Everything You Need to Know About Thyroid Diseases

What Is the Thyroid?

Your thyroid gland is a small organ in the front of your neck, wrapped around your windpipe. The shape of your thyroid looks like a small butterfly in the middle but has two broad wings that span across the sides of your throat. Your thyroid is one gland that helps make the hormones needed to control your body's vital functions, like regulating blood pressure, body temperature and heart rate.

A thyroid problem can have an impact on your entire body. If your thyroid gland creates too much of the thyroid hormone, it can develop a condition called hyperthyroidism. On the other hand, if it makes too little thyroid hormone, it can cause hypothyroidism.

What Does the Thyroid Do?

Two specific thyroid hormones, T4 (thyroxine, which contains four iodine atoms) and T3 (triiodothyronine, which includes three iodide atoms), help control your metabolism. The thyroid creates these hormones, and they are used to tell your body's cells how much energy they can use. In a properly functioning thyroid, your body can maintain the right amount of hormones that keep your metabolism working correctly. As these hormones are used, more are created to replace them.

Another gland called the pituitary is responsible for supervising this entire process. This gland is located at the centre of your skull below your brain. When the pituitary gland finds a low amount of T3 and T4 hormones in your system, it will release another hormone known as the thyroid stimulating hormone or TSH that tells your thyroid that your body needs more hormones to get back to normal. On the other hand, if there is an excess of T3 or T4 in your blood, the pituitary gland will adjust the amount of TSH it produces to reduce these hormone levels and avoid thyroid diseases.

What Is Thyroid Disease?

Thyroid disease is the term used for any medical condition that hampers your thyroid gland from producing the right amounts of hormones. When there is an increased production of T3 and T4 hormones, your body uses its energy too quickly, leading to a condition known as hyperthyroidism. Using power too quickly can cause you to be more tired, make your heart beat faster, lose weight quicker without even trying, and even make you feel more nervous.

Conversely, too little production of thyroid hormones can cause a thyroid disease known as hypothyroidism. This means your body will have too little thyroid hormone, making you feel tired faster, gain weight and be unable to tolerate colder temperatures.

Hyperthyroidism and hypothyroidism are two of the primary thyroid diseases. Still, different conditions can cause them and can also be inherited from your parents and them from their parents.

Who Is Affected by Thyroid Disease?

Thyroid diseases can affect anyone; men, women, teenagers, infants and the elderly are all prone to this disease. Hypothyroidism can be present right from birth, or it can develop over time, most often in women who have gone through menopause.

Thyroid disease is a common disorder, and it is estimated to affect around 42 million people in India. Women are between five and ten times more likely to develop thyroid diseases than men.

Some factors that can put you at higher risk of developing a thyroid problem are

• If you have a family history of thyroid diseases
• If you have medical conditions like pernicious anaemia, primary adrenal insufficiency or Type 1 diabetes
• If you take any medication that is very high in Iodine, like amiodarone
• If you are older than 60 years of age
• If you have had treatments like radiation or thyroidectomy for a thyroid condition or cancer

What Causes Thyroid Disease?

Hypothyroidism and hyperthyroidism are two diseases that other diseases can cause but impact the way your thyroid gland works.

Hypothyroidism can be caused by conditions like

• Thyroiditis: This is a disease in which an inflammation in the thyroid causes the production of lower amounts of thyroid hormones.
• Hashimoto's thyroiditis: This is a painless disease in which the body's cells attack and damage the thyroid gland. It is an autoimmune condition often passed down from generation to generation.
• Postpartum thyroiditis: It is a temporary condition that can occur in women who have just given birth. This condition affects 5% to 9% of women after childbirth.
• Iodine deficiency: The thyroid gland uses Iodine for the body to transduce hormones. An iodine deficiency is one of the leading causes of thyroid disease, affecting several million people globally.
• Non-functioning thyroid: In rare cases, your thyroid gland may not function correctly right from birth. Recent stats have shown that around 1 in 4000 newborns can have this condition. If this is left untreated, it can cause both physical and mental issues in the child as they grow older. All newborns undergo a thyroid screening test in the hospital to understand their thyroid function.

Hyperthyroidism is caused due to

• Graves disease: A condition in which the thyroid gland may be overactive and produce excessive hormones. This disease is also known as diffuse toxic goitre or enlarged thyroid gland.
• Nodules: Hyperthyroidism is often also caused by overactive nodules in the thyroid gland. One nodule is called a toxic autonomously functioning thyroid nodule, while a gland with many nodules is called a toxic multinodular goitre.
• Thyroiditis: This disorder is either very painful or may not be felt. In this condition, the thyroid slowly releases the hormone it stores. This can last anywhere between a few weeks to a few months.
• Excessive Iodine: High levels of Iodine in your body affect the thyroid, causing an excessive production of thyroid hormones.

Is There a Higher Risk of Developing Thyroid Disease If I Have Diabetes?

Those with diabetes are at higher risk of developing thyroid disease than those who do not have diabetes. Type 1 diabetes is an autoimmune disorder, and if you already have some form of autoimmune disease, you are more likely to develop another.

If you have type two diabetes the risk is slightly lower but still very present. Those with Type 2 diabetes are also likely to develop some form of thyroid disease later in life.

Regular testing for different types of thyroid diseases can help catch any thyroid problems well in advance. Although there is no set testing schedule for individuals who have Type 2 diabetes, it is best to talk to your healthcare provider about how often you need a thyroid test.

A few simple ways to feel better for those who have diabetes and have tested positive for thyroid disease is

• Getting enough sleep
• Keeping track of your diet
• Regular exercise
• Taking your medication as directed by your healthcare provider
• Getting tested as often as your doctor suggests

What Common Symptoms Can Happen with Thyroid Disease?

There are a variety of thyroid disease symptoms you may experience if you have thyroid disease. However, thyroid disease symptoms are very similar to other medical conditions that may arise in the later stages of your life, so it is a little tricky to differentiate between early warning signs of thyroid problems and what is not.

Symptoms of hyperthyroidism (overactive thyroid):

• Anxiety, nervousness, irritability
• Trouble sleeping
• Unexplained loss of weight
• Enlarged thyroid gland or goitre
• Muscle weakness and tremors
• Irregular menstrual periods or a break in your menstrual cycle
• Heat sensitivity and increased sweating

Symptoms of hypothyroidism (underactive thyroid)

• Feeling tired
• Weight gain
• Forgetfulness
• Regular and heavy menstrual periods
• Dry and coarse hair
• Changes in your voice
• Inability to tolerate cold temperatures

Can Thyroid Issues Make Me Lose My Hair?

Hair loss is a common thyroid disease symptom, especially for hypothyroidism. If you experience excessive hair loss, that is concerning; you can talk to your doctor about solutions and what can help.

Can Thyroid Issues Cause Seizures?

In many cases, thyroid diseases will not cause seizures. However, if you are suffering from severe cases of hypothyroidism that have not yet been diagnosed or treated, there are chances that you will develop low serum sodium. This could lead to seizures.

How Is Thyroid Disease Diagnosed?

The thyroid disease symptoms are very similar to other conditions, so they can be easily confused. Ageing and pregnancy also show similar signs and are two of the leading causes of thyroid in females.

Thanks to modern medicine, thyroid tests now help determine if the symptoms you display are related to a thyroid disease. These tests include

Blood Tests

A blood test is one of the most effective diagnoses of thyroid disease. Thyroid blood tests help understand if your thyroid gland is functioning effectively as they measure the amount of thyroid hormone in the blood. During this test, blood is drawn from a vein in the arm and then sent to the lab for further testing to diagnose hyperthyroidism and hypothyroidism.

Disease-specific blood tests for thyroid diseases include

• Thyroid-stimulating hormone (TSH) test: This is often the first test your doctor may ask you to do, as this hormone secreted by the pituitary gland helps balance the levels of thyroid hormones, including T3 and T4, in your body. Most often, a deficiency in thyroid hormones or hypothyroidism is caused by elevated levels of TSH, while hyperthyroidism/high levels of thyroid hormones are a result of low TSH levels. Any abnormality found in the measurement of TSH may result in the need to measure the levels of your thyroid hormones, including T3 and T4. The usual range of TSH in adults is between 0.40 and 4.50 mlU/mL.
• T4: In the case of both hyperthyroidism and hypothyroidism, a T4/thyroxine test is used to monitor how well the treatment works for your thyroid disease. Low levels of T4 hormone are an indication of hypothyroidism, while higher levels of this hormone are seen in cases of hyperthyroidism. The normal range for T4 hormones in adults ranges from 5.0 to 11.0ug/dL.
• T3: A triiodothyronine test helps in the diagnosis of hyperthyroidism. It also measures the severity of the disorder so you can get the proper treatment on time. While low levels of T3 hormone are observed in hypothyroidism, this test is more commonly used for the diagnosis and monitoring of hyperthyroidism where your T3 levels are elevated. The normal range for T3 in humans is between 100-200 ng/dL.
• FT4: A free thyroxine or T4 test measures T4 hormones present in the blood, eliminates the effects of proteins that naturally bind to T4, and can prevent any accurate measurement during the T4 test. The normal range for FT4 in adults is between 0.9 and 1.7 ng/dL.
• FT3: In the same way, the free triiodothyronine or free T3 test measures the amount of T3 hormone present in the blood that eliminates the effects of proteins that naturally bind to T3, which can cause a discrepancy in the measurement of this hormone in your blood. The normal range for FT3 in adults is between 2.3 and 4.1 pg/mL.

While these tests cannot help diagnose thyroid disease, they can help guide your healthcare provider towards the proper diagnostic test to evaluate the possible thyroid disorder. Additional tests can include

• Thyroid antibodies: This test aids in identifying the different types of autoimmune thyroid diseases. The most frequently used thyroid antibody tests include microsomal antibodies, also known as thyroid peroxidase antibodies or TPO antibodies, and thyroid receptor antibodies, which contain tests for thyroid-stimulating immunoglobulins (TSI) and thyroid-blocking immunoglobulins (TBI).
• Calcitonin: This test is often used to diagnose rare thyroid diseases such as C-cell hyperplasia and medullary thyroid cancer.
• Thyroglobulin: This test is used in the diagnosis of thyroiditis or thyroid inflammation and to monitor the treatment of your thyroid cancer.

You must speak to your healthcare provider about all the tests available and which one is most suitable for your needs. In some cases, the ranges for these tests also differ from person to person, so consult your healthcare provider if you have any concerns or worries about your test results.

Imaging Tests

Some thyroid diseases can be diagnosed by just looking at your thyroid gland. Your healthcare provider may carry out an imaging test known as a thyroid scan, which allows them to look at your thyroid and understand if there are any changes in its size or shape. It also helps look for thyroid nodules, one of the most common thyroid causes.

An ultrasound imaging test can be used to test your thyroid gland. This test uses high-frequency sound waves inaudible to the human ear through your body tissue. The waves that echo back are then recorded and transformed into photographic images or videos that can be further used to diagnose different thyroid diseases. Unlike X-rays, ultrasound waves do not use radiation.

Little or no preparation is needed for this test; all you have to do is lie flat on a padded examination table with your head on a pillow so it is a little tilted back. A water-soluble gel is then applied to your skin, where you must be examined. Your healthcare provider will then apply a probe on your neck and move it around to check your thyroid. This test can take about 20-30 minutes.

Physical Exam

This is a quick and easy way for your healthcare provider to check for any extra growths or enlargements in your thyroid.

How Is Thyroid Disease Treated?

The main goal of your thyroid treatment is to get your thyroid levels back to normal. This can be done in multiple ways, and the specific treatment you need will depend on the thyroid causes.

Thyroid treatment for high levels of thyroid hyperthyroidism includes

• Antithyroid drugs (propylthiouracil and methimazole): These medications help stop the gland's production of thyroid hormones.
• Beta-Blockers: These medicines do not alter the amounts of hormones in the body but aid in managing the symptoms of your thyroid disease.
• Radioactive Iodine: This type of treatment causes damage to the cells of your thyroid gland, leading to a lower production of thyroid hormones. However, this is not how to control the thyroid in pregnant females, as it can affect the foetus.
• Surgery: This is a more permanent type of thyroid treatment and is often done in severe cases. In this form of therapy, your healthcare provider will surgically remove your thyroid gland, thus stopping it from creating more hormones. However, in this case, you will have to take thyroid replacement hormones for the rest of your life.

Thyroid treatment options for hypothyroidism or low levels of thyroid hormone include

• Thyroid replacement medication: This is one of the most commonly used thyroid treatment options, in which a synthetic drug is used to add thyroid hormones to your body. The primary drug used in this case is known as levothyroxine. With the help of this medication, you will be able to manage your thyroid disease and live a relatively everyday life.

Are There Different Types of Thyroid Removal Surgery?

If your healthcare provider determines that your thyroid needs to be removed, he may do several surgeries. The first choice is between partially and completely removing your thyroid. This usually depends on how severe your condition is. If your thyroid is enlarged or has several growths, this can prevent you from being eligible for some types of surgery.

A surgery that removes your thyroid is called a thyroidectomy. There are two main ways this surgery can be done.

• Through an incision in the front of your neck
• Through an incision in your armpit

An incision in the front of your neck is a traditional method used to carry out thyroidectomy. This helps the surgeon to go straight into your throat and remove your thyroid gland. This is still the best option for most cases and is used in cases where your thyroid is particularly big or contains several large nodules.

When used through an incision in your armpit, the other method creates a tunnel to your thyroid. This is made with a unique tool called an elevated retractor. It creates an opening that can connect the incision from your armpit to your thyroid. The surgeon then uses a robotic arm that moves through the tunnel and gets to the thyroid. It then removes the thyroid and returns through the tunnel, bringing it with it.

This is a scarless surgery as the incision under your arm is often out of sight. However, it is a more invasive form of surgery and more complicated as compared to the incision in the throat. You may not even be a candidate for this form of surgery if you are

• Not at your healthy body weight
• Have huge thyroid nodules
• Have any conditions like Graves's disease or thyroiditis

Talk to your doctor about all the available treatment options and which kind of surgery would be best for you.

How Long Does It Take to Recover from Thyroid Surgery (Thyroidectomy)?

It usually takes your body up to a few weeks to recover from a thyroidectomy or surgical removal of your thyroid. However, there are a few precautions you have to take during this recovery period.

• Avoid submerging the incision underwater.
• Do not lift any object that is heavier than 15 pounds.
• Avoid anything more than light exercise.

These precautions are to be taken for about 2 weeks, after which you can return to normal activities.

How Long After My Thyroid Is Removed Will My Tiredness Go Away?

Immediately after your surgery, you will be given medications that will help with your symptoms of fatigue. Even after removing your thyroid, your body will still have the thyroid hormones circulating. These hormones typically stay within your body for 2 to 3 weeks before being naturally drawn. You will then need to take medication to reintroduce new hormones into your body after your thyroid has been removed. A little tiredness is a normal part of your recovery after any surgery, as it takes your body time to heal. If you are still experiencing fatigue and other symptoms of thyroid disease even after the surgery, it is essential to talk to your healthcare provider about what needs to be done.

Can I Check My Thyroid at Home?

There is a quick and easy home thyroid test that you can do to check for any thyroid diseases. The only tools you will need are a glass of water and a mirror.

The steps for this thyroid self-exam are

• Identify where your thyroid is located. You should find it on the front of your neck, between your collarbone and Adam's apple. The Adam's apple is more prominent and easy to locate in men; it is best to look at the region above the collarbone for women.
• Tip your head back when looking in the mirror and find a spot on your neck that you will pay attention to when you start the examination.
• Once you are in position and ready to start, drink water with your head tilted back. Watch your thyroid as you swallow the water. During this test, You must look for lumps or bumps in the thyroid area. Swallowing water helps make these changes in your thyroid more prominently visible.

Repeat this test several times to ensure you have had a good look at your thyroid. If you find any lumps or bumps, you must visit your healthcare provider to determine the next steps.

Should I Exercise If I Have a Thyroid Disease?

Regular exercise is a crucial part of living a healthy lifestyle. You do not need to change your workout routine if you have thyroid disease, as exercise does not drain your body's thyroid levels. However, talking to your healthcare provider and getting a general health checkup before starting any new exercise routine is essential.

Can I Live an Everyday Life with a Thyroid Disease?

Although thyroid disease is a medical condition that lasts throughout your life, there are ways to manage the symptoms and live a healthy life. This will involve you taking medication to control your thyroid hormone levels daily. Your doctor will also closely check your thyroid levels to check how well your treatment is working and make any adjustments it may need over time. Finding your proper thyroid treatment and food plan can take a little time. But once found, you will not have to live with many restrictions.

Metropolis diagnostic labs across India provide accurate blood testing and health check-up services. A team of qualified technicians make at-home visits to collect samples, which are processed at advanced diagnostic labs. The reports are shared online via email and the Metropolis TruHealth app.