Thyroid Problems

Thyroid gland is largest gland in endocrine system. Thyroid gland situated in neck. Main function of thyroid gland is producing hormones – T3[tri iodothyronin]  and T4[tetraiodothyronine] which controls body metabolism, thyroid gland also produce calcitonin which plays a role in calcium homeostasis. The hormonal output from thyroid is regulated by thyroid stimulating hormone [TSH ] produced by anterior pituitary, which itself regulated by thyrotropin releasing hormone [TRH] produced by hypothalamus.

The most common problems of thyroid gland consist of an overactive thyroid gland referred to as hyperthyroidism and underactive thyroid gland referred to as hypothyroidism. When there is fluctuation in thyroid hormones which causes thyroid problems. Normal range should be-

T3 – 80-230 ng/dl in adults

83-280 ng/dl in baby and old children

32-250 ng/dl in new born

T4 – 5-14 mg/dl in adult

5.6-16.6 mg/dl in babies and older children

9.8-22.6          mg/dl in new born

TSH – 0.4-6 mg/dl

When TSH is less than 0.4 mg/dl condition is called as hyperthyroidism .when TSH is more than 6 mg/dl condition is called as hypothyroidism.

CAUSES :

• Iodine deficiency –now days this is rare cause for thyroid problem because salt contains iodine. Other than this vitamin deficiency, magnesium deficiency etc.
• Mental stress.
• Hereditary.
• During pregnancy due to hormonal fluctuation. Iodine deficiency during pregnancy can cause maternal and fetal hypothyroidism [congenital hypothyroidism] and impair neurological development of fetus.

HYPOTHYROIDISM: Underactive thyroid gland

In this condition, TSH more than 6 mg/dl, T3 is normal and T4 is decreased or normal.

SYMPTOMS OF HYPOTHYROIDISM:

Initially it may be asymptomatic

• Cold intolerance                                       Weight gain
• Low heart rate > 60 bpm                         Weakness
• Decreased sweating                                 Muscle cramps and joint pain
• Dry itchy skin, puffy face                        Brittle and thin nails
• Depression                                               Hypotension
• Hair loss                                                   Anemia
• Increased sleep                                         Irritability
• Deafness                                                  Enlarged tongue
• Constipation, indigestion
• Gynaecomastia-breast development in men
• Female infertility due to hormonal imbalance which is produced from ovaries .which causes irregular menses
• Hyperprolactinamea – prolactin level increases in blood
• Galactorrhea – is spontaneous flow of milk unassociated with child birth
• Serum cholesterol level increases
• Goiter- enlargement of thyroid gland
• Slow speech, hoarseness of voice, breaking in voice, difficulty in swallowing, shortness of breath
• Low basal body temperature
• Decreased libido in men, decreased sperm count

HYPERTHYROIDISM: (Overactive thyroid gland)

In this condition, TSH will be less than 0.4mg/dl, T3 and T4 increased. Hyperthyroidism may cause thyrotoxicosis. some patient may develop thyrotoxicosis as a result of inflammation of thyroid gland[ thyroiditis]

SYMPTOMS OF HYPERTHYROIDISM:

• Heat intolerance                          Nervousness
• Irritability                                     Increased sweating
• Increased heart rate                      Hand tremors
• Anxiety                                        Decreased sleep
• Thinning of skin                           Fine, brittle hair
• Muscular weakness                      Weight loss even though appetite is good
• Irregular menses                           Palpitation
• Hair loss                                        Weakness
• Hypoglycemia                              Polyuria
• Polydipsia-increased thirst           Delirium
• Confusion                                     Amenorrhea-absence of menstruation
• Nausea and vomiting                    Diarrhea
• Gynaecomastia-development of breast in men
• Exophthalmos- bulging of eye anteriorly out of the orbit
• Swelling in front of the neck from enlarged thyroid gland called goite

HASHIMOTO’S THYROIDITIS:

Hashimoto’s thyroiditis or chronic lymphocytic thyroiditis is an autoimmune disease in which the thyroid gland is attacked by a variety of cell- and antibody-mediated immune processes.

SIGNS AND SYMPTOMS:

•  Hashimoto’s thyroiditis very often results in hypothyroidism with bouts of hyperthyroidism.
•  Symptoms of Hashimoto’s thyroiditis include myxedematous psychosis, weight gain, depression, mania, sensitivity to heat and cold, paresthesia , chronic fatigue, panic attacks, bradycardia, tachycardia, high cholesterol, reactive hypoglycemia , constipation, migraines, muscle weakness, joint stiffness, menorrhagia, cramps, memory loss, vision problems, infertility and hair loss.
•  The thyroid gland may become firm, large, and lobulated in Hashimoto’s thyroiditis, but changes in the thyroid can also be non-palpable.
•   Enlargement of the thyroid is due to lymphocytic infiltration and fibrosis rather than tissue hypertrophy.
•   Physiologically, antibodies against thyroid peroxidase (TPO) and/or thyroglobulin cause gradual destruction of  follicles in the thyroid gland
•  Accordingly, the disease can be detected clinically by looking for these antibodies in the blood.

DIAGNOSING THYROID CONDITIONS:

Diagnosis of various thyroid disease and conditions involves clinical examination, blood tests, and in some cases, imaging tests and/or biopsy. There are different tests and procedures used to diagnose the following thyroid problems:

• Hypothyroidism
• Hashimoto’s Disease
• Hyperthyroidism
• Graves’ Disease
• Goiter, Nodules
• Thyroid Cancer

INVESTIGATIONS FOR THYROID PROBLEM:

THYROID BLOOD TESTS-The blood tests that may be done as part of a thyroid diagnosis include the following:

• Thyroid Stimulating Hormone (TSH) Test
• Total T4/ Total Thyroxine
• Free T4 / Free Thyroxine
• Total T3 / Total Triiodothyronine
• Free T3 / Free Triiodothyronine
• Thyroglobulin/Thyroid Binding Globulin/TBG
• Thyroid Peroxidase Antibodies (TPOAb) / Antithyroid Peroxidase Antibodies
• Antithyroid Microsomal Antibodies / Antimicrosomal Antibodies
• Thyroglobulin Antibodies / Antithyroglobulin Antibodies
• Thyroid Receptor Antibodies (TRAb)
• Thyroid-Stimulating Immunoglobulins (TSI)

Nuclear Scan / Radioactive Iodine Uptake (RAI-U) – which can tell whether a person has Graves’ disease, toxic multinodular  goiter, or thyroiditis.

CT scan – to help detect and diagnose a goiter, or larger thyroid nodules.

MRI / Magnetic Resonance Imaging – to evaluate the size and shape of the thyroid

Thyroid Ultrasound – to evaluate nodules, lumps and enlargement of your gland. Ultrasound can tell whether a nodule is a fluid-filled cyst, or a mass of solid tissue.

THYROID BIOPSY/ASPIRATION-A needle biopsy, also known as fine needle aspiration (FNA) is used to help evaluate lumps or cold nodules.

OTHER DIAGNOSTIC TESTS – Iodine Patch Tests, Saliva Testing, Urinary Testing, Basal Body Temperature Testing.

TREATMENT FOR THYROID PROBLEM IN POSITIVE  HOMEOPATHY:

Positive homeopathy treats Thyroid problem positively by giving constitution medicine. Homeopathic medicines make diseased man to normal state.

“Homeopathic sweet pills kills the ills”

It helps to increase immune system in body to fight against disease. Homeopathy medicine acts on hypothalamus and brings thyroid hormones to normal range.