Thyroid Health

January 22, 2021

There are many different types of thyroid disorders which may affect either its structure or function. Generally, there are five common thyroid disorders. The first is hypothyroidism which happens when there is insufficient amount of thyroid hormone production.

Then there is Hyperthyroidism which signifies an excessive amount of thyroid hormone production. Next comes Thyroid nodules which are abnormal lumps or masses within the thyroid gland. Goiter is also a common thyroid disorder. It is an enlargement of the thyroid gland, regardless of cause and may be associated with hypothyroidism, hyperthyroidism or normal thyroid function.

Last of all, thyroid carcinoma or more commonly known as thyroid cancer.
Who are at risk?
Thyroid disease can affect anyone from infants to the elderly but there are several factors that put one at a higher risk of developing thyroid disease. This includes those who already have a family history of thyroid disease or a personal history of autoimmune disorder, also those who are taking medicine that is high in iodine such as amiodarone plus those who have had treatment for a thyroid condition or thyroid cancer (thyroidectomy or radiation). What makes the risk even higher is if you are a woman and especially so if you are above 60.
Symptoms of thyroid disorder
So how do we know if you have a problem with your thyroid? That really depends on the type of thyroid condition you have. If you have palpitations, heat intolerance, experience weight loss, lethargy, menstrual disturbance, subfertility, hand tremors, nervousness, irritability and diarrhea, you may have hyperthyroidism.

However, if you experience weight gain, poor concentration, feel sleepy, experience bloating, menstrual changes, cold intolerance, constipation, hair loss, coarse dry skin and hair as well as memory loss, you may have hypothyroidism. The best thing is to check with a medical professional such as a neurologist in order for you to determine your diagnosis.
Diagnosing thyroid diseases
In addition to a thorough medical history investigation and physical examination, there are specific tests to diagnose thyroid disorders. First and foremost is a blood test and a special one too, called Thyroid Function Test (TFT). This test measures levels of thyroid hormones. Another test is the Thyroid Stimulating Hormone (TSH) which utilises your hyroid autoantibodies affecting the anti- thyroglobulin (anti Tg), anti-thyroperoxidase (anti-TPO) and TRAb (TSH receptor autoantibodies).

Imaging can also determine thyroid symptoms. The ultrasound scan of the thyroid gland is commonly used when thyroid nodules or enlargements are present. Another option is the thyroid uptake scan, carried out to evaluate the function of thyroid nodules comprising either ‘hot’ or ‘cold’ nodules. ‘Hot’ nodules are hyperfunctioning nodules. ‘Cold’ nodules do not produce excess hormone and can sometimes represent cancer. Finally, the enterologist can order a fine needle aspiration and a biopsy. This is to obtain a sample of cells or tissues from the thyroid gland for further examination by a pathologist.
Thyroid diseases: long-term or short-term treatment?
In most cases, thyroid disorders can be well-managed with medical treatment. Only some conditions may need radioactive iodine therapy (RAI) or surgery. The duration of treatment will depend on any particular disease of the thyroid.

Synthetic thyroid hormone is given to replace the inadequacy of thyroid hormone in hypothyroidism. Antithyroid drugs are given to block the excessive production of thyroid hormone in hyperthyroidism. Radioactive iodine therapy is given when hyperthyroidism is not controlled with medications. Surgery is also an option if thyroid carcinoma is confirmed or the enlarged thyroid gland is causing obstruction to the adjacent structures.
Common causes and prevention of thyroid diseases
Common causes of hypothyroidism are Hashimoto’s thyroiditis and other types of thyroidism such as postpartum thyroiditis and acute thyroiditis. The common causes of hyperthyroidism are Graves’ disease, toxic multinodular goiter, solitary toxic nodule, excessive iodine consumption and the likes.

There are no specific precautions or steps to take to avoid getting thyroid disorders. Still, for those who have hyperthyroidism, it is recommended to avoid food and drinks that contain caffeine as this can worsen symptoms. The doctor will also advise you to consume food with low iodine content. You can take calcium and vitamin D supplements for bone health if you don’t take foods rich in calcium. For those who have hypothyroidism, it is recommended to take iodine-rich foods. And last but not least, avoid alcohol consumption and smoking!

Dr. Rohaya Abdul Razak
Consultant Internal Medicine Physician
and Endocrinologist (Visiting)
Columbia Asia Hospital - Taiping

MBBS (UM), M Internal Medicine (UM),
Fellowship in Endocrinology (Malaysia)
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