The thyroid is a gland that sits at the front of your neck. It releases hormones that control your body’s ability to burn energy, as well as how sensitive your body is to other hormones (such as growth hormone). When this gland releases too much hormone for too long, a condition known as Hyperthyroidism. When it releases too little, you have Hypothyroidism.
Hyperthyroidism is more common than hypothyroidism. It can happen at any age but becomes more common with age. Most people who have hyperthyroidism are women between the ages of 30 to 60.
Hypothyroidism is less common than hyperthyroidism. People with hypothyroidism often have no symptoms at first. Later, they develop problems concentrating and thinking clearly, they gain weight easily and they feel tired all the time.
What Causes Hyperthyroidism?
The most common cause of hyperthyroidism is an autoimmune disease called Graves’ disease (also known as Basedow’s disease). Other causes include surgery that removes part or all your thyroid gland, radiation treatment of your neck or upper chest area, overactive nodules in your thyroid gland and substance abuse (including cigarette smoking).
Hyperthyroidism is more common among women than men. It affects about 1% of women, according to the National Institutes of Health (NIH). Graves’ disease is the most common cause of hyperthyroidism. In Graves’ disease, the thyroid gland overproduces a hormone called thyroid-stimulating hormone (TSH).
Excessive thyroid hormone production leads to symptoms such as:
Restlessness, weight loss, thin skin, shaking, brittle hair and nails, muscle weakness, increased sweating, nervousness, bulging eyes, irritability, racing heart, trouble sleeping and anxiety.
Thyroid problems are more common than you might think. Many people are unaware they have a thyroid issue until they start feeling symptoms. If you are experiencing any of the above symptoms, your doctor should run several tests to ensure that your thyroid is functioning properly.
Treatment for a thyroid problem depends on its cause. Your doctor may adjust your medication dose, prescribe a new medication, or recommend other treatment options. It is important to track how you feel as treatment progresses. If you notice that your symptoms are getting worse or better at different points in the day, it could be a sign that your medication needs to be adjusted.
What is Hypothyroidism?
Hypothyroidism is a disorder in which the thyroid gland fails to produce adequate levels of thyroid hormone. Your body uses thyroid hormones to control your metabolism. They tell your body how fast or slow to burn calories and help control your temperature, heart rate, blood pressure and many other things. Hypothyroidism is when your thyroid gland is not making enough of these hormones. This slows down your metabolism and can cause a lot of different symptoms.
It can be difficult to diagnose hypothyroidism because its symptoms are often similar to those of other medical problems.
Other common symptoms include:
- Weight gain
- Unexplained hair loss
- Dry skin and brittle nails
- Loss of libido (sex drive)
- Constipation and bloating
- Tingling or pain in hands and feet (also known as neuropathy)
- Menstrual cycle changes, such as heavy menstrual bleeding or missed periods
Hypothyroidism Diagnosis and Treatment
The symptoms of hypothyroidism vary from person to person, depending on their individual levels of hormones. However, common symptoms include dry skin and hair, slow heartbeat, fatigue (especially after exercise), constipation and weight gain.
A diagnosis of hypothyroidism is based on a blood test showing low levels of thyroxine (T4) and triiodothyronine (T3). Levels of these hormones are checked at the start of treatment and then again after about four months. If your levels are still low after this period, you will be given a course of tablets to provide your body with enough thyroid hormone.
All you need to know about Hashimoto’s Thyroiditis
Hashimoto’s thyroiditis is an autoimmune disorder that causes inflammation in the thyroid gland. The immune system mistakenly attacks the thyroid gland and destroys it. This process can take years to develop, and it may start without any noticeable symptoms. It is estimated that one in 10 people have this disease, but most do not know they have it because they do not experience any symptoms. This disease can occur at any age, but it is most common among women aged 30 to 60 years old. The disease can remain stable for years and may never cause any symptoms or complications. But if left untreated, Hashimoto’s thyroiditis can slowly destroy your thyroid gland until you become permanently hypothyroid and need to take synthetic hormones for the rest of your life.
The primary symptom of Hashimoto’s is hypothyroidism, but even if you have this condition, you might not experience obvious signs or symptoms for many years. In fact, some people with Hashimoto’s have no signs or symptoms at all. Hypothyroidism itself can present with a variety of nonspecific signs and symptoms that are common to many other conditions — including fatigue, weight gain, depression, enlarged thyroid, or goitre, intolerance to cold heavy and irregular menstruation, dry skin, mild weight gain, constipation, dry, thinning hair and pale, puffy face.
Hashimoto’s diagnosis and Treatment
Diagnosis of Hashimoto’s involves ruling out any other possible causes of hypothyroidism by testing for abnormal amounts of TSH, T3 and T4 hormones. If you have signs and symptoms of hypothyroidism along with positive test results for thyroid antibodies, your doctor will likely confirm the diagnosis.
Treatment aims to relieve symptoms and improve quality of life. The first-line treatment for Hashimoto’s thyroiditis is medications that replace or supplement thyroid hormones. Surgery may be recommended for people with severe symptoms or complications from the disease.
The disease develops when a person’s immune system mistakenly attacks the thyroid gland, causing it to overproduce thyroid hormone. This can lead to heart problems, eye problems, and other issues. Graves’ disease occurs in about 1 in 200 people and is more common in women ages 20 to 30. It is also hereditary.
In Graves’ disease, the immune system releases antibodies that stimulate the thyroid gland to produce more hormones. These excess hormones may affect other organs such as the skin and cardiovascular system.
The most common symptoms of hyperthyroidism are:
- Hand tremors
- Bruising easily
- Upper body obesity
- Insomnia or excessive sleepiness
- Increased heart rate and blood pressure
- Reduced tolerance for heat; increased sweating
- Menstrual irregularities, which can lead to infertility in women
- Eye changes; bulging eyeballs (exophthalmos) with protrusion of the eyes (proptosis).
Graves’ disease diagnosis and treatment
Once you have a diagnosis, your doctor will most likely recommend that you take levothyroxine to bring your thyroid hormone levels back to normal. The dose will be determined by your age, weight, and symptoms. If you are pregnant or breastfeeding, you should not take levothyroxine unless you have hypothyroidism with severe symptoms.
Graves’ disease can also cause other problems, including anxiety and heart palpitations. Your doctor may recommend cognitive behavioural therapy or antidepressants if they are a problem for you.
The treatment for Graves’ disease is a lifelong commitment to control the symptoms of hyperthyroidism. There is no cure for Graves,’ so you must rely on medication for life. Some people with Graves’ disease have only mild symptoms and require little or no treatment. Others have severe symptoms that need more aggressive treatment. And some people with Graves’ disease can become seriously ill if they are not treated right away.
There are different ways to control the symptoms of Graves’ hyperthyroidism:
• Beta-blockers– Beta-blockers are medications that slow down your heart rate and reduce anxiety and sweating. Beta-blockers are commonly prescribed to patients with mild Graves’ disease. They may also be used in combination with antithyroid medications.
• Antithyroid medications (PTU, Tapazole, methimazole)- Antithyroid medications block the production of thyroid hormone by your thyroid gland. Most people who need antithyroid drugs respond well to them, but about 5 percent of people have side effects from these medications, such as hair loss and interference with normal menstrual cycles in women and low sperm counts in men.
• Radioactive iodine (RAI)- Radioactive iodine destroys all or part.
Goitres are most caused by an iodine deficiency. Iodine is vital to the production of the thyroid hormone, and when there is not enough iodine in the body, the thyroid becomes underactive — a condition known as hypothyroidism. Treatment for hypothyroidism includes taking supplemental iodine, which can help relieve swelling in the thyroid gland and restore normal function. A goitre can also be caused by hyperthyroidism. Hyperthyroidism is a condition in which the thyroid produces too much of a hormone that regulates metabolism and energy levels, resulting in symptoms such as weight loss and increased appetite.
As with hypothyroidism, treatment for hyperthyroidism typically involves taking synthetic thyroid hormone to replace what the body is lacking. In some cases, surgery may be required to remove part of the thyroid gland, especially if it is abnormally large.
The goitre itself can cause no symptoms at all, but it can affect your voice and breathing if it gets large enough.
Goitre diagnosis and treatment
Goitre is an abnormal enlargement of the thyroid gland. They can be small or large, visible, or hidden. Goitre is present in 25% of the world’s population and causes no symptoms in most people. It is common in areas with iodine deficiency.
Your doctor will feel your neck area and have you swallow during a routine physical exam. Blood tests will reveal the levels of thyroid hormone, TSH, and antibodies in your bloodstream. This will diagnose thyroid disorders that are often a cause of goitre. An ultrasound of the thyroid can check for swelling or nodules.
Goitre is usually treated only when it becomes severe enough to cause symptoms. You can take small doses of iodine if the goitre is the result of iodine deficiency. Radioactive iodine can shrink the thyroid gland. Surgery will remove all or part of the gland. The treatments usually overlap because goitre is often a symptom of hyperthyroidism.
When to Consult Doctor
See your doctor if you have symptoms of hyperthyroidism or hypothyroidism
It’s hard to diagnose a thyroid problem because symptoms of hyperthyroidism (where your thyroid overproduces hormones) are similar to hypothyroidism (where its underproduces hormones). Your doctor will therefore look for a number of symptoms including whether you have an enlarged thyroid gland and whether you have a tremor in your fingers when you hold them out straight.
Your doctor will consider your symptoms and medical history, then do a physical exam. They’ll check if your thyroid gland is bigger than it should be or feel whether it is tender. They’ll also check how fast your pulse is and how much energy you use to breathe. Your thyroid, pulse, and breathing should all be in the normal range for your size and age.
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