Thyroid Diseases

Thyroid diseases are broadly categorized into two main groups:

Functional Disorders – Hyperthyroidism (overactive thyroid) and Hypothyroidism (underactive thyroid).
Nodular Thyroid Diseases – Conditions involving thyroid nodules, which may be benign or malignant.

The thyroid gland plays a vital role in regulating metabolism, growth, and energy levels through hormone production. Any dysfunction can significantly impact multiple body systems.

Thyroid disorders can result from autoimmune conditions, iodine imbalance, genetic predisposition, or structural abnormalities in the gland.

• Hypothyroidism often occurs due to Hashimoto’s thyroiditis, iodine deficiency, or post-surgical thyroid removal.
• Hyperthyroidism is commonly caused by Graves’ disease, toxic nodules, or thyroiditis.
• Nodular thyroid disease may develop from benign growths or thyroid cancer.

Hypothyroidism – Underactive thyroid gland producing insufficient hormones.
Hyperthyroidism – Overactive thyroid gland producing excessive hormones.
Nodular Thyroid Disease – Presence of one or more nodules, which may be benign or malignant.

• Family history of thyroid disease
• Autoimmune disorders
• Iodine deficiency or excess
• Previous neck radiation exposure
• Female gender (higher prevalence)
• Smoking (linked to Graves’ disease and eye complications)

Hypothyroidism

Severe fatigue and sluggishness
Weight gain
Dry skin, brittle hair and nails
Sensitivity to cold
Swelling in face and limbs
Memory impairment and slow speech
Menstrual irregularities and fertility issues

Hyperthyroidism

Rapid heartbeat and palpitations
Irritability, anxiety, and insomnia
Weight loss despite normal appetite
Heat intolerance
Muscle weakness and tremors
Eye problems (bulging eyes, dryness, blurred vision)

Nodular Thyroid Disease

Often asymptomatic
Enlarged thyroid gland
Hoarseness or difficulty swallowing (if compressing nearby structures)

• Blood Tests: TSH, Free T3, Free T4, and thyroid antibodies (Anti-TPO, Anti-Tg, TRAb)
• Ultrasound: To assess gland size and detect nodules
• Radioactive Iodine Uptake (RAIU): Differentiates hyperthyroidism from thyroiditis
• Thyroid Scintigraphy (Scan): Evaluates nodules and gland function
• Fine Needle Aspiration (FNA): For suspicious nodules to rule out cancer
• Advanced Imaging: CT or MRI for large nodules or suspected invasion

Hypothyroidism

Levothyroxine: Lifelong hormone replacement therapy to restore normal thyroid function.

Hyperthyroidism

Anti-thyroid Medications: Methimazole, Propylthiouracil (PTU)
Radioactive Iodine Therapy (I-131): Destroys overactive thyroid tissue
Surgery (Thyroidectomy): Open or endoscopic techniques for severe cases or suspected cancer
Eye Surgery: For severe thyroid eye disease (orbital decompression, eyelid correction)

Nodular Thyroid Disease

Surgery: Partial or total thyroidectomy for cancerous or compressive nodules
Minimally Invasive Options:

Radiofrequency Ablation (RFA)
High-Intensity Focused Ultrasound (HIFU)
Ethanol Ablation for cystic nodules