Friday, September 18, 2020

Watch your weight: Check your thyroid!

1. What is thyroid gland?

The thyroid gland is a butterfly-shaped organ, located in front of the neck, below the chin. It secretes hormones called T3 and T4. These hormones are responsible for maintaining several metabolic processes in our body. This gland is under the control of the Pituitary gland which is located in the brain.

2. What are the disorders associated with thyroid gland?

The 2 important disorders of the thyroid gland are Hypothyroidism (low thyroid hormones) and hyperthyroidism (high thyroid hormones). These 2 disorders have exactly opposite symptoms and signs.

3. What is hypothyroidism?

Hypothyroidism is detected when the thyroid hormones are reduced in our body. The affected individual feels tired and lethargic, increased sleepiness, loss of appetite, constipation, increased weight, feels depressed, concentration is affected, feels cold all the time and may develop skin changes and hair loss.

4. What is hyperthyroidism?

Hyperthyroidism is excess circulation of thyroid hormones in our body. Affected individuals develop anxiety, increased appetite, weight loss, palpitations, diarrhea, insomnia and heat intolerance.

5. What is the cause for thyroid disorders?

Both the conditions can be autoimmune in nature, where the body produces antibodies to destroy the thyroid gland and disrupt its normal functioning. Other than this, hypothyroidism is seen in individuals who are on an iodine deficient diet and children who are born to hypothyroid mothers. Hyperthyroidism is seen in individuals who have toxic nodules in their thyroid gland or thyroid
cancer.

6. How are thyroid disorders treated?

Once a patient consults a doctor for above symptoms and doctor suspects a thyroid disorder, the doctor will do blood tests to check for TSH, T3 and T4 levels. The doctor will also check for antibodies which point to autoimmune nature of thyroid disorders. If hypothyroidism is diagnosed, the doctor will start treatment with thyroid hormone replacement (levothyroxine) which needs to be taken lifelong (in most of the cases). If hyperthyroidism is diagnosed then a scan of the thyroid gland will be done to check for any thyroid nodule or toxic goiter. The treatment will be initiated with carbimazole/methimazole or propylthiouracil. If a nodule or a toxic goiter is detected then surgery may be advised.

7. What are the challenges faced while treating thyroid disorders?

Thyroid hormones get affected in pregnancy, liver diseases, acute illnesses and other systemic illnesses affecting the whole body (sarcoidosis, amyloidosis). Each and every individual need to be checked thoroughly to screen for other illnesses and decision for treatment should be taken accordingly. In case of malignancy, oncologist referral is mandatory and in case of goiter, surgery consultation needs to be taken. Thyroid disorders may also be a part of pituitary problems and the doctor needs to examine the patient based on blood tests.

8. Who should be screened for thyroid disorders?

Patients who have any of the above-mentioned symptoms, who have first degree relatives with thyroid disorders, who were born to mothers with hypothyroidism, who developed thyroid dysfunction in pregnancy and people residing in hilly areas need to be screened for thyroid disorders. Patients who have a history of thyroid cancers in the family also need screening.

In conclusion, thyroid disorders may not present with classical signs and symptoms. If a patient has noticed sudden changes in weight, sleep cycle or palpitations, it’s worthwhile to get the thyroid hormones checked.

Dr. Sneha Shanbhag, M.D.

Internal Medicine Specialist

Bahrain Specialist Hospital

Email: sneha.shanbhag@bsh.com.bh

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