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Thyroid disease and disorders

What is thyroid disease?

Thyroid disease is a general term that is used for all medical conditions that interfere with the thyroid gland’s ability to make the optimum level of thyroid hormones. Generally, the two most common thyroid disorders are hypothyroidism and hyperthyroidism. 

Hypothyroidism occurs when the thyroid gland makes too little thyroid hormone, which results in tiredness, lethargy, weight gain, etc. On the other hand, hyperthyroidism occurs when the thyroid gland is overactive and produces too much thyroid hormone. Hyperthyroidism can result in anxiety, increased heart rate, etc. 

Additionally, other thyroid disorders include goiter and thyroid cancers. Goiter is the enlargement of the thyroid gland as a result of irregular cell growth resulting in lumps/nodules in the gland. While thyroid cancer is a malignant growth of the gland that can metastasize to other parts of the body.

How are thyroid diseases caused?

Thyroid problems are caused due to a variety of issues- such as iodine deficiency (or excess) in the body. Other common reasons are autoimmune disorders, bacterial (or viral) infection, nodules, medical treatments, etc. Knowing the exact cause of the thyroid disease is important to treat it effectively and permanently.

Types of Thyroid Disorders

Endoscopic Spine Surgery

Thyroid cancer

Diffuse goiter - Noncancerous enlargement of the thyroid gland

Goiter

Overactive thyroid gland

Hyperthyroidism

suspicious nodules on the thyroid gland

Nodules on Thyroid Gland

Causes

  • Inflammation of the thyroid gland (thyroiditis)
  • Hashimoto’s thyroiditis - an autoimmune condition of the thyroid gland
  • Postpartum inflammation of the thyroid gland
  • Iodine deficiency
  • Non-functional thyroid gland in newborns
  • Graves’ disease, also known as diffuse toxic goiter - overactivity of the thyroid gland
  • Thyroid nodules also called toxic multi-nodular goiter
  • Excessive iodine

Symptoms

  • Large, solid swelling in the throat
  • Anxiety, irritability, and nervousness
  • Difficulty in sleeping
  • Rapid weight loss or gain
  • Muscle tremors and weakness

Diagnosis

Most thyroid problems are often easily self-diagnosed as they are accompanied by irregular growth of the thyroid gland. Examine the front of your neck and feel for any lumps, nodules, or irregular growths. If you do, then consult an ENT doctor immediately.

Thyroid diagnosis by doctor

Risks & Complications

  • Family history of thyroid disease
  • Medical conditions like pernicious anemia, type 1 diabetes, primary adrenal insufficiency, lupus, rheumatoid arthritis, Sjögren’s syndrome, and Turner syndrome
  • Medicines that interfere with iodine absorption or have high iodine concentrations
  • Women in old age, especially above 60
  • Medical history of thyroid issues or cancer

  • Thyroid cancer prevention awareness month

    Prevention

    Thyroid cancer prevention awareness month

    You can reduce the risk of thyroid disease by doing the following:

    • If you are a smoker, then you should quit smoking.
    • Some studies have linked soy consumption to thyroid disease, so if you are consuming soy products, you should stop.
    • If you are getting X-rays, then you should ask for a thyroid collar to protect the thyroid gland from radiation exposure.
    • Selenium is an important mineral for thyroid health. If you are low on selenium, you should consider taking supplements.
    • Perform self-checks of the thyroid gland regularly so that if you have any lumps, growths, or nodules, they can be detected and treated early.
    • Incidence of thyroid disease is often linked with celiac disease, so get yourself checked and treated promptly.
    • If you are low on iodine, then consider taking iodine supplements.

When to consult a doctor?

You should consult an ENT/endocrinologist if:

  • you are feeling tired and weak all the time and you are experiencing extreme weight gain or loss issues.
  • you have a thyroid nodule or lump.
  • you have an enlarged thyroid gland.
  • you are having difficulty getting pregnant.
  • you have hair loss and skin rashes with dry and scaly skin.
  • you are pregnant.
  • you have pituitary gland troubles.
  • you are not feeling better despite treatment from your family doctor.

Questions to ask your doctor .

Are there any alternatives to surgical treatment for me?
How much experience do you have?
Have you performed any successful thyroidectomies before?
How much of my thyroid gland will be removed? How will it be decided?
What surgical technique will be used to perform my thyroidectomy?
How can I prepare for surgery?
How much follow-up will I need after surgery?
How long will I have to take supplements after my surgery?
Will the surgery affect my quality of living in any way?
How will I take my thyroid replacement hormones?
Will I have a scar after the surgery? How long will it be?
Can I reduce my chances of postoperative complications?
How long will I be hospitalized after the surgery?
What will my recovery entail?

Treatment Overview

The main goal of thyroid disease treatment is to return the thyroid hormone levels to normal. It can be done surgically and conservatively, depending on the patient’s health, the nature and severity of the condition, etc. Some common conservative treatments for thyroid disease are:

  • Anti-thyroid drugs (methimazole and propylthiouracil) help stop the thyroid gland from making excess thyroid hormones.
  • Radioactive iodine damages a part of the thyroid glands and prevents them from making thyroid hormones.
  • Beta-blockers help control and manage the symptoms caused due to thyroid disorders.
  • Thyroid replacement medications like synthetic thyroid hormones (levothyroxine), thyroid supplements, etc. help manage low thyroid hormone levels.

Other than this, patients can also get surgical treatment through a thyroidectomy to surgically remove part of the thyroid gland.

Health Insurance Coverage for Thyroid treatment

Insurance coverage

Thyroid treatments, both conservative and surgical, have long-term repercussions such as thyroid replacement supplements, systemic disorders, etc., which can make the treatment very expensive. Since it comes under the list of pre-existing conditions such as diabetes, its treatment may not be covered under insurance.

Most leading healthcare providers in India, such as Max Bupa, New India,  Religare, United India Insurance, Care Health, etc., cover the cost of thyroidectomy. If you have a health insurance policy and are unsure whether it covers thyroid treatment, then consult your insurance provider regarding your insurance coverage.

Health Insurance Coverage for Thyroid treatment

Frequently Asked Questions

Is thyroid disease hereditary?

Yes, over 75% of instances of thyroid disease are hereditary, however, it can still occur in people who have no family history of thyroid disease. Other than hereditary, thyroid disease can be an autoimmune disorder or caused due to medications, radiation therapy, etc.

Can thyroid disease be cured?

Yes, depending on the type of thyroid disease, it is possible to treat it permanently. Hyperthyroidism and goiter can be permanently cured by surgery, but for hypothyroidism, the patient may have to take hormonal supplements for a long time.

Can thyroid disease cause skin problems like melasma?

Yes, thyroid disorders can trigger hormonal disorders, which can lead to melasma. If you have melasma, you can contact your doctor for treatment to lighten the melasma.

Which doctor should I consult for thyroid disease?

If you are showing signs of thyroid disease, you should consult an endocrinologist, as they are experts in hormonal glands, their functions, and diseases. However, if you need thyroid gland surgery, you can consult a general surgeon or ENT specialist. 

Can I lose weight even if I have thyroid disease?

Yes, you can lose weight even with thyroid disease, but only if you’re willing to follow a strict diet. If you have an underactive thyroid gland, you should avoid inflammatory foods as they may contribute to weight gain. You should also try to keep your diet gluten-free, soy-free, and dairy-free.

According to a study published in the Indian Journal of Endocrinology and Metabolism, titled “Thyroid disorders in India: An epidemiological perspective”, about 42 million people in India suffer from thyroid diseases.

The most common thyroid disease in India is hypothyroidism, which occurs in about 79% of children. The study also indicates a high correlation between malnourished people and people with goiter as around 80% of the people who were found to be malnourished (around 82% of the subjects) had a goiter.

The study also concluded that nationwide, thyroid cancers account for about 0.1%-0.2% of all cancers, and among these, the most common thyroid cancer is papillary, followed by follicular cancer.

Citation: Unnikrishnan AG, Menon UV. Thyroid disorders in India: An epidemiological perspective. Indian J Endocrinol Metab. 2011 Jul;15(Suppl 2):S78-81. doi: 10.4103/2230-8210.83329. PMID: 21966658; PMCID: PMC3169866.

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