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Frequently Asked Questions (FAQs) on Thyroid

What are the different types of thyroid disorder?

Different types of thyroid disorder include hypothyroidism, hyperthyroidism, goiter (enlargement of thyroid gland), thyroid cancer, nodules (lump formation in thyroid gland), thyroiditis (swelling of the thyroid gland). 

How is hypothyroidism different from hyperthyroidism?

Hyperthyroidism is a condition characterized by hyperactive thyroid gland that produces excess thyroid hormones whereas hypothyroidism is a condition where the underactive thyroid gland produces insufficient thyroid hormones.

What symptoms should prompt one to see a thyroid specialist?

If one experiences symptoms like palpitations, fatigue, unexplained weight loss, swelling (in front of neck), hair loss, rapid heart rate, he/she should consult a thyroid specialist. One should also consult when he/she notices any lumps or nodules and if diagnosed with abnormal thyroid stimulating hormone (TSH) levels.

What are the signs of an overactive thyroid (hyperthyroidism)?

Symptoms of hyperthyroidism can include weight loss, feeling nervousness, irregular heartbeat, irritability, fatigue, nervousness, sweating, fatigue, difficulty sleeping, enlargement in neck (goiter).

What are the signs of an underactive thyroid (hypothyroidism)? 

Symptoms of hypothyroidism include coarse, dry skin, constipation, depression, fatigue, weight gain, joint and muscle pain, dry skin, heavy or irregular menses, and a slow heart rate. 

How do symptoms of thyroid disorders differ between men and women?

Symptoms of thyroid disorder in males tend to be similar as compared to female. However, there are differences on how this disorder affects male and female reproductive system etc. With abnormal increase or decrease in thyroid hormone it can affect other hormones like male sex hormone (testosterone) and female sex hormones (estrogen). In males it can cause low libido, gynecomastia (enlarged breast in males), erectile dysfunction, testicular atrophy, premature ejaculations. In women thyroid disorder causes irregular menses, complications in pregnancy etc.

Is thyroid surgery necessary for treating certain conditions?

An endocrinologist may recommend thyroid surgery for the following conditions:

• If a nodule or lump is detected
• If cancer is diagnosed
• For treating goiter that is causing compression of trachea, causing difficulty in swallowing
• For a toxic nodule, toxic multinodular goiter or graves disease.
  

What are thyroid nodules and how are they treated?

Thyroid nodule refers to a lump formation within the thyroid gland because of unexplained and abnormal cell growth of thyroid gland. Cancerous thyroid nodules are often removed by surgical treatment by experienced thyroid surgeons. Non-cancerous thyroid nodules are curable and can be treated chemotherapeutically. 

How does Iodine deficiency impact thyroid health?

Despite an increase in thyroid activity, iodine concentrations are low to enable production of thyroid hormones. Severe iodine causes goiter and hypothyroidism. Increased activity of thyroid can compensate for decreased or low iodine uptake and maintain euthyroidism during mild to moderate insulin deficiency. 

Can thyroid disorders be triggered by autoimmune diseases?

Yes, thyroid disorders can be triggered or caused by an autoimmune disease. Autoimmune thyroid diseases (AITD) are common autoimmune diseases followed by grave’s disease and Hashimoto Thyroiditis. Clinical manifestations are developed by reflecting the loss of immunological intolerance and share presence of cell and humoral immune response against antigens from thyroid with reactive infiltration of T cells and B cells.

Are there any risks for developing thyroid cancer with thyroid disorder?

Yes, the following are the risk factors for developing cancer having a benign non-cancerous thyroid condition, family history of thyroid cancer, previous history of benign (non-cancerous) breast condition, exposure to radiation therapy for prior treatment.

Can thyroid disorder cause eye problems or vision changes?

Yes, thyroid disorder affects the eye and causes vision problems. Hyperthyroidism leads to a condition known as Grave’s ophthalmopathy or thyroid eye disease characterized by swelling around the eyes causing the eyes to bulge out. Eyes become gritty, this is often mild and causes double vision.

What are the tests to diagnose thyroid disorder?

Following are the tests performed to diagnose thyroid disorder.

• TSH (Thyroid Stimulating Hormone): A high thyroid stimulating hormone (TSH) level indicates hypothyroidism (thyroid is not producing enough hormone therefore pituitary gland produces TSH and releases into blood. A low TSH level indicates hyperthyroidism (thyroid gland producing excess hormones thereby pituitary gland stops producing and releasing TSH in blood). 
• T4 test: An elevated blood level of T4 indicates hyperthyroidism whereas a low T4 indicates hypothyroidism.
• T3 test: T3 test is performed to confirm the diagnosis whether the patient has hyperthyroidism when the T4 values are obtained normal. Sometimes the value of T4 is normal whereas the T3 value is very high so both T3 and T4 are performed.

How does a fine needle aspiration (FNA) biopsy help in diagnosing thyroid nodules? 

Fine needle aspiration (FNA) biopsy is an accurate diagnostic test routinely used in initial evaluation of nodular thyroid disease. Follow-up surveillance of thyroid cancer patients is performed by Fine Needle Aspiration (FNA) with ultrasonographic guidelines (US - FNA). This is performed with a fine needle (22 to 27 Gauge), the cells or tissues are obtained by aspiration technique, the thyroid gland is palpated carefully, and nodules are identified under sonographic guidance.

Are there any specific markers that indicate autoimmune thyroid disease?

Autoimmune thyroid disease (AITD) is indicated by the presence of the following autoantibodies like Thyroglobulin antibodies (TgAb), Thyroid peroxidase antibodies (TPOAb), Thyroid stimulating hormone receptor antibodies (TRAb). Autoimmune thyroid disease (AITD) is also detected by genetic markers like Human leukocyte antigen (HLA), ABO blood group, Rh blood group. Other markers like thyroid stimulating hormone (TSH) and free T4 and total T4 levels are performed to indicate autoimmune thyroid disease.

What are the treatments for hyperthyroidism and hypothyroidism?

Hyperthyroidism is generally treated with medications, radioiodine therapy or by surgery.

• Treatment of hyperthyroidism includes antithyroid medications and betablockers. Treatment with antithyroid is the simplest and a permanent cure. Beta blockers are also included in the treatment of hyperthyroidism, they are symptomatic treatment. 
• Radio-iodine therapy includes taking radioactive iodine orally as a capsule or a liquid, this radioactive iodine destroys the cells of thyroid gland. This is a common and effective treatment.
• Surgery is performed in rare cases. Patients who developed goiter or pregnant women who cannot take antithyroid medications opt for surgery where part or most of the thyroid gland is resected out. 

Treatment of hypothyroidism includes hormone replacement therapy followed by regular monitoring of hormone levels. A low dose of hormone is recommended initially, after regular monitoring the serum levels, the correct dose of hormone replace met therapy is given.

When is surgery the best option for thyroid disorder?

Surgery is indicated mainly for treating grave disease, to treat benign and malignant tumors, to remove goiter and to remove large goiters when they cause respiratory difficulties. 

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