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Thyroid diseases

Your thyroid gland is like an executive that ensures that your body works at its peak performance. It regulates the release of the thyroxine hormone that runs the body’s overall metabolism and growth. But when your thyroid is out of balance, it can produce annoying symptoms of hypothyroidism (not enough hormone) or hyperthyroidism (too much hormone) and even life-threatening complications if left untreated.
While estimates vary, about 42 million people in India suffer from various kinds of thyroid disorders which are more common in urban women than men. Hypothyroidism is a particular problem as it tends to worsen over the years and affects 1 in 10 adults in the country.
Treatment is usually available for almost all thyroid disorders, though an early diagnosis offers the best results.

Symptoms of Thyroid disorder

Both overactive and underactive thyroid hormone production has different effects on an individual.

When a person has an overactive thyroid (hyperthyroidism), the condition may cause:

Sudden weight loss

Muscle weakness and tremors

Puffy or bulging eyes

Rapid and inconsistent heartbeat

Nervousness and irritability

Heat intolerance

Excessive hunger

Increased bowel movements

Extreme sweating

Neck swelling or a goiter (enlarged thyroid glands)

Short and light periods

On the other hand, having  an underactive thyroid ( hypothyroidism ) slows down the body’s metabolism leading to:

Excessive tiredness

Weight gain

Muscle and Joint Pain

Dry and itchy skin

Brittle nails

Hair loss

Double vision

Frequent and heavy periods

Intolerance to cold

Memory loss

Constipation

Elevated "bad" (LDL) cholesterol

Depression

Heart failure

Miscarriage or stillbirth

Coma (rare complication)

Causes of Thyroid disorders

Thyroid failure can be caused by several conditions. Those that cause hyperthyroidism include:

  • Graves’ disease or toxic goiter
  • Overmedication of thyroid hormone
  • Pituitary gland tumor
  • Overactive thyroid nodules ( causes multinodular goiter)
  • Inflammation of the thyroid(thyroiditis)
  • Excessive iodine intake

Whereas the reasons for your increased risk of hypothyroidism are:

  • Thyroid gland inflammation
  • Hashimoto’s thyroiditis (an autoimmune condition)
  • Hormonal changes after childbirth
  • Iodine deficiency
  • Radiation treatment of upper neck and chest area
  • Family history
  • Age above 50
  • Type -1 diabetes or arthritis
  • Thyroid surgery

Diagnosis and Treatment

Doctors sometimes struggle to diagnose thyroid disorders since their symptoms overlap with many other conditions. But to find out what has caused your thyroid issues, your doctor will conduct a physical exam, blood tests, and an ultrasound using radioactive iodine.

Your treatment plan will focus on regulating your thyroid hormone levels. Thus, before deciding which treatment might work for you, your age, health and disease status are usually assessed.   

If you’re diagnosed with hyperthyroidism, they may prescribe:

  • Anti-thyroid medication
  • Radioactive iodine therapy
  • Beta-blockers ( to control your heart rate and anxiety)
  • Thyroid gland removal surgery

And, if with hypothyroidism:

  • Thyroid replacement medicines like thyroxine sodium tablets

Furthermore, remember that treatment given for hypothyroidism is usually lifelong and cannot be replaced by any lifestyle change, diet, or alternative therapy and must also be continued throughout pregnancy. So,  try to stick to the doctor’s advice as it is the only way to live a normal and healthy life.

FAQ's :

The way your body produces thyroid hormone and its susceptibility to autoimmune thyroid disorders, such as Grave's disease and Hashimoto's thyroiditis, are strongly influenced by your genes. Therefore, if several members of your family have had thyroid disease, the problem has a hereditary root,  up ticking your chances of getting the same condition.

Over 20 genes have been identified that influence thyroid hormone synthesis or the function of the thyroid-stimulating hormone receptor(TSHR). Alterations in these genes are known to cause autoimmune or congenital thyroid diseases. For instance, the mutation in the TSHR gene has been associated with various thyroid disorders, such as Grave's disease, congenital hypothyroidism and some type of thyroid tumors. A few others are HLA, TG, CTLA4, PTPN22, CD40, CD25,  FCRL3, DUOX2,  TPO, LHX3, etc.

Several molecular testing options are now available to help screen, diagnose, and do a risk assessment of congenital hypothyroidism. Based on the information,  your doctor can then offer you a personalized treatment, nutrition profiling,  and other healthcare suggestions. Genetic sequencing, deletion/duplication analysis, and other similar tests are among the standard tests commonly employed.

A genetic test, though not recommended for every thyroid condition, may be helpful to patients having the clinical suspicion of congenital hypothyroidism and thyroid hormone resistance.

References:

  1. Bagcchi, S. (2014). Hypothyroidism in India: More to be done. The Lancet Diabetes & Endocrinology, 2(10), 778. https://doi.org/10.1016/S2213-8587(14)70208-6
  2. Ganie, M. A., Charoo, B. A., Sahar, T., Bhat, M. H., Ali, S. A., Niyaz, M., Sidana, S., & Yaseen, A. (2020). Thyroid Function, Urinary Iodine, and Thyroid Antibody Status Among the Tribal Population of Kashmir Valley: Data From Endemic Zone of a Sub-Himalayan Region. Frontiers in Public Health, 8. https://www.frontiersin.org/article/10.3389/fpubh.2020.555840
  3. Thyroid Gland Problems: Common Disorders, Types, Symptoms. (2022, May 3). Healthline. https://www.healthline.com/health/common-thyroid-disorders
  4. Thyroid Disease: Causes, Symptoms, Risk Factors, Testing & Treatment. (n.d.). Cleveland Clinic. Retrieved May 21, 2022, from https://my.clevelandclinic.org/health/diseases/8541-thyroid-disease
  5. Vaidya, B., Kendall-Taylor, P., & Pearce, S. H. S. (2002). The Genetics of Autoimmune Thyroid Disease. The Journal of Clinical Endocrinology & Metabolism, 87(12), 5385–5397. https://doi.org/10.1210/jc.2002-020492
  6. Davies, T. F., Latif, R., & Yin, X. (2012). New Genetic Insights from Autoimmune Thyroid Disease. Journal of Thyroid Research, 2012, e623852. https://doi.org/10.1155/2012/623852
  7. Panicker, V. (2011). Genetics of Thyroid Function and Disease. The Clinical Biochemist Reviews, 32(4), 165.
  8. TSHR gene: MedlinePlus Genetics. Retrieved May 20, 2022, from https://medlineplus.gov/genetics/gene/tshr/
  9. Hypothyroidism Panel | The University of Chicago Genetic Services. Retrieved May 21, 2022, from>https://dnatesting.uchicago.edu/tests/hypothyroidism-panel

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