TOPICS: Disorders of thyroid gland

Thyroid gland is a butterfly shaped gland that is located just behind our neck. It produces two main hormones : T3 and T4 that are needed for both physical and mental development.

The two common disorders of the thyroid gland are Hypothyroidism (due to low thyroid hormone level) and Hyperthyroidism (due to high thyroid hormone level).

Hypothyroidism is a condition of low or deficient thyroid hormone. This condition affects women more than men.

Hypothyroidism can be due to disease of the thyroid gland itself ( Primary Hypothyroidism) or sometimes due to disease of the pituitary gland (Central Hypothyroidism).

The most common cause of hypothyroidism is autoimmune destruction of the thyroid gland where the immune system attacks and destroys the thyroid gland leading to deficient thyroid hormone production.

People with hypothyroidism may complain of low energy, sleepiness, weight gain, generalized swelling, intolerance to cold, hair loss, constipation, irregular menstrual cycle and so on.

Diagnosis can be confirmed by blood test called thyroid function test.

There are no long term complications associated with hypothyroidism and lifestyle modifications (diet/ exercise) will not change the course of the disease.

Hypothyroidism is not a life threatening condition and can be easily treated with oral tablets called levothyroxine (which is an oral preparation of thyroid hormone). People who have hypothyroidism are advised to check their TSH level once every six months to one year interval.

Hyperthyroidism is a condition characterized by high thyroid hormone level. Females are affected more compared to their male counterpart.

The two common causes of hyperthyroidism are : Grave’s disease and thyroiditis. It is important to distinguish between the two since thyroiditis recovers on its own and does not require long term treatment.

Grave’s disease is an autoimmune condition characterized by auto antibodies that stimulate thyroid gland to produce high level of thyroid hormones. Grave’s disease needs to be treated.

The common symptoms of hyperthyroidism are weight loss, increased sweating, intolerance to heat, palpitation, insomnia, shakiness, irritability and so on. Grave’s disease can be life threatening if not treated on time.

Currently there are two treatment options for Grave’s disease: anti-thyroid medicines or radioactive iodine therapy. The success rate for oral anti-thyroid medications (eg carbimazole) is about 50% and needs at least 12 to 18 months of therapy.

Radioactive iodine is a one time therapy where a single dose of radioactive iodine is given to the patient.

The success rate of radioactive iodine is about 80% and most patients will achieve remission within six months of therapy.