ശല്യക്കാരനായ തൈറോയ്ഡ്*

[annie]

Hypothyroidism

Hypothyroidism refers to any state that results in a deficiency of thyroid hormone, including hypothalamic or pituitary disease and generalized tissue resistance to thyroid hormone, and disorders that affect the thyroid gland directly. The most common cause of hypothyroidism is primary failure of the thyroid gland. While secondary hypothyroidism from pituitary or hypothalamic dysfunction is rare, it is vital to identify the site of dysfunction at the outset. It covers a wide spectrum of clinical and biochemical disease, from clinically unapparent disease to myxoedema coma.

Hypothyroidism, is a disease with wide ranging symptoms and signs affecting many systems. The signs and symptoms of hypothyroidism are nonspecific and may be confused with those of other clinical conditions, especially in postpartum women and the elderly. Patients with severe hypothyroidism generally present with a constellation of signs and symptoms that may include lethargy, weight gain, hair loss, dry skin, forgetfulness, constipation and depression. Not all of these signs and symptoms occur in every patient, and many may be blunted in patients with mild hypothyroidism.5

Hyperthyroidism

Clinically hyperthyroidism, also called thyrotoxicosis, is caused by the effects of excess thyroid hormone. Although the terms hyperthyroidism and thyrotoxicosis are frequently used interchangeably, in the strictest sense hyperthyroidism refers to hyper function of the thyroid gland, whereas thyrotoxicosis refers to any state characterized by thyroid hormone excess, including ingestion of excess thyroid hormone and thyroiditis.

The cause of hyperthyroidism will differ between young and elderly patients. In young patients Graves's disease is the most common cause, whereas in elderly patients toxic nodular goiter is also a cause. Other causes include thyroiditis, toxic multinodular goiter, toxic adenomas, and side effects of certain medications.

Hyperthyroidism presents with multiple symptoms that vary according to the age of the patient, duration of illness, magnitude of hormone excess, and presence of comorbid conditions. Older patients often present with a paucity of classic signs and symptoms, which can make the diagnosis more difficult. Signs and symptoms of hyperthyroidism include tremors, nervousness, insomnia, excessive sweating, heat intolerance, tachycardia, hypertension, and goiter.

Thyroid storm is a rare presentation of hyperthyroidism that may occur after a stressful illness in a patient with untreated or undertreated hyperthyroidism and is characterized by delirium, severe tachycardia, fever, vomiting, diarrhea, and dehydration.

[annie]

TSH level T4 level T4 level

High High Low
Congenital absence of T4-T3*converting enzyme; amiodarone (Cordarone) effect on T4-T3 conversion

High Normal Normal
((6 to 10 µU
per mL
[6 to 10 mU
per L])

Subclinical hypothyroidism with low risk for future development of overt hypothyroidism

High Low Low
Primary hypothyroidism

[annie]

Hyperthyroidism Symptoms

The symptoms of hyperthyroidism tend to reflect the rapid metabolism that results from an oversupply of thyroid hormone. Common symptoms include anxiety, insomnia, rapid weight loss, diarrhea, high heart rate, high blood pressure, eye sensitivity/bulging and vision disturbances, and many other concerns.

[annie]

Risk Factors for Thyroid Disease

Some of the key risk factors for thyroid disease include...

• Female: Women are at greater risk than men.
• Age - being 50 and above poses the highest risk of thyroid disease, though it can strike at any age.
• A personal or family history of thyroid and/or autoimmune disease increases risk.
• Surgical removal of all or part of the thyroid, or radioactive iodine treatment to the thyroid -- both which typically result in an underactive thyroid.
• Being left-handed, ambidextrous or prematurely gray mean greater risk of autoimmune disease, including thyroid problems
• Being pregnant or within the first year after childbirth
• Current or former smoker
• Recent exposure to iodine via contrast dye or surgical antiseptic
• Iodine or herbal supplements containing iodine, in pill or liquid form
• Living in an iodine-deficient area
• Various medical treatments, including Interferon Beta-1b, Interleukin-4, immunosuppressants, antiretrovirals, monoclonal antibody (Campath-1H), bone marrow transplant, Lithium, amiodarone (Cordarone), and other medications
• Overconsumption of raw goitrogenic foods, i.e., Brussel sprouts, turnips, cauliflower, soy products and others
• Overconsumption of soy foods
• Recent neck trauma, biopsy, injection or surgery
• Radiation exposure, through radiation to neck area, or exposure to nuclear facility or accident, i.e., Chernobyl
• High stress life events