Thyroid

Your thyroid is a butterfly-shaped gland at the base of your neck, just below your Adam’s apple. Although it weighs less than an ounce, the thyroid gland has an enormous impact on your health. Every aspect of your metabolism is regulated by thyroid hormones. It consists of 2 lobes, left and right connected by a thin tissue known as Isthmus. Normal thyroid cannot be seen with your eyes and can barely be felt.

Thyroid disorders affect your body both physically and mentally. There are 2 different types of Thyroid diseases:

  1. Hyperthyroidism: Hyperthyroidism (overactive thyroid) is a condition in which your thyroid gland produces too much of the hormone thyroxine. Hyperthyroidism can accelerate your body’s metabolism significantly, causing sudden weight loss, a rapid or irregular heartbeat, sweating, and nervousness or irritability.
  2. Hypothyroidism: Hypothyroidism, also called underactive thyroid or low thyroid, is a disorder of the endocrine system in which the thyroid gland does not produce enough thyroid hormone. It can cause a number of symptoms, such as poor ability to tolerate cold, a feeling of tiredness, constipation, depression, and weight gain.
  3. The term thyroid nodule refers to an abnormal growth of thyroid cells that forms a lump within the thyroid gland. Although the vast majority of thyroid nodules are benign (noncancerous), a small proportion of thyroid nodules do contain thyroid cancer. A biopsy is required to take a sample of cells from the nodule to determine if it is cancerous.

Causes of thyroid disorders are categorized in 2 groups:

  1. Thyroid disorders are mostly due to autoimmune thyroid disease, produce too much or not affecting the body. Thyroid disorders are more common in women than in men. Some patients may have a family history of thyroid problems.
  2. The most common cause of thyroid disease is an underlying autoimmune disease, which can’t be prevented. Though experts aren’t sure what causes a person to develop an autoimmune disease, genetic ties and family history seem to play a part.

Symptoms:

  • Lump found on the neck and may affect swallowing; though most nodules are benign a small proportion of thyroid nodules do contain cancer. A fine needle aspiration and biopsy will be used to remove a sample of tissue for examination to determine if treatment is required.
  • A feeling of tiredness, rapid heart rate, increased sweating
  • Trouble sleeping, nervousness
  • Diarrhea due to increase in bowel movement
  • Bulging eyes due to inflammation of tissues behind your eyes
  • Menstrual changes; irregular, excessive or prolonged bleeding
  • Muscle weakness numbness and a tingling sensation in the hands
  • Depression, concentration problems
  • Hair loss (especially eyebrows), dry skin
  • Joint aches, feeling bloated (especially hands and feet)
  • Hoarse voice
  • High blood pressure

If you notice these symptoms, it is advised to see a doctor to be diagnosed and treated.

What thyroid patients should do to take care of him/herself?

  • Avoid food with saturated fat
  • Avoid smoking
  • Avoid alcohol
  • Avoid over excercising
  • Monitor your symptoms and general health
  • Annual blood test

Many methods of treatment for thyroid disorders are available; depending on the level of thyroid disorder that you have.  Several options are available:

  1. Medications

In treating thyroid nodules, it is important to do a biopsy.  For thyroid nodules, medication is usually prescribed as well as additional methods if response to oral medication is insufficient. Other methods are then used in addition such as Radioactive iodine or Surgery.

  1. Radioactive iodine

Radioactive iodine is used to treat patients with thyroid disorders to help produce less thyroid hormone.  The benefit of radioactive iodine treatment is that it is safe and patients do not have to undergo surgery. Radioactive iodine is the most widely-recommended permanent treatment of hyperthyroidism. This treatment takes advantage of the fact that thyroid cells are the only cells in the body which have the ability to absorb iodine. In fact, thyroid hormones are experts at doing just that.

By giving a radioactive form of iodine, the thyroid cells which absorb it will be damaged or killed. Because iodine is not absorbed by any other cells in the body, there is very little radiation exposure (or side effects) for the rest of the body. Radioiodine can be taken by mouth without the need to be hospitalized. This form of therapy often takes one to two months before the thyroid has been killed, but the radioactivity medicine is completely gone from the body within a few days. The majority of patients are cured with a single dose of radioactive iodine.

However, there are some patients who do not respond well to this treatment, and have to undergo surgery.

  1. Surgery

In the case of thyroid nodules, if the biopsy examination result shows abnormal cells, surgery will be the treatment required.  The benefits of thyroid surgery is being able to completely cure thyroid disorder but patients have to go through general anesthesia and also some complications may occur such as bleeding after surgery (1%), hoarseness or loss of voice (1-2%) or low calcium level which will require some medications.

Thyroid surgery, involves making an incision in the front of the neck, just 1-2 cm. below the Adam’s apple.  This is the standard operation in which the advantage is it can be used to treat all thyroid conditions regardless of size or if it is cancerous.  The only disadvantage is there will be a scar across the front of the neck.

Nowadays in order to avoid a visible scar, minimally invasive thyroid surgery has been developed and can be done through many entry points such as under the arm, behind the ear or through the mouth.   This method has been newly developed and involves inserting the instruments and camera trough the mouth.   Patients will not have any wounds on the outside of the body which makes it a very popular method and has been accepted worldwide especially by the USA. There are no unusual complications reported post-surgery During this type of surgery, the surgeon is able to see the laryngeal nerve which controls the vocal cords which ensures the safety of the vocal cords during the operation. The advantage of such a surgical procedure is that there is no visible scare on the neck.