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Thyroid diseases
Thyroid is a small, butterfly-shaped gland located at the front of the neck under the skin. It’s a part of endocrine system and controls many of our body’s important functions by producing and releasing (secreting) certain hormones. Thyroid’s main job is to control the speed of metabolism (metabolic rate), which is the process of how body transforms the food you consume into energy. All of the cells in the body need energy to function.
When your thyroid isn’t working properly, it can impact your entire body.
Thyroid disorders refer to conditions that affect the thyroid gland, which is responsible for producing hormones that regulate metabolism, energy use, and overall body function. The thyroid produces thyroid hormones (T3 and T4), which control many of the body's processes. When the thyroid becomes overactive (hyperthyroidism) or underactive (hypothyroidism), it can lead to a range of symptoms and complications.
Types of Thyroid Disorders
Hypothyroidism (Underactive Thyroid) :
Occurs when the thyroid gland does not produce enough thyroid hormones, leading to a slowing of body functions.
Fig 1. Hypothyroidism
Causes :
- Hashimoto’s Thyroiditis :
An autoimmune disorder where the body’s immune system attacks the thyroid.
- Iodine Deficiency :
Lack of iodine in the diet (rare in countries with iodine-rich salt).
- Thyroid Surgery or Radiation Therapy :
Removal or damage of the thyroid gland can lead to hypothyroidism.
- Medications :
Certain drugs like lithium and amiodarone can interfere with thyroid hormone production.
- Pituitary Disorders :
In rare cases, the pituitary gland doesn’t produce enough TSH to stimulate the thyroid.
Symptoms :
- Fatigue or feeling sluggish.
- Weight gain.
- Dry skin and hair.
- Cold intolerance.
- Constipation
- Depression and mood swings.
- Puffy face.
- Slow heart rate.
Diagnosis :
- Blood Tests :
Elevated TSH (Thyroid Stimulating Hormone) and low T3 and T4 levels.
- Ultrasound :
To evaluate the thyroid gland size or detect nodules.
- Antibody Testing :
To detect autoimmune diseases like Hashimoto’s.
Hypothyroid Treatment in Bangalore:
- Levothyroxine :
Synthetic thyroid hormone to replace the missing thyroid hormone.
- Monitoring :
Regular blood tests to ensure the correct dose of medication.
Hyperthyroidism (Overactive Thyroid):
Occurs when the thyroid gland produces excessive thyroid hormones, speeding up body functions.
Fig 2. Hyperthyroidism
Causes :
- Graves Disease :
An autoimmune disorder that stimulates the thyroid to overproduce hormones.
- Thyroid Nodules :
Benign growths (adenomas) or goiter that produce excessive thyroid hormone.
- Thyroiditis :
Inflammation of the thyroid, sometimes following a viral infection, can lead to the release of excess thyroid hormone.
- Excess Iodine Intake :
Overconsumption of iodine (from supplements or medications).
Symptoms :
- Unexplained weight loss.
- Rapid heartbeat or palpitations.
- Anxiety or irritability.
- Heat intolerance.
- Increased sweating.
- Tremors
- Sleep disturbances.
- Bulging eyes (in Graves' disease).
Diagnosis :
- Blood Tests :
Low TSH and elevated T3 and T4 levels.
- Radioactive Iodine Uptake Test :
To determine the cause of hyperthyroidism (e.g., Graves' disease, thyroid nodules).
- Ultrasound or Scans :
To detect thyroid enlargement or nodules.
Hyperthyroid treatment in Bangalore :
- Antithyroid Medications :
carbimazole or propylthiouracil (PTU) to reduce thyroid hormone production.
- Radioactive Iodine :
To destroy overactive thyroid tissue.
- Beta-blockers :
To control symptoms like rapid heart rate and tremors.
- Thyroidectomy :
Surgical removal of part or all of the thyroid in severe cases.
Thyroid Nodules:
Solid or fluid-filled lumps that form in the thyroid gland.
Causes :
- Most nodules are benign (non-cancerous).
- Some nodules can cause thyroid dysfunction (hyperthyroidism or hypothyroidism).
Symptoms :
- Often asymptomatic (no symptoms).
- Difficulty swallowing or breathing (if large).
- Possible signs of thyroid dysfunction (weight changes, mood shifts, etc.).
Diagnosis :
- Ultrasound :
To assess the size and characteristics of the nodule.
- Fine Needle Aspiration Biopsy :
To determine whether the nodule is benign or malignant
- Blood Tests :
To check thyroid hormone levels.
Treatment:
- Observation :
Small, benign nodules often don’t require treatment.
- Surgical Removal :
If the nodule is large, symptomatic, or cancerous.
- Radioactive Iodine or Medication :
For overactive nodules.
Goiter:
An enlargement of the thyroid gland, which can occur with both hyperthyroidism and hypothyroidism.
Causes :
- Iodine Deficiency :
Leads to goiter formation as the thyroid attempts to compensate for low iodine levels.
- Graves' Disease or Hashimoto's Thyroiditis :
Both can cause inflammation and enlargement of the thyroid.
- Thyroid Nodules :
Can cause a visible goiter.
Symptoms :
- Visible swelling in the neck.
- Difficulty swallowing or breathing if the goiter is large.
Diagnosis :
- Physical Examination :
Visible or palpable swelling.
- Ultrasound and Blood Tests :
To determine if the goiter is related to thyroid dysfunction.
Treatment:
- Iodine Supplementation :
In cases of iodine deficiency
- Antithyroid Medications or Thyroid Hormone Replacement :
Based on thyroid function.
- Surgery :
If the goiter is large or causes difficulty with swallowing/breathing
Complications of Thyroid Disorders
- It can lead to heart problems, infertility, and severe fatigue.
- In extreme cases, can lead to a life-threatening condition called myxedema coma.
- It can lead to heart problems like arrhythmias, osteoporosis, and infertility.
- Thyroid Storm: A rare, severe form of hyperthyroidism that is life-threatening.
Prevention and Monitoring
Regular thyroid screening for those at risk (e.g., family history, autoimmune disease). Monitoring thyroid function after thyroidectomy or treatment for thyroid cancer. Lifelong follow-up for thyroid hormone replacement in patients with hypothyroidism.
THYROID CANCER
Thyroid cancer is a type of cancer that develops from the cells of the thyroid gland (the butterfly-shaped gland located at the base of the neck). This gland produces hormones that regulate heart rate, blood pressure, body temperature and weight. It develops when cells in the thyroid gland genetically mutate or change. These abnormal cells begin multiplies in the thyroid and results in tumor or cancer. It is one of the most treatable forms of cancer if caught early.
Fig 1. Thyroid Cancer
Types of Thyroid Cancer
Thyroid cancer has the potential to spread to other parts of the body. The following are the main types of thyroid cancer:
- Papillary Carcinoma :
It is the most common type of thyroid cancer found. This type of cancer arises from follicular cells which produce thyroid hormone, it grows slowly and often spread to the lymph nodes in the neck. Even if there is spread, there is a good chance for full recovery. It may occur at any age, but most commonly it is found in people ages 30 to 50.
- Follicular thyroid cancer :
This type of cancer also arises in the follicular cells, it may spread into the lymph nodes and is more likely to spread into blood vessels and to distant organs such as lungs and bones. It usually affects middle-aged people, particularly women.
- Medullary Thyroid Cancer :
This type of cancer initiates when there is an elevated level of calcitonin in blood. Unlike the other types, the risk of this cancer increases at an early stage, as it develops due to certain genetic syndromes.
- Anaplastic Thyroid Cancer :
This type of cancer is rare but it is more severe and rapidly growing. This type of cancer is very difficult to treat. It usually affects people over the age of 60.
Causes
The exact cause of thyroid cancer is unknown, it occurs when there is a change in the DNA of the cells in thyroid, which results in the production of lump due to the uncontrollable growth of these cells.There are a number of factors that increase your risk of developing thyroid cancer, these include:
- Over or underactive thyroid
- Family history
- Exposure to radiation
- Obesity
- Gene mutation
- Radiation therapy for head and neck cancer
Symptoms
The most common symptoms of thyroid cancer include:
- A painless lump or swelling in the neck
- Neck or throat pain
- Swollen glands in the neck
- Difficulty in swallowing
- Difficulty in breathing
- Vocal changes or hoarseness that lasts more than two weeks
- A sore throat or a cough that doesn’t get better
Diagnosis of thyroid swelling/cancer:
Dr. Uday Ravi who is a one of the best doctor for thyroid swelling treatment. Doctor will do physical examination and examine for any swelling over the thyroid gland. He might advice further tests based on patients symptoms and the findings on examination
- Blood tests :
A thyroid blood test checks hormone levels and gauges whether your thyroid is functioning properly.
- Biopsy :
During a fine-needle aspiration biopsy, your healthcare provider removes cells from your thyroid to test for cancer cells. A sentinel node biopsy can determine if cancer cells have spread to your lymph nodes. Your provider may use ultrasound technology to guide these biopsy procedures.
- Radioiodine scan :
This test can detect thyroid cancer and determine if the cancer has spread. You swallow a pill containing a safe amount of radioactive iodine (radioiodine). Over a few hours, your thyroid gland absorbs the iodine. Your healthcare provider uses a special device to measure the amount of radiation in the gland. Areas with less radioactivity need more testing to confirm the presence of cancer
- Imaging scans :
Radioactive iodine scan, computed tomography (CT) and positron emission tomography (PET) scans can detect thyroid cancer and cancer spread.
Thyroid swelling/cancer treatment :
Thyroid cancer is usually very treatable, even if the patient has a more advanced stage, the main treatments for thyroid cancer are:
- Radioactive Iodine Therapy
- External Radiotherapy
- Surgery
- Chemotherapy
Reasons for thyroidectomy:
A thyroidectomy may become necessary for the following conditions if non-surgical treatment fails to achieve desired results:
- Thyroid Cancer :
Most thyroidectomies are performed to treat thyroid cancer. Thyroidectomy for cancer will likely remove most of the thyroid gland, if not all.
- Non-cancerous Enlargement of the Thyroid (goiter) :
Removing all or part of your thyroid gland is an option if you have a large goiter that is uncomfortable or causes difficulty breathing or swallowing or, in some cases, if the goiter is causing hyperthyroidism.
- Overactive Thyroid (hyperthyroidism) :
Hyperthyroidism is a condition in which your thyroid gland produces too much of the hormone thyroxine. If you have problems with anti-thyroid drugs and don’t want radioactive iodine therapy, thyroidectomy may be an option.
- Indeterminate Or Suspicious Thyroid Nodules :
Some thyroid nodules can’t be identified as cancerous or non-cancerous after testing a sample from a needle biopsy. Doctors may recommend that people with these nodules have thyroidectomy if the nodules have an increased risk of being cancerous
What are the types of thyroidectomies?:
There are two main categories of thyroidectomies:
- Partial thyroidectomies : It involves the removal of part of the thyroid which includes:
- Hemi-thyroidectomy or thyroid lobectomy :
Here the surgeon removes one lobe (one half) of the patient thyroid.
- Isthmusectomy :
Here the surgeon removes the thyroid tissue between the two lobes. Surgeons do this surgery specifically for small tumours which are located in the isthmus.
- Open thyroid biopsy :
Here the surgeon removes a thyroid nodule directly.
- Hemi-thyroidectomy or thyroid lobectomy :
- Total thyroidectomies :
Removing all or part of your thyroid gland is an option if you have a large goiter that is uncomfortable or causes difficulty breathing or swallowing or, in some cases, if the goiter is causing hyperthyroidism.
When does a patient need thyroidectomy surgery?
The doctor may recommend thyroidectomy for any of the following reasons:
- If a patient has a nodule (growth) on the thyroid that might be thyroid cancer.
- If a patient has a diagnosis of thyroid cancer.
- If a patient has a nodule or goitre that’s compressing the trachea or oesophagus
- If a patient has a nodule or goitre that’s releasing excess thyroid hormone
Book an appointment with Dr. Uday Ravi if you are having thyroid swelling and looking for thyroid treatment doctor in Bangalore
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ABOUT DR.
Dr. Uday Ravi is a renowned consultant General, Laser, Laparoscopic, Robotic and Bariatric surgeon practising in Bangalore since 15 years. He completed his MBBS from VIMS Bellary and MS from prestigious Bangalore Medical College, Bangalore. He has many fellowships FARIS, FMAS, FALS, FIAGES, FISCP and DMAS(France).
Dr Uday Ravi specializes in managing thyroid diseases both benign and malignant conditions. He is known for his patient centered approach, ensuring that each treatment plan is tailored to the individual’s needs.
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