small amount of synthetic hormone may be given to treat goiter in order to shrink it to its previous size.

Surgery: A surgery might be suggested for a number of reasons – either to remove a diseased part of the gland, to remove nodules or cysts or to remove an enlarged gland completely to ensure proper treatment. In such a case a lifelong thyroid hormone replacement might be necessary.

A new kind of surgery that is slowly gaining ground when it comes to thyroid surgeries is robotic thyroid surgery. This kind of surgery is suggested to treat benign and cancerous nodules of the thyroid gland and is done through a cut in the armpit (axilla). This avoids a visible scar on the neck. Specially designed retractors allow the robotic arms to reach the neck region and remove the tissue. 

Radioactive ablation: This form of treatment is usually offered to treat hyperthyroidism if oral medication turns to be ineffective for the treatment. The iodine used in the therapy destroys the part of the gland that has gone on an overdrive to bring the levels of thyroid hormone to normalcy.

Read more about causes, symptoms, diagnosis and treatment of thyroid disease.

You May Have Hypothyroidism If:

• You may be slowly feeling disinterested in everyday affairs, getting lethargic and developing a laid-back attitude towards everything.
• You may be doing just the routine work as always but have started feeling more fatigued than usual.
• You just don’t seem to understand why you remain constipated of late.
• Your friends have started noticing a sudden weight gain and you can’t seem to explain why as you wonder that you are not even overeating!
• You look at yourself in the mirror these days and notice your face getting puffy.
• You are feeling upset seeing your long, thick hair begin to thin suddenly and there are bunches of hair lying scattered all over the house.
• Your menstrual cycles are irregular (there could be other reasons for this too; better to check with your doctor).
• You are noticing excessive hair growth on the face which is becoming embarrassing.
• You can see your throat swell up. Surely, it’s time to see the doc. 

How Yoga Can Help Reduce Thyroid Disorder Symptoms:

Before you start practicing yoga for thyroid disorders, make sure to consult your physician. Also, these yoga techniques work on coping with the symptoms better and are not a substitute to medication (though in some cases the need for medicines may reduce with consistent yoga practice over a period of time).

Note: Although all yoga asanas are considered to be good for both hypo and hyperthyroidism patients, we recommend some of the postures below which can be particularly useful. You need not restrict your practice to only these poses; check with a Sri Sri Yoga teacher on more asanas for your condition.

The Following Yoga Asanas Can Be Practiced In Hypothyroidism Treatment:

• Shoulder Stand (Sarvangasana) is the most recommended posture in this condition. It stimulates the thyroid gland to function properly because of the pressure effect and also helps stimulate other glands in the head region, such as pituitary and pineal glands, which also have an indirect control on the functioning of the thyroid gland.
• Inverted Pose (Viparitakarani)
• One-legged Forward Bend (Janu Shirasasana)
• Fish Pose (Matsyasana)>
• Plow Pose (Halasana)
• Cat Stretch (Marjariasana)
• Fast-paced Sun Salutation (Surya Namaskar) can work well for controlling weight.

Besides these yoga postures, the practice of pranayamas (breathing techniques) such asKapal Bhati (skull shining breathing technique), Nadi Shodhan (alternate nostril breathing),Bhastrika and Ujjayi breathing work well in reducing hypothyroidism symptoms.

Food Tips For People With Thyroid Disorders

• Include high-fibre food in your diet.
• Reduce the intake of fats and carbohydrates.
• Take lots of fresh fruits and green leafy vegetables. It is better to avoid cauliflower, cabbage and broccoli in hypothyroidism.
• Limit the intake of non-vegetarian food, milk and milk products (skimmed milk is advisable), rice, spicy food, refined and fast food and food items with preservatives.

You May Have Hyperthyroidism If:

• You are either gorging on food too much or eating less than usual. There may be a sudden change in appetite. But no matter how much you eat, you still remain lean (if you are desperately trying to put on weight, that is).
• You are finding it difficult to sleep at night.
• If you are sweating too much and unusually.
• Small things are making you easily irritable.
• You usually remain anxious, nervous and quite hurried about things.

Yoga Asanas Recommended For Hyperthyroidism Treatment :

• Bridge Pose (Setubandhasana)
• Cat Stretch (Marjariasana)
• Child Pose (Shishu asana)
• Corpse Pose (Shavasana)
• Slow-paced Surya Namaskars practiced with mantra chanting will have a calm and soothing effect.

Ujjayi, Bhramari (Bee Breath), Nadi Shodhan and cooling pranayamas such as Sheetali andSheetkari are considered to be very effective in dealing with hyperthyroidism symptoms.

Also, it’s good to practice a few minutes of meditation everyday in both hypo and hyperthyroidism. Hypothyroidism patients who become laid-back due to the condition will need to make a conscious effort to stay physically active. And here is when meditation can really help strengthen your willpower to do so.

You may try Panchakosha and Hari Om meditations which you can learn from a Sri Sri Yoga teacher or at the Art of Living Part 2 Course near you.

Since stress is believed to be one of the major factors for thyroid disorders, meditation keeps the mind calm and relaxed and reduces everyday stress. The chanting of ‘Om’ everyday for a few minutes also helps. After chanting, do this small activity: put your hand on the thyroid gland and feel that it is getting healed. Let the positive vibrations of chanting have a stimulating effect on the thyroid gland.

Yoga Nidra also works well in both hypo and hyperthyroidism in reducing stress and calming down. For hyperthyroidism patients, who may find it difficult to sleep at night, yoga nidra can work like a power nap during daytime so that your body gets sufficient rest.

QUESTIONS ABOUT THYROID

You’ve often heard of people suffering from hypo or hyperthyroidism. If you’ve been putting on weight or losing it without any possible explanation, it is very likely that your doctor advises you a thyroid profile. So, what is the gland? Why is it so important?

In this post, we’ll try and answer some of the frequently asked questions on this topic.

 So, what is the thyroid gland?

A large ductless gland in your neck, the thyroid has many functions most important of which is to regulate your growth and development by controlling your metabolism.

 Why is the thyroid gland important?

The thyroid gland secretes hormones which control a lot of things; like the way you metabolize food, use energy, your sleep patterns, your temperature preferences, whether you gain or lose weight and a lot more.

How does it affect your health?

Both an increase and decrease in thyroid hormone production can cause health problems.

Increase in the hormone production can cause hyperthyroidism. If you’ve been noticing weight loss despite a good appetite, an increase in heart rate, high blood pressure, nervousness, increased sweating, enlargement in your neck, shorter menstrual periods, frequent bowel movements and trembling hands, it could signal hyperthyroidism.

Decrease in the hormone production can cause hypothyroidism. Weight gain or failure to lose weight despite a proper weight loss regime, lethargy, reduced heart rate, increased cold sensitivity, numbness in hands, enlargement in the neck, dry skin and hair, heavy menstrual periods and constipation could indicate hypothyroidism.

 You are at an increased risk of thyroid disease if you have a family history of thyroid disease, are a type I diabetic, over 50 years of age, lead a stressful life, have had thyroid surgery or suffer from Down’s or Turner’s syndrome. Women are also more prone to thyroid problems than men especially during periods of hormonal flux like during delivery and menopause.

How are thyroid problems diagnosed?

If your doctor suspects a thyroid disorder, he/she may ask you to undergo some tests like Thyroid profile to measure your Thyroid stimulating hormone -TSH. If TSH levels are high, it shows that you are hypothyroid and vice versa. He/she may also check for other thyroid hormones. In a few cases, imaging and biopsies are done.

Ideally, everyone should be screened for thyroid dysfunction every five years after they turn 35. People with symptoms or risk factors should get tested more often. 

 If you are diagnosed as hypothyroid, your doctor might prescribe thyroid hormone pills which you’ll need to take for life.

If you are ‘hyperthyroid’ you may be prescribed anti-thyroid medications and/or radioactive iodine. Certain drugs to reduce symptoms like increased heart rate and tremors may also be added.

In a few cases, people might also be diagnosed with thyroid cancer. A lump in the neck with pain and swollen lymph nodes, hoarse voice, trouble in breathing and swallowing could signal its presence. Surgery to remove the gland fully or a part of it along with radioactive iodine therapy could help such cases.

Whatever you are diagnosed with, do take your condition seriously and stick to the regime as prescribed by your doctor. If untreated, thyroid problems could lead to major heart problems, infertility, Alzheimer’s disease, stroke due to high blood pressure and death.

 How can one prevent thyroid disease?

Iodine and Selenium are very important for the proper functioning of your thyroid. Make sure you use only iodized salt and eat enough seafood. If you are a vegetarian, add spinach, sesame seeds and garlic in your diet. They could give you the required amount of iodine. For selenium, you could eat meat, fish, mushrooms, soybeans and sunflower seeds.

Women were three times more likely to be affected by hypothyroidism than men 

Women were three times more likely to be affected by hypothyroidism than men (15.86 % as against 5.02 %), especially those in the 46-54 years age group, it said. Hypothyroidism, a common form of thyroid disorder, is highly prevalent in India with one out of 10 people in the country diagnosed with the condition, a new report said on Thursday.

Thyroid is a gland which produces a hormone influencing almost all metabolic processes in the human body.

The most common thyroid problems involve abnormal production of thyroid hormones. Too much thyroid hormone results in a condition known as hyperthyroidism. Insufficient hormone production leads to hypothyroidism. Hypothyroidism was found to be affecting 10.95% of the studied population in India. 

The older population (above the age of 35 years) seemed to be at a higher risk of hypothyroidism than the younger population. Of the 5,360 people screened for the study, more than one-fourth (26.7%) were from Delhi.

Over 11% of the study population from Delhi reported hypothyroidism and one-third of them were not even aware of their disease, said the ‘Thyroid Epidemiological Study’ by Abbot India, a leading health care and pharmaceutical company.

Women were three times more likely to be affected by hypothyroidism than men (15.86 % as against 5.02 %), especially those in the 46-54 years age group, it said. Undetected cases were significantly higher in Delhi (3.97 %) as compared to other major cities like Mumbai (2.86 %) and Chennai (2.09 %). About 9.61 % of the study population in Delhi had mild thyroid failure, which may lead to hypothyroidism in future.

‘The study assessed the nationwide prevalence of thyroid disorder, particularly hypothyroidism in adults residing in various cities that represent diverse geographic origin, occupation, socio-economic status and food habits,’ said AG Unnikrishnan, principal investigator of the study and CEO and endocrinologist at Chellaram Diabetes Institute in Pune. Raj Kumar Lalwani, a consultant physician in a south Delhi hospital, said: ‘Over 11 % of the study population was diagnosed with hypothyroidism and one-third of hypothyroid cases were not aware of their disease.’

                                                           B INFORMEDmrinalronline.weebly.com