By Dr Anirban Banerjee, MS, MRCS (Consultant surgeon)
What is the thyroid gland?
The thyroid gland is the biggest gland in the neck. Derived from the Greek word meaning shield, the thyroid is a butterfly-shaped gland located in front of the windpipe (called the trachea) and just below the larynx or Adam’s apple in the neck. It is comprised of two halves, known as lobes, which are attached by a band of thyroid tissue called the isthmus. The sole function of the thyroid is to make thyroid hormones.
What are thyroid
hormones?
Thyroid hormones are chemicals that are released into the bloodstream through the gland. The thyroid gland secretes two hormones.
One is called T3 and the other one is T4, depending upon the number of iodine units they have. The iodine comes from our diet, so when a person does not get enough iodine through their diet, hypothyroidism typically results. To prevent these problems, iodine is often added to table salt.
Why are thyroid hormones so important?
Thyroid hormones which are secreted from the gland, circulate throughout the body to deliver messages. These messages regulates the body’s metabolism.
What are the disorders associated with the thyroid gland?
There are many diseases and disorders associated with the thyroid. They can develop at any age and can result from a variety of causes – injury, disease, or dietary deficiency, for instance. But in most cases, they can be traced to the following problems:
► Too much or too little thyroid hormone (hyperthyroidism and hypothyroidism, respectively)
► Abnormal thyroid growth
► Nodules or lumps within the thyroid
► Thyroid cancer
What is hypothyroidism?
Hypothyroidism is a medical condition that means too little thyroid hormone. It affects millions of people around the world. Hypothyroidism is often present for a number of years before it is recognized and treated. There are many disorders that result in hypothyroidism. These disorders may directly or indirectly involve the thyroid gland. Because thyroid hormones are important for the body’s growth, development and maturation, inadequate thyroid hormone has widespread consequences for the body.
What causes hypothyroidism?
Hypothyroidism is a very common condition. It is estimated that 3% to 5% of the population has some form of hypothyroidism. The condition is more common in women than in men, and its incidence increases with age.
There are two fairly common causes of hypothyroidism. The first is a result of previous ongoing inflammation of the thyroid gland, which leaves a large percentage of the cells of the thyroid damaged and incapable of producing sufficient hormone. The second major cause is the broad category of ‘medical treatments.’ The treatment of many thyroid conditions warrants surgical removal of a portion or all of the thyroid gland. If the total mass of thyroid producing cells left within the body is not enough to meet the needs of the body, the patient will develop hypothyroidism.
Hypothyroidism can affect men, women, and even children, but women are most often diagnosed with this condition. Typically women find they have a hard time losing weight when they have a sluggish thyroid. Simply treating the underactive thyroid and eating well, along with regular exercise can eliminate unnecessary weight gain.
What are the symptoms of hypothyroidism?
The symptoms of hypothyroidism are often subtle. They are not specific (which means they can mimic the symptoms of many other conditions) and are often attributed to aging. Patients with mild hypothyroidism may have no signs or symptoms. The symptoms generally become more obvious as the condition worsens. Common symptoms are listed below:
► Fatigue
► Depression
► Weight gain despite loss of appetite
► Cold intolerance
► Excessive sleepiness
► Constipation
► Dry skin
► Muscle cramps
► Increased cholesterol levels
► Vague aches and pains
► Swelling of the legs
As the disease becomes more severe, there may be puffiness around the eyes, slowing of the heart rate, a drop in body temperature, and heart failure. In its most profound form, severe hypothyroidism may lead to a life-threatening condition (myxedema coma). This condition requires hospitalization and immediate treatment with thyroid hormones. Often people ignore the symptoms of hypothyroidism because they associate them with other conditions like stress or aging. Hypothyroidism can be diagnosed by monitoring the levels of TSH and thyroid hormones in a person’s blood. When hypothyroidism is present, the blood levels of thyroid hormones can be measured directly and are usually decreased. However, in early hypothyroidism, the level of thyroid hormones (T3 and T4) may be normal. Therefore, the main tool for the detection of hyperthyroidism is the measurement of the TSH, the thyroid stimulating hormone which helps the gland in hormone production.
What is the treatment of hypothyroidism?
Hypothyroidism is an easily treatable condition. With the exception of certain conditions, treatment requires life-long therapy with synthetic levothyroxine (T4). Ideally, synthetic T4 replacement should be taken in the morning, 30 minutes before eating. Other medications containing iron or antacids should be avoided, because they interfere with absorption.
Is hypothyroidism a serious condition?
Many people have borderline hypothyroidism and go a long time with minor symptoms and do not realize that they may benefit from treatment. If hypothyroidism persists for a long time people may suffer unnecessarily.
What is best for you?
If you are concerned that you may have hypothyroidism, you should mention your symptoms to your physician. A simple blood test is the first step in the diagnosis. From there, both you and your doctor can decide what the next steps should be. Remember that thyroid disease is very common and, in good hands, hypothyroidism is easily addressed and treated.
