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Thyroid Disorders

The thyroid gland is located in front of the neck and is responsible for tissue development and metabolism. The thyroxine hormone commonly abbreviated as T3 and T4 has systemic effects. Abnormality or inadequacy in the levels of hormone secretion results in the disorders of the thyroid. The pituitary gland and the hypothalamus are essentially in control of the functioning of the thyroid gland and any dysfunction or disturbance to these tissues can also result in thyroid disorders. Congenital hypothyroidism is known to cause irreversible brain damage.

Kinds of thyroid disorders

Hyperthyroidism: Excess synthesis or secretion of the thyroid hormone leads to elevated levels of FT4 and / or FT3 causing thyrotoxicosis. There are several forms of hyperthyroidism such as toxic goiter, toxic nodular goiter or Plummer disease, toxic adenoma and Grave’s disease. Hyperthyroidism is caused due to genetic syndromes especially the mutations of the TSHR gene. Sufficient or excessive intake of iodine is a known cause of hyperthyroidism. The destructive release of an already formulated thyroid hormone leads to subacute thyroiditis, which provokes hyperthyroidism.

Hypothyroidism: Deficiency of the thyroid hormone leads to an endocrine disorder where the thyroid gland is unable to produce adequate amounts of thyrotropin or the thyroid-stimulating hormone (TSH) leading to a condition called hypothyroidism. Iodine deficiency is the principal cause of hypothyroidism. Other known causes are Hashimoto’s disease or auto-immune thyroid disease and Grave’s disease, which uses radioactive iodine, causing permanent hypothyroidism. Damage to the hypothalamic-pituitary axis causes secondary or tertiary central hypothyroidism. There are several types of primary hypothyroidism such as chronic lymphocytic thyroiditis, iatrogenic hypothyroidism, subacute thyroiditis, postpartum thyroiditis and drug-induced hypothyroidism.

Thyroid nodules – Nodular disease of the thyroid is a palpable and visible presence of the thyroid nodule. A common occurrence in women than in men, factors suggesting malignancy are: age > 70 years, past neck irradiation, symptoms of dysphagia or dysphonia, history of thyroid carcinoma, immobile and hard nodule and cervical lymphadenopathy.

Goiter – A diffuse or nodular, enlarged thyroid gland is a goiter. It can extend into the retrosternal space and may or may not show anterior enlargement. TSH receptor agonists can cause goiter. Physical examination reveals swelling in the neck. Patient presents with dysphagia, stridor, plethora and dyspnea. The goiter is painful due to necrosis, inflammation and haemorrhage. Goiters can be toxic or nontoxic.

Thyroid cancer – Papillary carcinomas, follicular carcinomas, anaplastic carcinomas, primary thyroid sarcomas, MTCs or medullary thyroid carcinomas and primary thyroid lymphomas are all classifications of thyroid cancer. The etiology of thyroid cancer is associated with neuroendocrine-derived calcitonin-producing C cell that leads to MTCs, low intake of dietary iodine, and exposure to radiation.

Thyroid treatments require a multi-disciplinary approach with the right combination of diagnostics and systematic management plans. Contact Dr. Deepak for treatments to all types of thyroid disorders.

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