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    Thyroid Disorders

    Overview
    Symptoms
    Treatment
    Where To Seek Treatment
    Singapore General Hospital
    Contributed by Dept of Endocrinology

    Overview

    The thyroid is a butterfly-shaped gland situated in the front of the neck. Its main function is to produce two hormones - thyroxine and triiodothyronine - which are crucial to the control of various bodily functions.

    Should the thyroid malfunction, it can cause health problems that can affect your quality of life. Women are more susceptible than men to thyroid disorders. Thyroid hormone (TH) imbalances are usually related to autoimmune disorders - when healthy cells and tissues in your body are mistakenly attacked by your own immune system. It is not known why this happens, but there appears to be a genetic link.

    Too little, too much?

    When an underactive gland doesn't produce enough thyroid hormones to adequately meet the body's needs, the condition is referred to as hypothyroidism. Conversely, in hyperthyroidism; an overactive thyroid gland results in the excessive production of thyroid hormones.

    Hypothyroidism and hyperthyroidism are the two most common thyroid disorders in women between the age of 20 and 50, who are also five times more likely than men to develop thyroid disorders.

    Hypothyroidism

    There are several causes of hypothyroidism, including autoimmune disease, treatment for hyperthyroidism, radiation therapy, thyroid surgery and certain medications. The most common cause is an autoimmune disorder called Hashimoto's disease.

    Hyperthyroidism


    In 70% of the cases, hyperthyroidism results from an autoimmune disorder known as Graves' disease, a condition in which the body's own antibodies attack the thyroid. This causes it to produce too much of the hormone thyroxine, which speeds up the body's metabolism in turn.


    Symptoms

    Symptoms for Hypothyroidism

    • Fatigue
    • Sluggishness
    • Increased sensitivity to the cold
    • Constipation
    • Pale, dry skin
    • Puffy face
    • Hoarseness of voice
    • Unexplained weight gain
    • Muscle weakness, aches, tenderness and stiffness
    • Joint pain, stiffness or swelling
    • Light or irregular periods
    • Brittle fingernails and hair
    • Depression
    • Forgetfulness

    Symptoms for Hypethyroidism

    • Sudden, unexplained weight loss
    • Increased sensitivity to heat
    • Increased heart rate
    • Nervousness, anxiety and irritability
    • Hand tremors
    • Changes in menstrual patterns
    • Diarrhoea
    • Bulging eyes
    • Enlarged thyroid gland (goiter) that can appear as a swelling at the base of the neck
    • Fatigue, muscle weakness
    • Restlessness and insomnia


    Treatment


    Treatment for Hypothyroidism

    Hypothyroidism is treated with hormone replacement, using a synthetic thyroid hormone pill that aims to regulate thyroid hormone levels and normalise your metabolism. Do note that there may be some trial and error before arriving at the right dose. Your doctor will typically start you on a low dose, to be increased as necessary, if the symptoms persist or blood tests still show abnormal levels. You will be put on medication for life, and have to see your doctor regularly to check your thyroid stimulating hormone (TSH) levels, to ensure that the treatment is not causing hyperthyroidism. 

    Treatment for Hyperthyroidism


    Treatment options for hyperthyroidism depend on your age, physical condition, and the cause and severity of your condition. These include: 

    Anti-thyroid medicine
    These drugs gradually reduce the symptoms of hyperthyroidism by blocking the production of thyroid hormones. Symptoms usually improve within 6-12 weeks of taking the medication, and this may last for at least a year or longer.

    Radioactive iodine treatment
    For those who don't respond to anti-thyroid medications, radioactive iodine is taken orally and absorbed
    by the thyroid. Symptoms usually subside within three to six months. This treatment causes thyroid activity to slow considerably and possibly permanently (hypothyroidism), and you may have to take thyroid supplements.

    Surgery (Thyroidectomy)
    Removing your thyroid gland as a last resort. Risks include damage to your vocal cords and parathyroid glands - the four tiny glands located on the back of your thyroid gland that help to control the level of calcium in your blood. You may need life-long treatment with medication to keep your thyroid hormone level normal post-surgery. If the parathyroid glands are also removed, you'll need medication to keep your blood-calcium levels normal.



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