A surprising number of individuals living in Anguilla have a disorder of the thyroid gland. There might be many factors for this, but we are fortunate that many of these disorders can be treated successfully.
What Is the thyroid gland?
The thyroid is a butterfly-shaped gland in the front of the neck. It produces hormones that control the speed of our metabolism — the system that helps the body use energy. The thyroid gland can be considered as the great regulator of the body and mind. Thyroid disorders can slow down or speed up our metabolism by disrupting the production of thyroid hormones. When hormone levels become too low or too high, we might experience a wide range of symptoms.
What are some common symptoms and signs of thyroid disorders?
The symptoms and signs of thyroid disorders vary from one individual to another and they might also mimic other disorders. Individuals with signs and symptoms are encouraged to see their doctor for a complete evaluation. The following are some signs and symptoms of thyroid disorders:
Weight gain /loss
An unexplained change in weight is one of the most common signs of a thyroid disorder. Weight gain may signal low levels of thyroid hormones, a condition called hypothyroidism. In contrast, if the thyroid produces more hormones than the body needs, you may lose weight unexpectedly. This is known as hyperthyroidism. Hypothyroidism is far more common in Anguilla and tends to affect more women than men.
Changes in energy or mood
Thyroid disorders can have a noticeable impact on our energy level and mood. Hypothyroidism tends to make people feel tired, sluggish, and depressed. Hyperthyroidism can cause anxiety, problems sleeping, restlessness, and irritability.
Swelling in the neck
A swelling or enlargement in the neck (goitre) is a visible clue that something may be wrong with the thyroid gland. A goitre may occur with either hypothyroidism or hyperthyroidism. Sometimes swelling in the neck can result from thyroid cancer. It can also be due to a cause unrelated to the thyroid. If you have swellings in the neck see your doctor.
Changes in heart rate
Thyroid hormones affect nearly every organ in the body and can influence how quickly the heart beats. People with hypothyroidism may notice their heart rate is slower than usual. Hyperthyroidism may cause the heart to speed up. It can also trigger increased blood pressure and the sensation of a pounding heart, known as heart palpitations.
Hair loss
Hair loss is another sign that your thyroid hormones may be out of balance. Both hypothyroidism and hyperthyroidism can cause hair to fall out. In most cases, the hair will grow back once the thyroid disorder is treated.
Feeling too cold or hot
Thyroid disorders can disrupt the ability to regulate body temperature. People with hypothyroidism may feel cold more often than usual. Hyperthyroidism tends to have the opposite effect, causing excessive sweating and an aversion to heat.
Other symptoms of hypothyroidism
Hypothyroidism can cause many other symptoms, including:
• Dry skin and brittle nails
• Numbness or tingling in the hands
• Constipation
• Abnormal menstrual periods
Other symptoms of hyperthyroidism
Hyperthyroidism can also cause additional symptoms, such as:
• Muscle weakness or trembling hands
• Vision problems
• Diarrhea
• Irregular menstrual periods
Is it thyroid disorder or menopause?
Thyroid disorders can cause changes in your menstrual cycle and mood. The symptoms are sometimes mistaken for menopause. If a thyroid problem is suspected, a simple blood test can determine whether the symptoms are related to the thyroid gland, to menopause or a combination of both. If you have severe symptoms of menopause see your gynaecologist for assistance.
When to see your doctor
If you have signs and symptoms suggestive of thyroid disorder you should see your doctor for a complete medical examination and further evaluation. If you detect a swelling in your neck then you should also see your doctor.
How are thyroid disorders diagnosed?
If your doctor suspects a thyroid disorder, a blood test can help provide an answer. This test measures the level of thyroid stimulating hormone (TSH). If TSH is high, it typically means that your thyroid function is too low (hypothyroid). If TSH is low, then it generally means the thyroid is overactive (hyperthyroid.) Your doctor may also check levels of other thyroid hormones in your blood. In some cases, imaging studies are used and biopsies are taken to evaluate a thyroid abnormality.
Hashimoto’s disease
The most common cause of hypothyroidism is Hashimoto’s disease. This is an autoimmune disorder in which the body attacks the thyroid gland. The result is damage to the thyroid, preventing it from producing enough hormones. Hashimoto’s disease tends to run in families.
Other causes of hypothyroidism
In some cases, hypothyroidism results from a problem with the pituitary gland which is at the base of the brain. This gland produces the thyroid-stimulating hormone (TSH) which tells the thyroid to do its job. If your pituitary gland does not produce enough TSH, your levels of thyroid hormones will fall. Other causes of hypothyroidism include temporary inflammation of the thyroid or medications that affect thyroid function.
Graves’ disease
The most common cause of hyperthyroidism is Graves’ disease. This is an autoimmune disorder that attacks the thyroid gland and triggers the release of high levels of thyroid hormones. One of the hallmarks of Graves’ disease is a visible and uncomfortable swelling behind the eyes.
Other causes of hyperthyroidism
Hyperthyroidism can also result from thyroid nodules. These are lumps that develop inside the thyroid and sometimes begin producing thyroid hormones. Large lumps may create a noticeable goiter. Smaller lumps can be detected with ultrasound.
Thyroid disorder complications
When left untreated, hypothyroidism can raise your cholesterol levels and make you more likely to have a stroke or heart attack. In severe cases, very low levels of thyroid hormones can trigger a loss of consciousness and a life-threatening drop in body temperature. Untreated hyperthyroidism can cause serious heart problems and brittle bones.
Treatment
Once a correct diagnosis is made you doctor will be able to prescribe the appropriate treatment. In the case of hypothyroidism, your doctor will most likely prescribe thyroid hormones in the form of a pill. Long-term treatment can result in more energy, lower cholesterol levels, and gradual weight loss. Most people with hypothyroidism will need to take thyroid hormones for the rest of their lives.The most common treatment for hyperthyroidism is antithyroid medication which aims to lower the amount of hormones produced by the thyroid. The condition may eventually go away, but many people need to remain on medication for the long term. Other drugs may be given to reduce symptoms such as rapid pulse and tremors. Another option is radioactive iodine which destroys the thyroid gland over the course of 6 to 18 weeks. Once the gland is destroyed, or removed by surgery, most patients must begin taking thyroid hormones in pill form.
Surgery for thyroid disorders
Removing the thyroid gland can cure hyperthyroidism, but the procedure is only recommended if antithyroid drugs do not work, or if there is a large goitre. Surgery may also be recommended for patients with thyroid nodules. Once the thyroid is removed, most patients require daily supplements of thyroid hormones to avoid developing hypothyroidism.
Is it thyroid cancer?
Thyroid cancer is uncommon and is among the least deadly of cancers. The main symptom of thyroid cancer is a lump or swelling in the neck, and only about 5% of thyroid nodules turn out to be cancerous. When thyroid cancer is diagnosed, it is most often treated with surgery followed by radioactive iodine therapy or, in some cases, external radiation therapy.
Conclusion
The thyroid gland is an important gland in the body that is essential in controlling our body’s metabolism. Thyroid disorders can present in a number of ways, but the diagnosis is not very difficult to make by most well trained doctors. If you have symptoms and signs suggestive of thyroid disorder please see your doctor today.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty years in clinical practice. Dr Hodge has a medical practice in the Johnson Building in The Valley.
