Today (May 25 2016), on World Thyroid Day, we are going to have a wonderful interview with our very own largest endocrine gland in our body – The Thyroid.
Shaped like a butterfly, Mr Thyroid is located below the Adam’s apple in the lower part of the neck. He produces hormones that affect the function of virtually all our organs, thus making him very important. Let’s catch up with him before he gets busy again!
Me : Hello Mr Thyroid! I know you are an extremely busy gland working 24 hours regulating our body’s metabolism, growth and other important functions. Thank you for sparing some time for us amidst that.
Mr Thyroid (Mr T): Well, when your world has dedicated an entire day to spread awareness about me and the diseases related with me, it is more than my pleasure to share some of my time with you! But before we begin our interview, I am curious as to why you are celebrating this day?
Me: As I pointed out earlier, you are an very important organ in our body with critical functions. If your function is impaired, it can lead to a variety of disorders including cancers to anyone at any age. There are about 750 million people worldwide affected by thyroid disorders!
Mr T: No wonder! Well, do you know that my most common disorder is hypothyroidism and goitre, which is primarily caused by iodine deficiency. Just about 150 µg of iodine is required by me per day. Supplementing with iodized salt (just less than half tea spoon) or with multivitamin pills can usually provide sufficient iodine for my function. Natural sources include milk, cheese, yogurt, eggs, and vegetables grown in iodine-rich soil or ocean-caught or ocean-farmed fish and shellfish tend to be naturally rich in iodine. But there are other reasons that contribute to my impaired function, not just iodine deficiency!
Me: That’s the exact reason why the World Thyroid day was declared on May 25th by the American Thyroid Association (ATA), the European Thyroid Association, the Asia & Oceania Thyroid Association, and the Latin American Thyroid Society – to spread awareness on thyroid diseases. This year we are celebrating its 9th anniversary. The five main aims of this day is to
- Increase awareness of thyroid health.
- Promote understanding of advances made in treating thyroid diseases.
- Emphasize the prevalence of thyroid diseases.
- Focus on the urgent need for education and prevention programs.
- Expand awareness of new treatment modalities.
By the way, you were telling us there are other disorders too. Could you please elaborate on those conditions and available treatments?
Mr T: Sure! There are 4 major disorders that can affect me. Let me explain in detail:
- Hypothyroidism: As I mentioned earlier, it is caused due to my under activity. Primary hypothyroidism is not only caused by iodine deficiency but also due to autoimmune thyroiditis (where our own immune systems destroys the thyroid), thyroidectomy (removal of thyroid surgically) or even pregnancy.
The major symptoms include fatigue, poor memory and concentration, weight gain with poor appetite, shortness of breath, abnormal menstrual periods in women, hair loss, slow pulse rate, swelling of limbs to name a few.
Hormone replacement therapy is the most common treatment for hypothyroidism. Supplementation of iodine is the effective method to prevent hypothyroidism in a population.
- Hyperthyroidism: This is the exact opposite of the above, as it is caused due to my over activity where I produce more hormones than what the body actually needs. There are several reasons, including Grave’s disease (which is an autoimmune disease) and thyroiditis that can lead to hyperthyroidism.
The symptoms include restlessness, tremors, weight loss despite an increased appetite, sweating, rapid heart rate, intolerance to heat, and frequent bowel movements.
Prolonged untreated hyperthyroidism causes a medical emergency called Thyroid storm, which is a severe form of thyrotoxicosis and requires immediate hospitalization.
In some women, symptoms of hyperthyroidism may be mistaken with symptoms of menopause as they are mostly similar.
Treatments include medications (to suppress the thyroid function), radioactive iodine (to destroy the thyroid), or surgery (to remove the thyroid). However, permanent hypothyroidism should be expected after radioiodine or thyroidectomy, though it can be treated with supplements. High risk groups should reduce the intake of iodine to prevent hyperthyroidism.
- Goitre (Nodular abnormalities): The swelling of the neck or larynx because of my enlargement is called goitre. However it is not cancerous. About 90% of goitre cases are caused due to iodine deficiency. Other causes include selenium deificeny and Hashimoto’s thyroiditis. People who eat cassava root as staple should also look out for goitre as the cassava root is rich in cyanide and goitre can result from cyanide poisoning.
Goitre can be associated with both hypo and hyperthyroidism and treatments are given according to the underlying cause.
- Thyroid cancer: Though the actual cause of thyroid cancer is unknown, it may be caused due to environmental exposures to ionizing radiations (especially after nuclear disasters like Chernobyl and Fukushima disasters), genetic susceptibilities or underlying other thyroid diseases.
However, if thyroid cancer is detected early, it can be completely cured through chemo therapy, radio therapy or removal of thyroid gland.
By the way, do you know that women are more susceptible to thyroid diseases than men?
Me: Oh is it? Why is it so?
Mr T: Yes, Women are more prone to getting thyroid diseases, especially thyroiditis and cancer, than men. It may be due to hormonal and immune system changes during pregnancy and child birth, but the exact reasons are not known.
Hypothyroidism may be caused during pregnancy and post-partum in women. A severe case of maternal hypothyroidism may lead to congenital hypothyroidism where the baby has no thyroid gland formed at birth. This can later lead to a condition called cretinism in these individuals, characterized by stunted physical and mental growth due to untreated congenital deficiency of thyroid hormones.
WHO recommends that pregnant and breastfeeding mothers, who are most susceptible to hypothyroidism, should supplement up to 250 µg of Iodine in their diet. Moreover women at high-risk for thyroid disease should be tested early in their pregnancy as thyroid dysfunction can have a bad impact on both the fetal and maternal health.
Me: That’s a wealth of information from you! Thank you very much!
Well, we are almost at the end of our talk. Do you have any special message for us?
Mr T: Yes! Most of the thyroid related diseases/ disorders are easily preventable or mostly curable. The key is early detection. Hence I suggest that everyone should screen for thyroid functionality every 5 years, beginning at an age of 35.
If you more than few of the following symptoms, there is something wrong with me and its time for a check up:
- Unexplained weight loss/ gain
- A visible swelling in the neck
- Changes in heart rate
- Changes in energy or mood
- Hair loss
- Feeling too hot or cold
I would like to end with one message:
TAKE CARE OF ME AND I WILL TAKE CARE OF YOU BETTER!
So long my friends!