Thyroid disease definition
Thyroid disease, also known as thyroid gland disorder or thyroid dysfunction, is an umbrella term for conditions that affect the function of the thyroid gland. The thyroid gland (a butterfly-shaped, two-lobed endocrine gland located in the front of the neck) produces hormones (t3: triiodothyronine and t4: tetraiodothyronine), to regulate various functions in the body, including metabolism, breathing, digestion etc. Any abnormalities (either too much or too little) in the production of thyroid hormones lead to thyroid diseases, which are caused mainly by autoimmune conditions or deficiency of iodine.
Heart disease, osteoporosis, and infertility are some complications that could arise if a patient with thyroid disorders goes undiagnosed. Thyroid disease treatment includes pharmacological therapy (Such as thyroid medications) and surgical interventions (like thyroidectomy). Depending on the type of thyroid disorder, the endocrinologists will opt for either.
Across the world, thyroid diseases are one of the most prevalent endocrinopathies. It is estimated that about 20 crore people globally are diagnosed with thyroid disease, with hypothyroidism (1-2%) and hyperthyroidism (0.2-1.3%) being common, and autoimmune thyroid diseases, like Hashimoto's and Graves' disease, frequently being the causes.
According to epidemiological studies, thyroid nodules are clinically found in 1% of men and 5% of women, and their frequency rises with age and in iodine-deficient populations.
In India, about 4.2 crore people suffer from thyroid disease, making it the most common endocrine disorder. As per an Indian research study (a population-based study done in Cochin), the prevalence of hypothyroidism and subclinical hypothyroidism was reported as 3.9% and 9.4%, respectively. The prevalence in women (11.4%) is higher than in men (6.2%). In the iodine-sufficient areas, congenital hypothyroidism affects about one newborn in every 3500–4000 births.
It is well-understood that thyroid disease is not a major cause of mortality. However, it does cause significant complications which lead to disability.
People of all ages are prone to have thyroid disorders. Thyroid disease in more frequently affected in women than men. The thyroid's functioning greatly influences a woman's reproductive, menopause, pregnancy, post-partum, puberty, and menstruation. The types of thyroid disorder in females are similar to those in males, such as hypothyroidism and hyperthyroidism.
In general, there are 2 types of thyroid disease, which are as follows.
As per a few research reports, there are different types of thyroid gland diseases, including Hyperthyroidism, Hypothyroidism, Hashimoto's thyroiditis (An autoimmune disease), goiter, thyroid nodules, and thyroid cancer.
It occurs when the thyroid gland releases an excessive thyroid hormone into the bloodstream.
It occurs when the thyroid gland fails to release the required hormones into the bloodstream.
It is an autoimmune disease where the thyroid cells are attacked by the immune system, resulting in an insufficient amount of thyroid hormone production.
It is a thyroid disease characterized by enlargement of the thyroid gland, which is caused by iodine deficiency.
It is an abnormal growth (Usually non-cancerous) of thyroid gland cells, which are often asymptomatic.
It is a cancerous condition of the thyroid where the thyroid cells mutate and multiply, resulting in the formation of a tumor.
A condition caused by decreased activity of the thyroid gland at birth (congenital hypothyroidism), resulting in developmental delay, growth retardation, and other abnormal features.
The causes of thyroid gland disorders vary based on several factors. The common causes of thyroid disease are autoimmune diseases such as Hashimoto's disease and Graves' disease, which attack the thyroid gland and can cause glandular destruction, leading to hormone imbalance (hypothyroidism/hyperthyroidism) or thyroid hormone overproduction (thyrotoxicosis).
Other common causes of thyroid disease include:
Rare causes such as:
The thyroid causes in females are mainly due to the presence of autoimmune conditions, which might occur due to the effects of sex steroids on the immune system. Several research studies have demonstrated the exacerbation of autoimmune conditions during pregnancy (due to high oestrogen and progesterone levels) and post-partum (after childbirth) period, resulting in thyroid gland problems.
In addition, few studies estimated the immune inhibitory cytokines that are produced by the mother, placenta, or foetus inhibit the immune response during pregnancy. Decrease in these inhibitors after childbirth results in the beginning or exacerbation of autoimmune diseases.
Persons with thyroid disease can experience a variety of symptoms. Unfortunately, thyroid disease symptoms closely resemble the signs of other medical conditions and stages of life, which makes it difficult to identify whether these symptoms are related to thyroid disease or other conditions. The following are the common thyroid disease symptoms:
Hyperthyroid Symptoms (high thyroid symptoms/ overactive thyroid symptoms)
Hypothyroid Symptoms (low thyroid symptoms/ underactive thyroid symptoms)
The thyroid disease symptoms in women might include tiredness, difficulty passing the stools, menstrual irregularities, infertility, muscle cramps, weight gain, cold intolerance, depression, brittle nails, and difficulty concentrating in patients suffering from primary and central hypothyroidism.
Untreated or poorly managed thyroid disease, whether hyperthyroidism (overactive thyroid) or hypothyroidism (underactive thyroid), can lead to many serious health complications, including heart problems, bone issues, fertility problems, and in severe cases, life-threatening conditions.
Complications of Hyperthyroidism (Overactive Thyroid)
Complications of Hypothyroidism (Underactive Thyroid)
Thyroid disease diagnosis can be challenging for an endocrinologist, as the symptoms resemble those of other conditions. The following are the diagnostic tests that are used to detect thyroid problems, including:
The primary goal of thyroid disease treatment is to normalize the abnormal thyroid levels, and this can be done through either thyroid medications (pharmacological) or thyroid surgery.
If the patient has high levels of thyroid hormones (hyperthyroidism)
If the patient has low levels of thyroid hormones (hypothyroidism) and Hashimoto's thyroiditis:
The prevention of thyroid disease is not possible as autoimmune diseases are the major cause. However, the following measures can aid in minimizing the risk of developing thyroid diseases:
The following are the foods to avoid for thyroid patients or supplements that aid in preventing thyroid inflammation or worsening the thyroid condition.
A well-maintained thyroid diet plays a pivotal role in managing and reducing the risk of thyroid diseases. The thyroid diet plan should include micronutrients such as zinc, iodine, iron, selenium, and vitamins B12, D3, and A that consist of antioxidant and anti-inflammatory properties, thereby reducing body fat, thyroid autoantibodies, and improving thyroid function.
Maintaining a high consumption of a Mediterranean diet (that consists of fruits, whole grains, vegetables, and healthy fats), low consumption of meat, and complete consumption of lactose and gluten aids in reducing thyroid symptoms.
The following are the best foods for thyroid patients that aid in decreasing symptoms, such as
Normal neck vs Enlarged thyroid
The neck is a vital part of the body, supporting the head and facilitating essential functions like breathing, swallowing, and movement. However, variations in the neck’s appearance or size can sometimes signal different underlying health conditions or anatomical differences. Here are some variations of normal and enlarged necks:
Elements | Normal neck | Enlarged thyroid |
---|---|---|
Appearance | Absence of bulge or swelling | The presence of a bulge or swelling at the front of the neck |
Size of Thyroid Gland | Normal butterfly shape, absence of a lump | Enlarged thyroid gland with the presence of a lump or mass that can be sensed with touch. |
Movement | Moves freely while swallowing | Less freely movable while swallowing |
Thyroid levels | Normal levels | Abnormal levels |
The thyroid gland is the main organ responsible for producing hormones that affect various body functions. Long-term effects of thyroid disease include goitre, heart problems, peripheral nerve damage, depression, myxoedema, infertility, birth defects, obesity, joint pain, weak, brittle bones, and severe eye problems such as Graves' ophthalmopathy and Graves' dermopathy (redness and swelling in the skin).
Yes, thyroid problems can cause kidney disease as thyroid hormones increase renal blood flow and glomerular filtration rate (GFR) through both pre-renal and intrinsic renal effects. Hyperthyroidism results in an increase in the renin-angiotensin-aldosterone pathway and GFR, but hypothyroidism is associated with decreased GFR.
Yes, thyroid dysfunction is a leading cause of hormonal problems that impact milk production. Thyroid hormone levels in women may fluctuate during pregnancy and immediately after delivery, which might impact milk production. Because a small amount of thyroid hormone reaches the baby through breast milk, the baby's thyroid levels may also need to be checked regularly after birth, depending on the mother’s medication intake.
Thyroid diseases are generally manageable with lifelong hormone treatments, medications, radioiodine therapies, or surgeries, but they are not always curable. Proper treatment helps manage symptoms and prevent complications, though ongoing care is often necessary.
Yes, patients suffering from thyroid autoimmunity can have hives. As per the research study,4.3% to 57.4% of patients had shown chronic spontaneous hives (symptoms that persist for more than six weeks) that are associated with autoimmune thyroid disease.
No, thyroid hormone secretion abnormalities are not contagious and cannot be spread through bodily fluids, insect bites, or inhaled viruses. It can be passed down only through genetic transmission (parent to child).
Thyroid disease in women can affect women of any age. Overactive or underactive thyroid gland has a major impact on a woman's reproductive system.
Too low or high thyroid hormone levels can cause:
Yes, in the majority of cases, total thyroidectomy (removal of the thyroid gland) is the optimal treatment for hyperthyroidism caused by Graves' disease, and it has the added benefits such as:
Graves' disease and Hashimoto's disease are the autoimmune disorders that cause the occurrence of thyroid disease. Anti-thyroid medications, beta-blockers, radioiodine therapy, and thyroid surgery are the treatment options for Graves' disease. T4 and T3, hormone replacement therapy, are the treatment options for Hashimoto's disease.
Thyroid eye disease (TED), an autoimmune condition and eye disorder, causes inflammation (swelling) and damage to the fatty tissue, muscles, and connective tissue around the eye. The endocrinologist will try to treat the thyroid condition if the patient has it.
In addition to that, the endocrinologist may prescribe anti-inflammatory medications, other systemic steroids to reduce inflammation, and eye drops to relieve irritation and dryness. Eyelid, eye muscle, and orbital decompression surgery are options for treating thyroid eye disease. In some cases, the endocrinologist might opt for radiation therapy.
The common symptoms of hypothyroidism in elderly patients include fatigue, increased weight, cold intolerance, change in voice (hoarse), difficulty in passing stool, and myalgias. Hyperthyroidism includes a decrease in weight, sweating or heat intolerance, feeling tensed, tiredness, muscle weakness, and shortness of breath.
Yes, thyroid disease runs in families because genetics plays a role in determining thyroid hormone and thyrotropin (TSH) concentrations, as well as susceptibility to autoimmune thyroid disease.
Yes, swelling and inflammation are the characteristic features of Graves’ eye disease, also termed thyroid eye disease.
Progressive swelling may cause:
Yes, hypothyroidism and hyperthyroidism can both increase the risk of high blood pressure (Hypertension). Lipid abnormalities are found in patients with thyroid dysfunction, which can cause atherosclerotic changes (the accumulation of fat, cholesterol and other substances accumulate in the blood artery walls) in the blood vessels, leading to a rise in blood pressure.
No, a person cannot have Hashimoto's disease without a thyroid gland, as it is an autoimmune disorder, where the immune system makes antibodies that attack thyroid cells, causing hyperthyroidism.
Polycystic thyroid disease is a rare cause of hypothyroidism characterised by multiple thyroid cysts that are detected through ultrasonography. High iodine consumption increases the risk of developing polycystic thyroid disease, leading to hypothyroidism.
To support thyroid health naturally, focus on a balanced diet rich in iodine, selenium, and zinc, as these nutrients are vital for thyroid function. Additionally, manage stress through relaxation techniques, regular exercise, and adequate sleep. Always consult a healthcare professional before making significant changes.
Thyroid diseases can be prevented by
As per the WHO recommendations, the daily intake of iodine is as follows.
Group | µg per day |
---|---|
Infants (0‐59 months) | 90 µg/day |
School children (6‐12 years) | 120 µg/day |
Adolescents | 150 µg/day |
Pregnant and lactating women | 200 µg/day |
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