Thyroid: Symptoms and cure

Thyroid: Symptoms and cure                   

Today I am going to discuss a medical problem, which most commonly we are seeing in underdeveloped and developing countless mostly. It is called thyroid, This is mainly due to iodine deficiency.

What is the thyroid ?

The thyroid gland is a small gland, it is present in the front of the neck below, resembles a butterfly. It is wrapped around the windpipe. The thyroid gland controls the energy from food. Delivers energy to all parts of a body through the bloodstream . It maintains the metabolic system in our body. Excessive or low release of this hormone is harmful to our body. These hormones strengthen our old cells.

Common conditions  of the thyroid 

There are several conditions of the thyroid , today we discuss to major conditions of the thyroid.

A. Hypothyroidism

B. Hyperthyroidism  

C. GOITER 

A.Hypothyroidism: Hypothyroidism is common, affecting over 1% of the general population and about 5% of individuals over age 60 years. Thyroid hormone deficiency affects almost all body functions. In hypothyroidism thyroid gland excretion of T3 and T4 are decreasing and increases the excretion of TSH.

Symptoms of  hypothyroidism 

• Weight change  

• Depression  

• Hoarseness  

• Cold intolerance  

• Constipation 

Differential  diagnosis of Hypothyroidism 

Many clinical manifestations of hypothyroidism are common in the general population without thyroid illness. The differential diagnoses are the conditions and drugs that can cause aberrations in laboratory tests, resulting in a low serum T4 or T3 or high serum TSH in the absence of hypothyroidism.

Laboratory investigations  

Hypothyroidism is a common disorder and thyroid function test should be obtained for any patient with its nonspecific symptoms. The single best screening test for hypothyroidism is the serum TSH serum, TSH is increased with primary hypothyroidism but low or normal with hypothyroidism.

Imaging

Radiologic imaging is usually no need for hypothyroidism's patient. However, on CT or MRI, a goitre may be noted in the neck or in the mediastinum.

Medication for Hypothyroidism 

Before therapy with thyroid hormone is commenced. Levothyroxine is the preferred preparation for treating hypothyroid patients. Otherwise healthy young and middle-aged adults with hypothyroidism may be treated initially with levothyroxine in doses of 25 -75 mg orally daily.

B.Hyperthyroidism: During hyperthyroidism, the excretion of T3 and T4  from thyroid gland increases and decreases the excretion of TSH.

Iodine induced hyperthyroidism is also known as Jod Basedow disease.

Symptoms of Hyperthyroidism

• Weight loss or gain  

• Sweating  

• Palpitations  

• Weakness  

• Fatigue  

• Anxiety  

• Heat intolerance  

• Irritability  

• Menstrual irregularity 

Signs of hyperthyroidism also include fine resting finger tremors, moist warm skin, hyperreflexia, fever, and onycholysis.

Differential diagnosis of Hyperthyroidism 

Hyperthyroidism must be distinguished from those conditions that elevate serum T3 and T4 or suppress serum TSH is commonly suppressed in early pregnancy and only about 10% of pregnant women with a low TSH have clinical hypothyroidism.

Laboratory investigations

Hyperthyroidism can cause other laboratory abnormalities including hypercalcemia anaemia, increased alkaline phosphate and decreased granulocytes.

T3 test  

Serum FT4, T3, FT3, T4 thyroid resin uptake,andFT4 index are all usually increased, sometimes the FT4 level may be normal but with an elevated serum T3 can be misleading elevated when blood is collected in the tube using a gel barrier, which causes certain immunoassays to report falsely elevated serum T3 levels in 24% of normal patients.

Imaging 

RAI should never be administered to pregnant women. In others, RAI scanning may be helpful to determine the cause for hyperthyroidism.

Treatment for Hyperthyroidism 

1.  Propranolol: Propranolol is generally used for sympathetic relief until the hyperthyroidism is resolved. It is the initial treatment of choice for thyroid.

2   Thiourea drugs: Propylthiouracil or methimazole is generally used for young adults.Carbimazole another thiourea that is converted to methimazole.

3.   Radioactive iodine:  This is an excellent method of destroying overactive thyroid tissue. Adult patients who have been treated with RAI in early-stage don't have an increased risk of subsequent thyroid cancer and leukaemia.

4.   Thyroid Surgery 

Thyroidectomy may be performed for pregnant women whose thyrotoxicosis is not controlled with low doses of thioureas and for women who desire to become pregnant in the very near future. Surgery is also an opinion for nodular goitres when there is a suspicion for malignancy.

C.  Goitre: In goitre enlarged thyroid gland like a pouch (Nodule ) in the front of the neck because of severe iodine deficiency. A Populations in areas of iodine deficiency have a high ratio of goitre.

About 1 billion people are iodine deficient, having no access to iodized salt .sever iodine deficiency increases the risk of miscarriage. In iodine-deficient patients, smoking can induce goitre growth. Goitre may become multinodular and enlarge.

Symptoms of Goiter :   

• Difficulty in breathing  

• Hoarseness  

• Difficulty in swallowing (Dysphagia)   

• Respiratory distress    

Laboratory investigation

The serum T4 and TSH are generally normal.TSH falls in the presence of hyperthyroidism if a multinodular goitre has become autonomous in the presence of a sufficient amount of iodine for thyroid hormone synthesis.TSH rises with hypothyroidism.

Treatment for goitre 

Adults with large multinodular goitre may require thyroidectomy for cosmesis, compressive symptoms. The addition of potassium iodide to table salt greatly reduces the prevalence of endemic goitre and cretinism but is less effective in shrinking established goitre.

There is a high goitre recurrence rate in iodine-deficient geographic areas, so near-total thyroidectomy is preferred if surgery is indicated. Many patients may be treated with Radioactive iodine for large compressive goitre.

Always use iodized salt 

Diet  for thyroid patient

• Coconut oil 

• Olive oil   

• Seafood  

• eggs  

• low-fat milk  and yoghurt 

• Ginger  

• Apple 

• Beans 

• Walnuts  

• Almond  

There are no restrictions on the diet of thyroid patients .but it is better for thyroid patients not to eat fatty foods.

The thyroid is a problem that is treatable. Patients with thyroid should have regular check-ups with their doctor. People should take Iodine in their diets as recommended by WHO. If anyone finds any problem suspecting related to the thyroid gland, one must go to a competent doctor evaluate it.

 

 

                                     

                                      .                                                     

.