Thyroid Gland Disorders

Thyroid Gland Disorders

• Thyroid disease and disorders range from harmless goiter to life-threatening cancer.
• The most common thyroid problems involve abnormal production of thyroid hormones, leading to hyperthyroidism (too much hormone) or hypothyroidism (too little hormone).

Anatomy of the Thyroid Gland

• The thyroid gland is located at the front of the neck, under the skin, and is small and butterfly-shaped.

Biosynthesis and Physiological Function of Thyroid Hormones

• Thyroid hormones play a crucial role in various bodily functions, including heart rate, mood, energy level, metabolism, bone health, and pregnancy.
• Thyroid hormones are released through a complex pathway involving the pituitary gland and hypothalamus.

Risk Factors for Thyroid Problems

• Anyone can develop thyroid problems, but women are five to eight times more likely than men to be diagnosed.
• Risk factors include:
  • Family history of thyroid problems
  • History of autoimmune disease
  • Taking medications with iodine
  • Age 60 or older
  • Previous thyroid condition or cancer

Hyperthyroidism

• Causes of hyperthyroidism:
  • Graves' disease
  • Toxic adenomas
  • Subacute thyroiditis
  • Pituitary gland malfunctions or cancerous growths
• Clinical presentation of hyperthyroidism:
  • Restlessness, nervousness, racing heart rate, irritability
  • Increased sweating, shaking, anxiety, and trouble sleeping
  • Thin skin, brittle hair and nails, muscle weakness, and weight loss
  • Frequent bowel movements and bulging eyes (in Graves' disease)
• Algorithm for hyperthyroidism involves trapping antibodies and treating thyrotoxicosis.

Treatment of Hyperthyroidism

• Treatment options:
  • Radioactive iodine treatment
  • Antithyroid medication
  • Surgery
• Treatment lines:
  • Antithyroid medication to prevent thyroid hormone production
  • Radioiodine therapy to damage the thyroid gland
  • Beta-blockers to alleviate symptoms
  • Surgery to remove the thyroid gland

Hypothyroidism

• Causes of hypothyroidism:
  • Hashimoto's thyroiditis
  • Postpartum thyroiditis
  • Iodine deficiency
  • Removal of the thyroid gland
  • Exposure to excessive amounts of iodine
  • Past thyroid issues
  • Lithium
• Clinical presentation of hypothyroidism:
  • Tiredness, weight gain, depression, and abnormal bone development
  • Early signs of thyroid disease include changes in tolerance for hot or cold temperatures, menstrual cycle, energy level, mood, and weight
• Treatment of hypothyroidism:
  • Thyroid hormone replacement for life
  • Man-made forms of thyroid hormone, such as levothyroxine
  • Side effects are rare, but some people may experience nervousness or chest pain

Thyroid Nodules

• Diagnosis and treatment:
  • Identification during a routine physical exam
  • Additional tests, such as ultrasound, CT scan, TSH test, and thyroid scan
  • Fine-needle aspiration biopsy to determine if the nodule is cancerous
• Prognosis:
  • Benign thyroid nodules are not typically life-threatening and usually do not require treatment
  • If the nodule grows, a doctor may recommend radioactive iodine

Dietary Recommendations

• Foods rich in iodine, such as fish, seafood, dairy products, and egg yolks
• Selenium-rich foods, such as meat, seafood, and whole grains
• Iron-rich foods, such as shellfish, red meat, and legumes
• Limiting "ultra-processed" foods and getting enough iron and selenium in the diet

Nutrients and Thyroid

• Vitamin A plays a role in thyroid hormone metabolism
• Vitamin D is often accompanied by hypothyroidism
• Selenium is essential for thyroid hormone metabolism
• Zinc and iron are critical for thyroid health