Thyroid Disease Problems

The Goiter is one of the problems faced by Thyroid patients. A Goiter is an enlarged Thyroid and is associated with Hypothyroidism. Some physical symptoms include an obviously large neck, choking sensation while consuming food, pain in the neck from time to time, hoarse voice, discomfort in wearing anything close to the neck, and a vibrating feeling. The Goiter may be traced in Iodine deficiencies, which is the result of excess simulation from pituitary.

Thyroid Nodules refer to any kind of abnormal growth of thyroid cells into a lump. Most of the time Thyroid nodules do have specific symptoms, apart from slight lump noticeable at times. Similarly the causes of the non cancerous Thyroid lumps are not too well defined. While a patient with hypothyroidism may be prone to thyroid nodules, at times the lack of iodine in the food may cause such nodules. Some autonomous nodules may also be caused due to genetics.

Thyroid Cancer is caused due to malignant thyroid tissue or nodules present in the gland. There are four types of cancers related to Thyroid; they are follicular, papillary, medullary, and anaplastic. Some of the primary symptoms of Thyroid cancer are, persistent pain in the neck, swollen lymph nodes, having problems in swallowing, formation of a lump near the Adam's apple and even hoarseness.

Thyroiditis describes the general inflammation of the Thyroid gland. There are no specific symptoms other than similar to that of Hypothyroidism. Thyroiditis is mainly caused by attacks by antibodies on the thyroid gland, which leads to inflammation and eventual damage of the Thyroid cells.

Thyroid Disease Risk Factors

Because hyperthyroidism puts the body’s metabolism in overdrive, patients may risk the complications of being underweight if they are not treated. Cardiovascular health can also degenerate due to sustained irregularities in heartbeat. Should atrial fibrillations develop, the patient may develop chest pains, blood clots, and even heart failure. Chronic fatigue, tremors, muscle weakness, or severe muscle spasms may also occur. Osteoporosis can also potentially develop if the thyroid hormones begin to interfere with the absorption of calcium into the bones. Hyperthyroidism can also lead to various problems with the eyes, including redness, swelling, blurring, and double vision. Protrusion of the eyes is specific to Graves’ disease, but other disorders leading to an overabundance of hormones can cause the eyes to be perpetually widened into a stare. Untreated hyperthyroidism can also put a patient at risk for thyrotoxic crisis, a complication triggered by extreme stress or illness. During these episodes, the heart rate increases dramatically and heartbeat may be irregular. Severe nausea, vomiting, and diarrhea can also occur, putting the patient at risk for dehydration, coma, and death.

Untreated hypothyroidism may lead to an ever-enlarging goiter due to constant stimulation of the thyroid gland. As the thyroid continues to increase in size, it may significantly crowd the other structures in the neck, causing difficulties with breathing and swallowing. Insufficient thyroid hormone levels can also cause an increase in LDL cholesterol, the “bad” cholesterol that contributes to cardiovascular diseases such as atherosclerosis. Hypothyroidism can also impact mood, leading to irritability, depression, and general mood instability. Cognitive problems, such as memory loss, poor attention span, and “brain fog” can also be experienced. Chronic pain, chronic fatigue, and an increased need for sleep may also be noted. In rare cases, hypothyroidism can induce a dangerous condition called myxedema, during which the person becomes profoundly sleepy and lapses into unconsciousness and coma. These episodes may be triggered by stress, illness, or exposure to toxins.

Thyroid disorders can also potentially lead to menstrual abnormalities and female infertility. Should a woman with a known thyroid imbalance become pregnant, it is critically important to balance hormone levels so that the fetus will develop normally. Hyperthyroidism or hypothyroidism during pregnancy can significantly increase the incidence of miscarriage, stillbirth, and birth defects. For pregnant mothers with hypothyroidism, it is safe to take thyroid hormone supplements during pregnancy, though doctors may adjust dosages as the mother’s body chemistry changes. It is highly recommended that issues with hyperthyroidism be dealt with before pregnancy occurs, however, as the more commonly recommended treatments may not be safe for the fetus.

Nodules discovered in the thyroid should always be investigated to determine whether they are cancerous. Papillary and follicular thyroid cancers, which together make up almost 90% of thyroid cancer cases, tend to have good recovery rates, though diligent monitoring of the thyroid should continue in case of reoccurrence. Medullary and anaplastic thyroid cancers tend to be more invasive and spread to other organs, making them far more difficult to treat. The prognosis for patients with anaplastic thyroid cancer is currently poor, though combinations of surgical techniques, chemotherapy, radiation, and promising new cancer drugs can help prolong life for these patients.

Conventional Thyroid Treatment

Hyperthyroidism is initially treated through the prescription of medications that control the production or activity of excessive thyroid hormones. Thyrostatics are a class of drugs that interfere with production of the hormones by blocking critical steps in the synthesis of the precursor hormone T4. Propylthiouracil is a thyrostatic that additionally prevents the conversion of T4 to its more active form, T3. Because the body naturally keeps a lot of T4 on reserve, it may take these drugs quite some time to have an impact on overall thyroid hormone levels, and high doses may be necessary as these therapies begin. Beta blockers, drugs typically used to control heart rate and blood pressure, may additionally be prescribed to help reduce tremors, heart palpitations, and anxieties as the thyroid hormones are being rebalanced.

For more permanent treatment of hyperthyroidism, radioiodine therapy may be given to destroy cells that are producing too much thyroid hormone. Iodine is only taken up by the thyroid and is taken up more readily by the overactive thyroid cells. This localized destruction of the problematic thyroid cells has a very high success rate and has been used for more than fifty years to treat overactive thyroids. If a patient is allergic to iodine or is unable to undergo this therapy for other reasons, portions of the thyroid (or the gland in its entirety) may be surgically removed. With either of these approaches, hypothyroidism may result, but this is a far easier condition to treat.

Hypothyroidism is typically treated through replacement of thyroid hormones with synthetic or animal-derived hormones. Therapies may involve administration of T4 only or a combination of T4 and T3, usually in tablets that are taken daily. Desiccated thyroid extracts containing natural T4 and T3 (typically from pigs) are another potential source for hormone replacement. As these treatments begin, the patient’s thyroid hormone levels must be carefully monitored to ensure that the dosages are correct and a stable balance is achieved.

If a goiter has formed, doctors normally perform blood tests to determine the nature of the thyroid disorder causing the abnormal growth and treat that directly. If a goiter is small, treatment may not be necessary. If the thyroid has increased in size such that it visibly protrudes, it may interfere with breathing or swallowing. If a goiter does not respond to hormone treatments, surgical removal of the enlarged thyroid may be recommended.

Thyroid cancer treatments depend on the specific type of cancer and how far it has spread. In the cases of the less invasive cancers (papillary and follicular), all or part of the thyroid may be surgically removed, taking into consideration the progression of the cancer and the risk that it could reoccur. If some of the thyroid remains following surgery, radioiodine treatment may also be recommended to destroy cancerous cells that are overzealously producing thyroid hormones.

Medullary thyroid cancers may be candidates for surgery if they are caught early, but because this cancer spreads more aggressively, the odds of recurrence are high. The cells affected by this cancer do not take up iodine, so radioiodine therapy is not helpful. Radiation therapies, however, have improved recovery rates. Clinical studies also show promise for treatments with tyrosine kinase inhibitors, a class of drugs that block enzymatic reactions to decrease tumor size. Because of the extreme aggressiveness of anaplastic thyroid cancers, surgeries are rarely successful in controlling their spread. Combinations of radiation therapy and chemotherapy are almost always performed to destroy the rapidly dividing cancer cells and slow the progression of the disease, though expectations of recovery are unfortunately low. There are several new drugs involved in limiting the maturation of tumors that have improved survival times, but anaplastic thyroid cancers are generally considered to be fatal.

Our Thyroid Treatment

Thyroid imbalances often go undiagnosed in the absence of clear, characteristic symptoms such as thyroid enlargement or thyroid nodules. This is partly because people simply brush off their symptoms, assuming that they are just stressed, fatigued, or having weight issues as part of the normal course of their life. When they do seek help, the vagueness of the symptoms may make proper diagnosis elusive. Conventional blood tests for TSH, T4, and T3 levels may also not be sensitive enough to pick up on subtle cases of hypothyroidism.

Because of this, at Patients Medical, we additionally measure the efficacy of thyrotropin-releasing hormone (TRH) stimulation. As described in the overview, TRH is released from the hypothalamus. It then stimulates the pituitary gland to release thyroid-stimulating hormone (TSH), which induces the release of thyroid hormones T4 and T3. During medical testing, we measure your body’s TSH levels before and after injections of TRH to get a far more accurate view of your thyroid function.

Given the intricate connections between the thyroid hormones and other hormones, a complete hormonal diagnostic may be recommended. It is well-known that estrogen reduces the efficiency of thyroid hormones, for example. Rebalancing estrogen and other hormones may help thyroid hormone levels rebalance themselves. Other physiological imbalances that may be contributors to or consequences of thyroid disorders will also be investigated. Some of these include blood sugar, cholesterol, and blood pressure. Tests of heart, liver, and kidney function may also indicate the risks of additional complications, as well. Depending on the patient’s current health and medical history, dietary and lifestyle changes may be recommended to improve overall health and increase the likelihood of a full recovery from their thyroid imbalance. Diverse diet, balanced body composition, and regular exercise are the most natural solutions to many health problems and can radically increase a person’s longevity.

Thyroid hormone replacements, like all hormone replacement therapies (HRT) at Patients Medical, are also done naturally, using bio-identical hormones. Unlike the synthetic hormones used in conventional HRT, bio-identical hormones are structurally the same as their natural counterparts in the human body. Pharmaceutical companies engineer small changes during their synthesis of hormones so that they can patent the molecules. Bio-identical hormones are instead synthesized so that they are structurally the same, eliminating side effects and allowing the body to metabolize them just as they would their natural hormones. (Please see our article on Bio-Identical Hormones for more details on these and other available treatments.)

We are located at: Patients Medical PC, 800 Second Avenue, Suite 900 (Between 42nd & 43rd Street), Manhattan, NYC, New York, NY 10017.

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Article Last Updated: 06/26/2009