Thyroid Disease: Causes, Symptoms, Diagnosis, and Treatment

Thyroid disease is a variety of disorders that occur in the thyroid gland, this disorder can be either an increase (hyperthyroidism) or a decrease (hypothyroidism) levels of thyroid hormone. Also, be aware, the thyroid is a gland located under the Adam’s apple which functions to regulate various metabolic systems in the body.

What is a thyroid gland?

Thyroid is a small gland, which is shaped like a butterfly and is located under the Adam’s apple or the base of the throat. This gland plays a very important role to control the body’s metabolism by producing the hormone thyroxine (T4) and triiodothyronine (T3).

These two main hormones will later spread through the blood throughout the body. The main function of the T4 and T3 hormones is to notify cells in the body in terms of controlling the use of energy for metabolism, and protein production.

In addition, the thyroid gland also produces the hormone calcitonin, which is a hormone that functions to regulate the regulation of calcium levels in the blood, by inhibiting bone damage (reabsorption) and increasing the elimination of calcium from the kidneys.

What Is Thyroid Gland Disease?

Already mentioned a little earlier thyroid gland disease is all conditions associated with levels of production of thyroid hormone in the blood, either in the form of an increase (hyperthyroidism) or a decrease (hypothyroidism) level of the thyroid hormone itself.

According to data from The American Thyroid Association, it is estimated that 20 million Americans have some form of thyroid, and about 60% of those suffering from thyroid disease do not know it.

Women are more likely to have thyroid problems than men, with a ratio of 1 in 8 women experiencing thyroid disorders during their lifetime.

Causes of Thyroid Disease

Thyroid disease in the form of an increase or decrease in thyroid hormone levels, can be triggered by several thyroid-causing factors, including:

  • There is damage or problems to the glands in the brain (pituitary or hypothalamus), which are the hormones that play a role in regulating the output of the thyroid hormone itself.
  • Radiation exposure (x-ray or CT-Scan) that causes damage to the thyroid gland.
  • Previous surgical removal of the thyroid gland.
  • Excessive levels of iodine in the body
  • Patients with Lithium (Li) treatment

Risk Factors that Increase Thyroid Disease

Risk factors for thyroid are divided into two namely hyperthyroidism and hypothyroidism:

Hyperthyroidism

  • Family history, specifically Graves’ disease.
  • Female gender.
  • A history of certain chronic diseases, such as type 1 diabetes, pernicious anemia, and primary adrenal insufficiency.

Hypothyroidism

  • Woman.
  • Age more than 60 years.
  • Have a family history of thyroid disease.
  • Have autoimmune diseases, such as type 1 diabetes or celiac disease.
  • Has been treated with radioactive iodine or anti-thyroid medication.
  • Receive radiation to the neck or upper chest.
  • Have had thyroid surgery (partial thyroidectomy).
  • Pregnant or gave birth to a baby in the past six months.

Symptoms of Thyroid Disease

The following are symptoms for hypothyroidism:

  • Fatigue.
  • Severe menstrual periods.
  • Easy to forget.
  • Gain weight.
  • Dry skin and rough hair.
  • Hoarseness.
  • Intolerance to cold.

The following are symptoms for hyperthyroidism:

  • Easy red.
  • Muscle weakness/tremor.
  • Little menstrual periods.
  • Weight loss.
  • Sleep disturbance.
  • Enlarged thyroid gland.
  • Visual problems or eye irritation.
  • Heat sensitivity.

Various thyroid diseases

Here are some examples of thyroid diseases that are commonly found:

1. Hypothyroidism

Is a decrease or at least thyroid levels, resulting in decreased metabolic function of the body. In general, the appearance of thyroid symptoms of this type is an increase in body weight, dry mouth, constipation, intolerance to cold, swollen skin, hair loss fatigue, and menstrual irregularities in women.

Severe untreated hypothyroidism can fall in a condition called myxedema, with symptoms of heart failure, seizures, and coma. In children, hypothyroidism can inhibit growth and delay sexual development. Some specific types of hypothyroidism include: congenital hypothyroidism, hashimoto thyroiditis, and iodine deficiency.

2. Hyperthyroidism

The opposite of hypothyroidism, is a condition of increased or too much thyroid levels in the body. This condition is often also known as overactive thyroid. This high thyroid hormone causes increased acceleration of the body’s metabolic functions.

Symptoms of this type of thyroid include increased heart rate, anxiety, weight loss, insomnia, tremors in the hands, fatigue and diarrhea. Sometimes also found swelling in the eyes, dry eyes and irritation, and in some cases found more prominent eyes.

People affected by this disease may experience light sensitivity and visual disturbances. This may be because the eyes do not move normally, so they are often considered to be wide-eyed or staring intently.

Some specific types of hyperthyroidism include: Graves’ disease, thyroid tumor, and abnormal stimuli in the thyroid gland (there is an effect of hCG levels in pregnant women).

3. Goiter

An enlarged thyroid gland that is seen as a lump in the neck. This condition is relatively common and is caused by iodine deficiency. This goiter can compress the vital structures of the neck, including the trachea and esophagus. This compression can make it hard for you to breathe and swallow.

4. Thyroiditis

An inflammation or inflammation of the thyroid that can be related to hyper or hypothyroidism. This inflammation can be caused by an autoimmune disorder (Hashimoto thyroiditis), exposure to chemicals or is idiopathic. This inflammation can be acute temporarily or chronic.

5. Thyroid nodules

It is a small lump in the thyroid gland that is dense or can also contain fluid such as a cyst. These nodules in general and most are harmless. But in certain cases, these nodules can turn into cancer and need special treatment.

Diagnosis of Thyroid Disease

In order to diagnose a thyroid disease, the doctor will usually first conduct a question and answer session around thyroid complaints and symptoms and proceed with a physical examination in the neck area. The next step the doctor will require several supporting examinations such as:

1. Laboratory Examination

If the patient’s history and physical examination are suspected to lead to an abnormality of the thyroid gland, the doctor will usually ask the patient to have a blood test in the form of a TSH (thyroid-stimulating hormone) examination.

If abnormalities are found from the TSH value, an ordinary doctor will also require another examination such as Free T4 (Free Thyroxine) and Free T3 (Triiodothyronine) to confirm the diagnosis. The uses of each of these checks are:

  • TSH (thyroid-stimulating hormone) – is a test for hypothyroidism, hyperthyroidism, screening of newborns suspected of hypothyroidism and for monitoring therapy of thyroid disease itself.
  • Free T4 (Free thyroxine) – similar to TSH, is an examination to determine whether a person is hypothyroid, hyperthyroid, screening a newborn with suspected hypothyroidism and for monitoring therapy of thyroid disease itself.
  • Free T3 (triiodothyronine) – is the main test for hyperthyroidism, especially for patients with iodine deficiency (where Free T4 does not increase).
  • Thyroid Antibody – is an additional examination used to distinguish between several types of thyroiditis and can also identify several autoimmune thyroid conditions. Included in this examination include: Thyroid peroxidase (TPO) antibody, Thyroglobulin (TG) antibody, Thyroid stimulating hormone receptor (TSHR) antibodies, Thyroid stimulating immunoglobulin (TSI), Thyroid binding inhibitory immunoglobulin (TBII).
  • Thyroglobulin – is a useful test to monitor thyroid cancer therapy and can also detect a recurrence.

2. Thyroid Ultrasound (USG)

Thyroid ultrasound is a test that is commonly used for thyroid nodules. This check is useful to determine whether the contents of a thyroid nodule are solid or liquid. Besides this ultrasound can also help doctors to determine the number and size of these thyroid nodules.

3. Biopsy

The biopsy used most often is by fine-needle biopsy. This examination is done by inserting a needle into the thyroid and freeing up a small piece of tissue or fluid in the area that the examiner wants. Then the tissue is then observed under a microscope by an anatomic pathologist to look for signs of a malignancy.

4. CT scan

This examination is useful to determine the area, size and can also assess other organs around the thyroid (such as the trachea, esophagus, etc.) whether experiencing an abnormality or not.

Complications of Thyroid Disease

If you have thyroid problems that are not treated properly, serious health problems can occur.

  • Overactive thyroid (hyperthyroidism) can cause a number of problems including: eye problems, such as protruding eyes, blurred or double vision to loss of vision.
  • Heart problems, such as rapid heartbeat, problems with heart rhythm or heart failure. This condition can usually be treated.
  • Brittle bones (osteoporosis).
  • The skin is red and swollen especially on the shins and legs.
  • Thyrotoxic crisis, is a symptom that can cause fever, rapid heartbeat, and delirium (conditions that require immediate medical attention).

An underactive thyroid (hypothyroid) can cause various complications, including:

  • Enlarged thyroid, or goitre, which can cause problems with swallowing and breathing
  • High cholesterol and related heart disease
  • Nerve damage that causes tingling, numbness, and pain in the legs, arms, or other affected areas.
  • Infertility.
  • Birth defects.
  • Miscarriage or premature birth.
  • Mental health problems such as depression.
  • Myxedema is a rare condition, but this life-threatening condition involves intense cold intolerance, lethargy and drowsiness which can cause unconsciousness. Myxedema requires immediate medical attention.

Treatment of Thyroid Disease

One question that is often asked is whether thyroid disease can be cured? Basically, the treatment or administration of thyroid medication depends on the cause of the thyroid gland, the severity of thyroid symptoms, and the level of hormone production.

Therapy for disorders that cause hyperthyroidism may involve radioactive iodine to destroy part or all of the thyroid gland to stop overproduction, thyroid medication or anti-thyroid medication, or surgery to remove the thyroid. Sometimes all three treatments can be used together.

If the thyroid is removed or removed, the person will become hypothyroid and need to use thyroid hormone as a substitute to meet blood thyroid levels that are no longer produced by the thyroid gland.

Treatment for all types and causes of hypothyroidism is usually immediate and involves thyroid hormone replacement therapy. As for the treatment of thyroid cancer depends on the type of cancer and how far the cancer has spread.

Thyroid cancer usually requires removal of all or part of the thyroid and may involve treatment of radioactive iodine and treatment with thyroid hormones. Radiation and chemotherapy are commonly used before and after thyroid removal surgery.

Prevention of Thyroid Disease

In many cases, hypothyroidism or hyperthyroidism cannot be prevented. Hypothyroidism itself is often caused by iodine deficiency, while hyperthyroidism is often caused by Graves’ disease, an autoimmune disease that cannot be prevented.

In addition, the thyroid in the body can become very active if you consume drugs that contain too much thyroid hormone. Therefore, make sure the consumption of the correct dose.

In rare cases, the thyroid can become overactive if you eat too much food containing iodine, such as table salt, fish, and seaweed.

Although you may not be able to prevent thyroid disease, you can prevent complications immediately diagnosed and follow the treatment prescribed by your doctor.

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