Thyroid Disease: Symptoms, Causes, Treatment & Prevention | SPARSH Hospital

Introduction

The thyroid is a butterfly-shaped gland located at the base of your neck. It plays a crucial role in regulating your body’s metabolism, energy levels, and hormone balance. Thyroid disorders, such as underactive thyroid (hypothyroidism), hyperthyroidism, and autoimmune conditions like Hashimoto’s disease, can significantly impact your health. Early recognition of thyroid symptoms, routine thyroid gland tests, and proper treatment are vital for managing these conditions.

What is Thyroid?

The thyroid is a butterfly-shaped, small gland located just below your Adam’s apple. It is part of the endocrine system which is a network of glands that produce and regulate hormones to control essential body functions. Despite its small size, the thyroid plays an important role in your overall health by producing hormones that regulate your metabolism - the process of converting the food you eat into energy your body needs to function.

Your thyroid’s primary function is to control the speed of your, also known as your metabolic rate. This involves determining how quickly your body burns calories and uses energy. These functions are vital because every cell in your body depends on energy to perform its tasks, from supporting brain activity to aiding muscle movements.

When the thyroid doesn’t function properly, it can disrupt the delicate balance of hormones your body needs, leading to widespread effects on your health and well-being.

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Where is the Thyroid Located?

The thyroid is located in the front of your neck, just below the Adam’s apple. Shaped like a butterfly, it has two lobes on either side of the trachea, connected by a thin strip of tissue called the isthmus. Despite its small size, this gland has a massive impact on your body’s overall function.

What Are the Parts of the Thyroid?

The thyroid consists of two main lobes:

  • Right Lobe: Located on the right side of the neck.
  • Left Lobe: Found on the left side of the neck.

These lobes are connected by the isthmus, a small bridge of tissue that allows them to work together. Surrounding the thyroid are four tiny glands called the para thyroid glands, which regulate calcium levels in the blood.

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What Does the Thyroid Do?

The thyroid plays a central role in maintaining your body’s energy balance and regulating vital physiological processes. This is accomplished through the production and release of specific hormones that directly affect how your body uses and stores energy, controls its temperature, and maintains proper organ function. Let’s break down the key hormones produced by the thyroid and their functions:

Thyroxine (T4)

  • What it is: Thyroxine, also known as T4, is the primary hormone produced by the thyroid gland. It serves as a precursor to its more active form, triiodothyronine (T3).
  • Function: While T4 itself has limited direct impact on your body’s metabolism, it is essential because it converts to T3 through a process called deiodination, where iodine is removed to activate the hormone.
  • Role in metabolism: Once converted, T4 ensures that cells in your body receive the necessary energy to perform basic functions like muscle contractions, brain activity, and digestion.

Triiodothyronine (T3)

  • What it is: T3 is the active form of thyroid hormone and is significantly more potent than T4—approximately three to four times stronger.
  • Function: T3 directly interacts with cells to regulate the speed of metabolic processes, ensuring optimal energy production and utilization.
  • Impact on the body:
    • Increases your basal metabolic rate (BMR), determining how quickly your body burns calories.
    • Influences growth and development, especially critical during childhood.
    • Regulates heart rate and body temperature.
    • Supports brain function, including mood stability and cognitive abilities.

Reverse Triiodothyronine (RT3)

  • What it is: RT3 is a biologically inactive form of T3. Instead of promoting metabolism, it acts as a counterbalance, ensuring that metabolic processes don’t become overly active.
  • Function:
    • Helps regulate the energy demands of the body during stress, illness, or injury by slowing down metabolism when necessary.
    • Acts as a feedback mechanism, ensuring hormonal balance and preventing overactivity caused by excessive T3.

Calcitonin

  • What it is: Calcitonin is a hormone produced by specialized cells in the thyroid called C-cells (parafollicular cells). It is not directly involved in metabolism but plays a crucial role in maintaining calcium balance.
  • Function:
    • Helps regulate the levels of calcium and phosphate in the blood.
    • It supports bone health by reducing the activity of osteoclasts, the cells that break down bone tissue, which keeps calcium from being released into the bloodstream.
    • Works alongside hormones from the parathyroid glands to ensure proper calcium levels for muscle contractions, nerve signalling, and blood clotting.

Together, these hormones ensure proper energy balance, temperature regulation, and organ function.

What is Thyroid Disease?

Thyroid disease refers to any condition that impairs the proper function of the thyroid gland. These disorders occur when the gland produces either too much or too little hormone, disrupting your body’s balance.

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Types of Thyroid Disease

Below is an overview of some common thyroid diseases.

Hyperthyroidism (Overactive Thyroid): Hyperthyroidism occurs when the thyroid gland produces too much of the T3 and T4 thyroid hormones. This causes the body’s metabolism to speed up, which can lead to issues like weight loss, rapid heart rate, nervousness, and excessive sweating. Essentially, the body is running at an accelerated pace.

Hypothyroidism (Underactive Thyroid): Hypothyroidism, on the other hand, occurs when the thyroid doesn’t produce enough thyroid hormones. This leads to a slowing down of the body’s metabolic processes. People with hypothyroidism may experience fatigue, weight gain, cold intolerance, and dry skin, among other symptoms. The body’s functions become slower and less efficient in this condition.

Graves' Disease: Graves' disease is an autoimmune condition where the immune system mistakenly attacks the thyroid gland. As a result, it produces too many hormones, often leading to hyperthyroidism. It can also cause other symptoms, such as bulging eyes, which is characteristic of this disease.

Endemic Goitre: An endemic goitre is an enlargement of the thyroid gland caused by iodine deficiency, which is more common in certain geographical areas where iodine-rich foods are scarce. This condition leads to the thyroid growing larger in an attempt to compensate for the lack of iodine needed to produce thyroid hormones.

Autoimmune Thyroiditis (Hashimoto's Disease): Hashimoto's disease is an autoimmune disorder where the immune system mistakenly targets and damages the thyroid, often resulting in an underactive thyroid (hypothyroidism). It is one of the most common causes of underactive thyroids. People with Hashimoto’s may experience symptoms like fatigue, weight gain, and depression.

Thyroid Cancer: Thyroid cancer occurs when abnormal cells in the thyroid gland start to grow uncontrollably. Though it is relatively rare, it is becoming more commonly diagnosed. Most types of thyroid cancer are treatable, especially when detected early.

Thyroid Adenoma: A thyroid adenoma is a non-cancerous (benign) tumour that forms in the thyroid gland. While it may not always cause symptoms, it can sometimes affect thyroid function, leading to conditions like hyperthyroidism if the tumour produces thyroid hormones.

Which Bodily Functions Does the Thyroid Affect?

The thyroid plays a key role in regulating many essential functions throughout your body. Its hormones influence a variety of physiological processes, and any imbalance in thyroid hormone levels can affect the following:

1. Metabolism

The thyroid directly controls your metabolism, which is the process by which your body converts the food you eat into energy. Thyroid hormones (T3 and T4) determine how quickly or slowly this energy conversion occurs. An overactive thyroid (hyperthyroidism) speeds up metabolism, causing weight loss and increased energy, while an underactive thyroid (hypothyroidism) slows down metabolism, which can lead to weight gain and fatigue.

2. Heart Function

Your thyroid has a significant impact on heart function. It helps regulate your heart rate, blood pressure, and the overall rhythm of your heart. An overactive thyroid (hyperthyroidism) can cause the heart to beat faster or irregularly, leading to palpitations or arrhythmias. Conversely, an underactive thyroid (hypothyroidism) may lead to a slower heart rate and increased risk of high blood pressure.

3. Digestive System

Thyroid hormones also influence the digestive system, affecting how quickly food moves through your intestines. A normal level of thyroid hormones helps to maintain healthy digestion. In cases of hyperthyroidism, food moves too quickly, which can cause diarrhoea. With hypothyroidism, digestion can slow down, leading to constipation.

4. Reproductive Health

The thyroid plays an essential role in reproductive health, particularly in regulating the menstrual cycle and fertility. Thyroid imbalances can lead to irregular periods or heavy menstrual flow in women. An overactive thyroid (hyperthyroidism) can result in lighter periods or even the cessation of periods, while hypothyroidism can lead to more frequent and heavier periods. Both conditions can also impact fertility and the ability to conceive.

5. Brain Function

The thyroid directly controls your metabolism, which is the process by which your body converts the food you eat into energy. Thyroid hormones (T3 and T4) determine how quickly or slowly this energy conversion occurs. An overactive thyroid (hyperthyroidism) speeds up metabolism, causing weight loss and increased energy, while an underactive thyroid (hypothyroidism) slows down metabolism, which can lead to weight gain and fatigue.

What Other Organs and Glands Interact with the Thyroid?

  • Pituitary Gland: Produces thyroid-stimulating hormone (TSH) to regulate thyroid activity.
  • Hypothalamus: Controls the release of TSH from the pituitary.
  • Para Thyroid Glands: Manage calcium levels, indirectly influencing bone health.

What Are the Early Warning Signs and Symptoms of Thyroid Problems?

1. Hyperthyroidism

When your thyroid produces too much of the hormone’s thyroxine (T4) and triiodothyronine (T3), your metabolism speeds up. Early signs of hyperthyroidism include:

Weight Loss – Even if you eat more, you might lose weight due to an accelerated metabolism.

Rapid Heartbeat (Palpitations) – Fast or irregular heartbeat is a common symptom.

Nervousness or Anxiety – Feeling jittery, anxious, or having difficulty relaxing are signs that your body’s systems are running at high speed.

Increased Sweating – Excessive sweating or feeling unusually hot, even in cooler environments, is common.

Fatigue– Although hyperthyroidism causes an increase in energy, it can also lead to extreme fatigue and muscle weakness due to the body’s overactivity.

Tremors – Fine shaking or tremors in the hands are a common early symptom.

Sleep Problems – Difficulty falling or staying asleep due to a constantly elevated metabolic rate.

2. Hypothyroidism

Hypothyroidism occurs when your thyroid produces insufficient amounts of thyroid hormones, slowing down your metabolism. The early symptoms of hypothyroidism may include:

Fatigue and Weakness – Feeling constantly tired, sluggish, or weak even after a good night’s sleep is one of the most common early signs.

Weight Gain – Unexpected weight gain, even if your diet and exercise habits haven’t changed, can occur due to a slowed metabolism.

Cold Sensitivity – Feeling unusually cold, especially in your hands and feet, can be an early warning sign.

Dry Skin and Hair – Hypothyroidism often causes dry, rough skin and brittle hair that breaks easily.

Constipation – Slow digestion and constipation are common early symptoms of an underactive thyroid.

Depression – A feeling of sadness, depression, or a lack of motivation can be a result of an underactive thyroid affecting brain function.

Memory Problems – Difficulty concentrating, brain fog, or memory lapses may occur due to the slowed metabolism affecting cognitive function.

Puffy Face – Puffiness, especially around the eyes, is a visible sign of hypothyroidism.

3. Autoimmune Thyroid Conditions

1. Graves' Disease (Hyperthyroidism):

  • Bulging Eyes (Exophthalmos): One of the hallmark signs of Graves' disease, where the eyes may appear to bulge out due to inflammation behind them.
  • Thyroid Enlargement: The thyroid may become swollen, leading to a noticeable lump in the neck (goitre).

2. Hashimoto’s Disease (Hypothyroidism):

  • Goitre: Like in Graves’ disease, Hashimoto's can also cause swelling of the thyroid, leading to a visible bulge in the neck.
  • Lethargy and Weight Gain: These are often seen in the early stages of Hashimoto’s disease, as the immune system attacks the thyroid, impairing its function.

Other Early Warning Signs of Thyroid Problems

Some additional early signs of thyroid issues may include:

  • Irregular Menstrual Cycles – Women with thyroid disorders may experience changes in their menstrual cycles, such as heavier or lighter periods.
  • Changes in Heart Rate – An elevated heart rate or heart palpitations can indicate hyperthyroidism, while a slow heart rate might be a sign of hypothyroidism.
  • Muscle or Joint Pain – Muscle stiffness or joint pain can be symptoms of hypothyroidism.
  • Thinning or Brittle Hair – Both hyperthyroidism and hypothyroidism can cause hair thinning or hair loss.

Causes of Thyroid Disease

Thyroid diseases can result from:

  • Autoimmune diseases: Hashimoto’s or Graves’ disease Conditions like Hashimoto's (causing hypothyroidism) and Graves' disease (leading to hyperthyroidism) occur when the immune system mistakenly attacks the thyroid.
  • Iodine deficiency or excess Both iodine deficiency and excess can disrupt thyroid hormone production, leading to conditions like hypothyroidism or hyperthyroidism.
  • Genetics: Family history of thyroid problems A family history of thyroid issues increases the likelihood of developing thyroid disorders due to inherited genetic factors.
  • Medications: Certain drugs can interfere with thyroid function Some medications, like lithium and amiodarone, can affect thyroid hormone levels, potentially causing thyroid problems.

Diagnosis and Tests for Thyroid

To check how well your thyroid is working, doctors use different tests. These tests help identify if you have thyroid problems and what might be causing them.

Blood Tests

  • TSH Test: This test checks for thyroid-stimulating hormone (TSH) in your blood. High levels can mean your thyroid is underactive (hypothyroidism), and low levels can mean it’s overactive (hyperthyroidism).
  • T4 and T3 Tests: These tests measure the levels of thyroid hormones in your blood. If levels are too high or low, it could show thyroid issues.
  • Thyroid Antibody Test: This test looks for antibodies that might suggest an autoimmune disease like Hashimoto's or Graves' disease.

Imaging Tests

  • Ultrasound: This test uses waves of sound to look at your thyroid and check for lumps (nodules). It can also help doctors see if the lumps are cancerous or not.
  • Thyroid Scan: This test uses a little amount of radioactive iodine to take pictures of your thyroid. It helps doctors see if your thyroid is producing too much hormone or if there are any abnormal growths.
  • Radioactive Iodine Uptake Test: This test checks how well your thyroid absorbs iodine to make hormones. It helps identify causes of overactive thyroid.

Biopsy for Thyroid Nodules

If doctors find a lump in your thyroid, they might do a biopsy. This involves using a needle to take a small sample of the lump to check if it’s cancerous.

How Are Thyroid Conditions Treated?

Hypothyroidism Treatment

  • Medication: Levothyroxine is the standard treatment.
  • Diet: A balanced diet rich in iodine can help support thyroid health.

Hyperthyroidism Treatment

  • Antithyroid Medications: Reduce hormone production.
  • Radioactive Iodine Therapy: Shrinks the gland to normal size.
  • Surgery: In severe cases, partial or complete thyroidectomy.

Diet for Thyroid Patients

  • Foods rich in iodine, selenium, and zinc support thyroid function.
  • Controlling thyroid with diet is especially beneficial in mild cases.

Risk Factors for Developing Thyroid Conditions

  • Gender: Women have a higher chance of developing thyroid related diseases.
  • Age: Risk increases with age.
  • Family History: A genetic predisposition to autoimmune diseases.
  • Lifestyle: Stress and poor diet can exacerbate thyroid issues.

How Can I Keep My Thyroid Healthy?

  • Eat a balanced diet with sufficient iodine and selenium.
  • Exercise regularly to maintain overall health.
  • Schedule routine thyroid blood tests to monitor hormone levels.
  • Visit your endocrinologist (thyroid doctor) from time to time.

How Can I Keep My Thyroid Healthy?

Book an appointment with a doctor if you experience:

  • Persistent fatigue or weight changes.
  • Swelling in the neck or noticeable goitre.
  • Symptoms of hypo or hyperthyroidism like rapid heart rate or extreme tiredness.

FAQ's

Can a Person Live Without a Thyroid?

Yes, individuals can live without a thyroid gland. Hormone replacement therapy ensures the body gets enough T4 and T3 for normal functioning.

How to decrease thyroid?

To manage thyroid health, adopt a healthy diet, engage in regular exercise, avoid smoking, and ensure sufficient vitamin D levels.

Is thyroid a serious problem?

An overactive thyroid, which produces excess hormones, causes your body to burn energy too quickly, leading to hyperthyroidism. If left untreated, it can result in serious issues, including heart problems, bone loss, and more.

Is thyroid the cause of hair fall?

Both severe and prolonged cases of hypothyroidism and hyperthyroidism can lead to hair loss.

Does thyroid affect periods?

An imbalance in thyroid hormones can lead to changes in menstrual cycles, causing periods to become irregular, very light, or heavy. In some cases, thyroid disease can stop menstruation altogether, known as amenorrhea, and may also affect other glands like the ovaries.