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Thyroid Conditions

The thyroid is a butterfly-shaped gland that is situated at the base of the neck just above the breastbone. It is part of the body’s endocrine system. As part of the endocrine system, the thyroid secretes the following hormones into the blood: thyroxine (T4), triiodothyronine (T3), reverse triiodothyronine (RT3), and calcitonin. The hormones T4, T3, and RT3 are comprised of iodine and work to control cell metabolism. Calcitonin works to control levels of calcium in the blood. A thyroid condition may develop if there is a problem with the thyroid. Several thyroid conditions are listed below:

  • Iodine deficiency
  • Postpartum thyroiditis
  • Nodules
  • Graves’ disease
  • Excessive iodine
  • Thyroiditis
  • Hashimoto’s thyroiditis

Symptoms

The thyroid conditions listed above can lead to either hyperthyroidism or hypothyroidism. Hyperthyroidism occurs when the thyroid is overactive and produces too much hormone. This is the opposite of hypothyroidism. Hypothyroidism occurs when the thyroid is underactive and produces too little hormone. Graves’ disease and excessive iodine are two thyroid conditions that lead to hyperthyroidism. Meanwhile, Hashimoto’s thyroiditis and iodine deficiency are two thyroid conditions that cause hypothyroidism.

Hyperthyroidism is characterized by the following symptoms:

  • Anxiety
  • Nervousness
  • Irritability
  • Restlessness
  • Trouble sleeping
  • Tremor
  • Weight loss
  • Frequent bowel movements
  • Irregular and lighter periods
  • Increased heart rate
  • Increased sweating
  • Muscle weakness
  • Brittle hair and nails

Hypothyroidism is characterized by the symptoms listed below:

  • Goitre due to thyroid enlargement
  • Depression
  • Memory problems
  • Fatigue
  • Weakness
  • Muscle and joint pain
  • Weight gain
  • Constipation
  • Irregular and heavy periods
  • Fertility issues
  • Decreased heart rate
  • Dry skin and hair
  • Sensitivity to cold temperatures

Causes

Thyroid conditions can be caused by the following:

  • Not enough iodine in one’s diet
  • Too much iodine in one’s diet
  • Bacterial infection (i.e., infections from aureus or Streptococci)
  • Viral infection (i.e., infections from the mumps virus or influenza virus)
  • Medications (i.e., interferon and lithium)
  • Genetics

For some thyroid conditions, such as postpartum thyroiditis, Graves’ disease, and Hashimoto’s thyroiditis, the cause for the condition remains unknown.

Reference Articles

Risk Factors

The factors that increase one’s likelihood for developing a thyroid condition are as described below:

  • Gender

Thyroid conditions occur more often in women than in men.

  • Age

Thyroid conditions occur more often in older adults over the age of 50.

  • Family history

Having a family member with a thyroid condition increases one’s own chances of having one.

  • Autoimmune disease

Those who already suffer from an autoimmune disease, such as Type 1 diabetes or celiac disease, have increased odds of developing another autoimmune condition (i.e., Graves’ disease or Hashimoto’s thyroiditis).

  • History of previous thyroid problems

The odds of developing a thyroid condition increase if one has undergone treatment for thyroid cancer, had surgery on the thyroid, or has had previous problems with the thyroid.

Diagnosis

Before diagnosing a thyroid condition, a doctor will review the patient’s medical history, discuss all symptoms, and conduct a physical exam. The doctor will also conduct various tests to assist them in their diagnosis. These tests include the following:

  • Lab tests

A thyroid blood test is used to check the levels of various hormones and antibodies found within the blood:

  • Thyroid-stimulating hormone (TSH)
  • Thyroxine (T4)
  • Triiodothyronine (T3)
  • Thyroid peroxidase antibody (TPOAb)
  • Thyrotropin receptor antibodies (TRAb)
  • Thyroglobulin antibodies (TgAb)

The levels of these hormones and antibodies will indicate whether the thyroid is overactive or underactive and whether the body has launched an autoimmune response against the thyroid.

  • Imaging

Imaging tests can be used to measure the thyroid and check for nodules and other abnormalities. The types of imaging performed on the thyroid include an ultrasound and a thyroid uptake and scan. A thyroid uptake and scan is a technique used to evaluate how well the thyroid collects iodine.

Treatment

If one is diagnosed with a thyroid condition that causes hyperthyroidism, treatment involves daily medication. Medication will consist of anti-thyroid drugs (i.e., propylthiouracil and methimazole), radioactive iodine, or potassium iodine. These drugs work to stop the thyroid from making too much hormone. Another form of treatment for hyperthyroidism and for nodules on the thyroid is surgery to remove all or part of the thyroid.

If one is diagnosed with a thyroid condition that causes hypothyroidism, treatment also involves daily medication. Medication will consist of iodine supplements or thyroid hormone supplements, which work to raise the levels of thyroid hormones in the body. The most common medication used as a thyroid hormone replacement is called levothyroxine.

Treatment for any thyroid condition is typically continued for six months to a year before it is tapered down. The patient is then re-evaluated so as to decide whether they require daily medication for the rest of their life.

Prevention

There is no way to prevent all thyroid conditions. Nonetheless, there are ways to protect and care for the health of one’s thyroid, as described below:

  • Adults should maintain a diet that contains appropriate levels of iodine. Recommendations specify a minimum of 150 micrograms/day and a maximum of 1 mg/day. Iodine can be found in drinking water, seafood, dairy products, and iodized salt. It should be noted that the iodine recommendations for children are significantly lower. For example, the maximum limit of iodine for children who are between one and three years old is only 200 micrograms/day.
  • Women who are pregnant or breastfeeding should maintain a diet that contains at least 250 micrograms of iodine per day. This is usually achieved by taking a prenatal vitamin with iodine in it.
  • X-rays of the teeth, head, neck, or chest area can expose the thyroid to harmful radiation. When receiving these X-rays, ask for a thyroid collar. A thyroid collar is lined with lead and will protect the thyroid from X-rays.
  • Celiac disease has a strong correlation with Graves’ disease and Hashimoto’s thyroiditis. It is important that one manages their celiac disease to lessen the chances of developing a thyroid condition.

As always, living a healthy lifestyle can help mitigate the development of illnesses. A healthy lifestyle implies that one quits smoking, eats a healthy diet, and avoids toxins in the environment.

 
 
 

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