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Thyroid ailments can really bother us; know them well

by Our Correspondent | 29 Jun 2018

Thyroid is an all too familiar word today and even those who are not medical professionals are quite aware of its implications.

Though thyroid manifests in various types of ailments and diseases, people in general seem to be more aware of hypothyroidism, the condition when the thyroid glands become underactive. The thyroid is a butterfly-shaped gland in the front of the neck. It’s the thyroid gland which controls the functioning of the entire body. Hence, when it works overtime or decides to go slow, what gets affected is the human system.

Here's a post by Dr T M Jamal which tells us all about the gland and its functioning.

The doctor begins with an anecdote. There was this woman who came in to see him along with her husband, who, all of a sudden had started showing symptoms of mental unrest. Thoroughly baffled by his behaviour, his wife took him to a psychiatrist who prescribed medicines.

"He has changed a lot," said the distraught wife. "He's become restless, nervous and suffers from bouts of anxiety. He’s sleep-deprived and keeps staring at people. Though he eats well, he's lost a lot of weight," she continued, as she explained the changes she saw in her husband to Dr Jamal.

Dr Jamal took a good look at the man who was brought in. There were beads of perspiration all over his face and the eyes had a protruded look. This was why it gave out the effect of staring pointedly at someone. His hands, carelessly spread out on the doctor’s table had a slight shiver. However, he gave reasonably sound answers to all the questions he was asked. He did not appear to be a case for mental illness. That's the way with diseases, says Dr Jamal. You can make out a patient the moment one steps into the room. You don’t have to examine him to make a diagnosis. There are again diseases which you can identify from afar and this is no exaggeration, says the doctor. It was with one such identifiable ailment that the man had come in along with his wife.

The very first thing Dr Jamal prescribed was a thyroid check after a careful scrutiny of the patient’s neck which betrayed the tell-tale signs of a small thyroid bulge.

As expected, his blood test showed elevated levels of the thyroid hormone, medically termed as hyperthyroidism. A month’s treatment later, it was an amazingly changed man who walked in to see the doctor. He was not restless any more. Gone was that fixed stare. He was sleeping soundly and his hands had stopped shivering. He had gained weight too.

Today, thyroid-related ailments are aplenty. But the common notion is that only hypothyroidism needs to be addressed.

Elevated as well as low levels of the thyroid hormone are detrimental to health and can control all of our actions. But then the next question would logically be whether all our actions are controlled solely by the thyroid gland. No, says Dr Jamal. There’s another gland, the pituitary gland, a major one, that regulates vital body functions and provides overall well-being. This is a pea-shaped gland located at the base of the brain just below the hypothalamus. It’s the TSH (Thyroid Stimulating Hormone) from the pituitary gland which helps the thyroid gland function.

Therefore, the reality is that thyroid-related ailments can occur even though the thyroid gland is not affected in any way. There are concrete ailments.

A) The most common thyroid-related ailment is hypothyroidism or a drop in the required levels of the thyroid hormone.

What causes hypothyroidism is the ailment called autoimmune thyroditis or Hashimoto’s thyroditis when the body's auto immune system, unbeknown to itself, kills its own thyroid. In other words, it can prevent your body from making the necessary hormones it needs to function perfectly.

Either way, when the iodine content in food falls low or turns high, it affects the functioning of the thyroid gland. Other factors which affect the gland include:

• Radiation around the neck done as part of cancer treatment

• Surgery on the gland as part of treating other ailments

• Medication for mental and heart ailments.

In very rare instances, a malfunctioning of enzyme production can also cause hypothyroidism.

Symptoms of hypothyroidism:

• Facial swelling

• Swollen eyelids

• Dull hair

• Alarmingly excessive hair fall

• Dry and parched skin

• Dull and tired face

• Hoarseness of voice

A few other noticeable and important signs are:

• Excessive sleep

• Weight gain

• Swelling in the legs

• Edema in the heart and lungs

• Constipation

• Irregular periods

• Infertility

• Excessive muscle growth

• Increase in BP, cholesterol

All these symptoms are unlikely to manifest in all patients. In some others, the symptoms may be very negligible. Hence, it’s vital to get the patient tested to check for thyroid abnormalities.

B) Hyperthyroidism is the excess production of the thyroid hormone. A few factors which contribute to it are:

• Graves' Disease; This occurs when the gland gets inflamed and overshoots the normal level.

• Toxic multi-nodular goiter: When multiple nodes inside the gland produce hormones in excess.

• Toxic nodule: When one big node pumps out more hormones.

• Nodes inside the hypothalamus and pituitary gland.

Different stages of the disease:

• When certain other nodes and cancers in very rare cases produce thyroid hormones which increases the total hormone level.

Symptoms of hyperthyroidism

• Loss of weight

• Weakening of muscle strength

• Shivering of hands

• Excessive heartbeats

• Bulging eyes

• Excessive appetite

• Pressure on the heart pumping

• Irregular bowel movements

• Excessive sweating

• Prolonged fever

C) What's thyroiditis?

It's a condition when thyroid cells release all of the hormones they had stored into the blood stream in the aftermath of a temporary or permanent injury to them. When all the hormones are released into the blood, early tests may lead to the conclusion that the ailment could indeed be Graves' Disease. The best way to test for thyroid is the nuclear scan. But it has to be done under the supervision of a super specialist.

D) Thyroid nodules

Patients panic when they notice those thyroid nodules. The nodules vary in several ways with most of them being benign. Once they have been checked and found to be benign, there’s no harm in living with their presence around the neck. Twice a year check-up would be fine in such cases. But if they show symptoms of enlargement and cause distress to the organs around, immediate medical intervention is recommended.

What to do when a nodule is detected?

The doctor can physically feel the nodule. This will give a rough idea of the nodule's size. The next step is to check the thyroid hormone level followed by an ultrasound scan of the hormone. The scan will show up symptoms of early malignancy. Once abnormal cell growth is detected, an FNAC (fine needle aspiration cytology) will dispel doubts.



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