The thyroid gland is located in the front of the neck, shaped like a butterfly straddling the voice box. It secretes thyroid hormones that are responsible for regulating different aspects of the body’s metabolism

 

Disorders of thyroid can result in a reduced function of the gland (hypothyroidism), excess function (thyrotoxicosis), a tumour (adenoma or carcinoma) or just an enlargement of the gland (euthyroid goitre)

 

Hypothyroidism results when the thyroid gland is unable to produce enough hormone. Clinical features are suggestive of disease, eg weakness, weight gain, lethargy, increased sleep, constipation or menstrual irregularities in women. 

 

A doctor must assess the symptoms, do a physical examination and confirm the diagnosis  by biochemical tests

 

Treatment consists of replacing the hormone which is deficient (thyroxine). Like all other conditions, periodic check ups by the doctor is essential to know the well-being as well as assessing whether the dose of hormone is appropriate

 

Once a stable state is achieved, follow up visits are not as frequent as for other conditions

 

Thyrotoxicosis is the opposite of hypothyroidism: in this case the gland produces more hormone than the body requires. Suggestive features include weight loss despite increased appetite and food intake, weakness, rapid beating of heart, shortness of temper, intolerance to heat, hair loss, frequent bowel movement. Note that these are specific for thyrotoxicosis. Leave the assessment to your doctor

 

Following a physical examination and lab tests, if the diagnosis is confirmed, treatment is started. A variety of options exist: medicines to lower the level of excess thyroid hormones, radio iodine treatment to destroy the excessively working thyroid tissue or surgical removal of the thyroid gland to lower the amount of hormone produced

 

Each of the methods has its own advantages and disadvantages; discuss with your doctor the choice to be made

 

Remember that the above two conditions are not water-tight. Thyrotoxicosis can progress to hypothyroidism, either by itself over time, or after treatment with radio iodine treatment or surgery.

 

Cycling between thyroid deficiency and excess is uncommon, but can occur

 

Thyroid tumour is a result of excess growth of thyroid tissue. It can lead to a diffuse goitre when the whole of the gland is involved or a nodule when the growth is localised to a part of the gland. 

 

The doctor will assess clinically, and get tests done such as fine needle aspiration of the nodule, radionuclide scan and if necessary blood or gene tests. If a tumour is confirmed it can be surgically removed

 

Speak to your doctor about the particular kind of growth or tumour you may have

 

In general, tumours of the thyroid are not as aggressive as tumours from other parts of the body. There is a saying that a person is more likely to die with the tumour than because of the tumour. This is not to belittle the danger from the tumours, but to give a perspective

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