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Thyroid Disease Samples

by | May 29, 2022 | Uncategorized | 0 comments

Thyroid Disorders

Thyroid diseases or disorders are conditions that affect the thyroid gland, a butterfly-shaped gland in the front of the neck. The thyroid has an important role to regulate numerous metabolic processes throughout the body. Different types of thyroid diseases affect either its structure or function of the thyroid.

The location of the thyroid gland is below Adam’s apple, it is wrapped around the trachea (windpipe). A thin area of tissue in the gland’s middle, known as the isthmus, joins the two thyroid lobes on each side. The thyroid uses iodine to produce vital hormones.

Thyroxine, also known as T4, is the primary hormone produced by the gland. After delivery via the bloodstream to the body’s tissues, a small portion of the T4 released from the gland is converted to triiodothyronine (T3), which is the most active hormone.

The function of the thyroid gland is regulated by a feedback mechanism involving the brain. When thyroid hormone levels are low, the hypothalamus in the brain produces a hormone known as thyrotropin-releasing hormone (TRH).

This causes the pituitary gland (located at the base of the brain) to release thyroid-stimulating hormone (TSH), which stimulates the thyroid gland to release more T4.

Since the thyroid gland is controlled by the pituitary gland and hypothalamus, disorders of these tissues can also affect thyroid function and cause thyroid problems.


Types of Thyroid Disorders

Following are the specific kinds of thyroid disorders:
  • Thyroid cancer
  • Goiter
  • Hypothyroidism 
  • Hyperthyroidism
  • Thyroid nodules

 

Thyroid Cancer

This type of cancer is far more common among adult women than men or youth. About 2/3 of cases occur in people under age 55. There are different kinds of thyroid cancer, depending upon the specific cell type within the thyroid that has become cancerous. Most cases of thyroid cancer have a good prognosis and high survival rates, especially when diagnosed in its early stages.


Goiter

The enlargement of the thyroid gland is called goiter, regardless of cause. A goiter is not a specific disease per se. A goiter may be associated with hypothyroidism, hyperthyroidism, or normal thyroid function.


Hypothyroidism

Hypothyroidism results from the thyroid gland producing an insufficient amount of thyroid hormone. It can develop from problems within the thyroid gland, pituitary gland, or hypothalamus.

Following are some of the signs and symptoms of hypothyroidism:
Following are some common causes of hypothyroidism:

 

Hyperthyroidism

Hyperthyroidism means excessive production of thyroid hormone, a less common condition than hypothyroidism. Symptoms of hypothyroidism usually relate to increased metabolism. In mild cases, there may not be apparent symptoms.

Symptoms and signs of hyperthyroidism can include:

Following are some of the common causes hyperthyroidism:

  • Excessive iodine consumption
  • Grave’s Disease
  • Thyroid nodules that overexpress thyroid hormone (known as “hot nodules)
  • Toxic multinodular goiter

Signs and Symptoms of Hypothyroidism

Hypothyroidism signs and symptoms in adults may include the following:

Following are the signs and symptoms of hypothyroidism in babies:

  • A large, protruding tongue
  • Difficulty breathing and feeding
  • Excessive sleepiness
  • Hoarse cry
  • Poor muscle tone
  • Physical and mental retardation in untreated infants
  • Yellow skin and eyes

Signs and symptoms are similar to those in adults, but in addition, they may also present with the following:

  • Delayed emergence of permanent teeth 
  • Potbelly and poor muscle tone
  • Short stature
  • Poor physical and mental development
  • Delayed puberty

Signs and symptoms of Graves Ophthalmopathy

  • Blurry or double vision
  • Dry eyes 
  • Excessive tearing or discomfort in one or both eyes
  • Light sensitivity
  • Protruding eyes
  • Swollen or red eyes


Complications of Hypothyroidism

If untreated, hypothyroidism can lead to various complications

  • Birth defects: Babies born to women with untreated thyroid disease may have a higher risk of being born with birth defects. The children also have a risk of serious developmental problems.
  • Goiter: The lack of thyroid hormone causes constant stimulation of the thyroid gland causing enlargement of the thyroid gland. This is called goiter. Goiter can cause cosmetic concerns and can affect breathing and swallowing.  
  • Cardiac (heart) problems: Hypothyroidism increases the risk of heart disease and causes irregular heart rate and heart failure. Hypothyroidism increases the levels of low-density lipoprotein (LDL) cholesterol, known as the “bad” cholesterol, leading to cardiovascular complications.
  • Infertility: Low levels of thyroid hormone can interfere with ovulation presenting with irregular periods.
  • Mental health issues: Depression, slow mental function, lethargy, and poor memory can occur and may worsen over time.
  • Peripheral neuropathy: Long-term untreated hypothyroidism can cause damage to your peripheral nerves (in the arms and legs). Patients present with pain, numbness, and tingling feeling in affected areas.
  • Myxedema: This is a rare, life-threatening complication of long-term, untreated hypothyroidism. Its signs and symptoms include swelling of the face including the lips, eyelids, and tongue, and swelling and thickening of the skin and underlying tissues anywhere in the body having a waxy texture. Patients also have intense cold intolerance and drowsiness followed by profound lethargy and unconsciousness.
  • Pregnant women: Untreated hypothyroidism during pregnancy increases the risk of miscarriage, premature delivery preeclampsia (high blood pressure in the last trimester of pregnancy), and birth defects in the developing baby.
  • Infants: Infants with untreated hypothyroidism present at birth are at risk for serious problems with both physical and mental development. 

Signs and Symptoms of Hyperthyroidism

Hyperthyroidism can mimic other health problems; hence, it may be misdiagnosed. Following are the common signs and symptoms of hyperthyroidism:

  • Anxiety
  • Arrhythmia (irregular heartbeat or rhythm)
  • Changes in menstrual cycle
  • Excessive Sweating
  • Fatigue
  • Goiter (an enlarged thyroid gland) 
  • High sensitivity to heat
  • Increased appetite
  • Irregular bowel movements
  • Irritability
  • Muscle weakness
  • Problems sleeping
  • Thinning of skin and hair
  • Tremor (trembling) of the hands and fingers
  • Weight loss despite normal diet and appetite 

Diagnosis of Thyroid Disorders

In addition to thorough medical history and physical exams, specialized tests are used to diagnose thyroid disorders.

  • Blood tests are typically done to measure levels of thyroid hormones and TSH. Blood tests to identify antibodies against thyroid tissue may also be ordered by your doctors, such as titers of anti-thyroglobulin, anti-thioperoxides, or TSH receptor stimulating antibodies.
  • Imaging tests are commonly used when thyroid nodules or enlargement are present. Ultrasound can visualize the consistency of the tissue within the gland and can often reveal cysts or calcifications. Ultrasound examination cannot distinguish a benign from a malignant process.
  • Thyroid scans using radioactive iodine are often performed to evaluate the function of thyroid nodules. The thyroid is the only location in the body that takes up iodine, so when radioactively labeled iodine is given, it is taken up by the thyroid gland. An imaging test typically shows uptake of radioactive iodine by normal thyroid tissue. Areas or nodules that are producing excess hormone (referred to as hyperfunctioning) will show increased uptake of iodine. These are referred to as “hot” nodules or areas.
  • Fine needle aspiration and biopsy are techniques that remove a sample of cells or tissue from the thyroid gland for examination and diagnosis by a pathologist, who is a physician trained in the diagnosis of conditions based on tissue samples. Fine needle aspiration (FNA) uses a long, thin needle to withdraw a sample of cells from the thyroid. FNA can be performed in the doctor’s office. Sometimes, ultrasound imaging is used to guide the FNA procedure. A biopsy is the surgical sampling of tissue.


Treatment of Thyroid Disorders

Thyroid disorders can be treated by medications or, in some cases, surgery. Treatment will depend on the particular disease of the thyroid.

Thyroid Medications

Medications can be given to replace the missing thyroid hormone in hyperthyroidism. Synthetic thyroid hormone is given in pill form by mouth. When hyperthyroidism is present, medications can be used to decrease the production of thyroid hormone or prevent its release from the gland.

Other medications can be given to help manage the symptoms of hyperthyroidism, such as increased heart rate. If hyperthyroidism is not controlled with medications, radioactive ablation can be performed. Ablation involves giving doses of iodine labeled with radioactivity that selectively destroys the thyroid tissue.

Thyroid Surgery

  • Surgery can be used to remove a large goiter or a hyperfunctioning nodule within the gland.
  • Surgical procedure is necessary when there is a possibility of thyroid cancer. If the thyroid gland is removed entirely, the individual will need to take synthetic thyroid hormone for life.
  • Thyroid surgery can also be used in Graves’ Disease (subtotal thyroidectomy) and was the treatment of choice prior to RAI therapy and anti-thyroid medications. It is not used much now.


Complications of Thyroid Disorders

The thyroid is a small, butterfly-shaped gland located at the anterior (front) aspect of the neck. Thyroid hormones regulate metabolism, body temperature, heartbeat, and the digestive system.

Hypothyroidism occurs when the thyroid gland is unable to produce sufficient levels of thyroid hormones. Hyperthyroidism occurs when the thyroid gland produces excess levels of thyroid hormones.

Thyroid problems can begin at any age and women are more affected than men. The clinical presentation and complications of hypothyroidism and hyperthyroidism are different. They may be diagnosed after a routine blood test or after symptoms begin. Several treatment options are safe and effective.


Outlook of Thyroid Disorders

  • In most cases, thyroid disorders can be well managed with medical treatment and are not life-threatening.
  • Some thyroid diseases might require surgery.
  • The outlook for most patients with thyroid cancer is also good, although patients with thyroid cancer that has spread throughout the body have a poorer prognosis.

 

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