Understanding Thyroid Illness – Types, Symptoms and Treatment Options

Doctor Pramodh is an expert Endocrinologist with over 20 years of experience working in some of the UK’s most prestigious Healthcare Systems. Now a full-time physician with the Integra Healthcare team he specialised in in Diabetes, pituitary, and thyroid disorders. Below, he outlines some of the most common questions he received around Thyroid Disease types, symptoms and treatments. 

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What are Thyroid Disorders?

Any condition that affects how your thyroid gland functions can be referred to as a thyroid disease. The thyroid is an important gland in the endocrine system of the human body. It is a butterfly-shaped gland located at the front of the neck, straddling your windpipe. The thyroid glands produce an important hormone called thyroxine (thyroid hormones). These hormones are responsible for controlling the body’s normal metabolism, deciding the pace of your body’s ability to burn energy. If this hormone production is disrupted, it has an adverse effect on the body.

Thyroid disorders are becoming increasingly common, particularly in women and can tamper with a person’s quality of life. Thyroid disorders can significantly impact heart rate due to the influence of thyroid hormones (primarily thyroxine, or T4, and triiodothyronine, or T3) on the cardiovascular system. These hormones play a crucial role in regulating metabolism, and their levels directly affect how the heart functions.

Thyroid conditions are generally treated in health care by hormone specialists known as endocrinologists. Your GP or family healthcare provider may also be involved to allow for seamless care. Endocrinologists are skilled at involving other specialists. An ophthalmologist may be involved for eye complications, which occasionally occur with Grave’s disease. Sometimes an ENT surgeon will be contacted if surgery is needed on the thyroid gland. It’s important to trust the team of medical professionals you are entrusting with your care.

What are the different types of Thyroid Disorders?

• Hashimoto’s disease/Hashimoto’s Thyroiditis: Increasingly common, this is an autoimmune disease that is diagnosed when there is long standing inflammation in the thyroid gland due to a circulating thyroid autoantibody. This can sometimes cause nodules or swelling in the neck (goiters).
• Underactive thyroid (hypothyroidism): A disorder that occurs when there isn’t enough thyroid hormone in your body for what your immune system requires.
• Overactive thyroid gland (hyperthyroidism): This is due to the production of too much thyroid hormone in the body, resulting in an enlarged thyroid. Grave’s Disease is a common cause.
• Thyroid tumours/ thyroid nodules: The majority of nodules and tumours are non-cancerous (benign) lesions, however some can be thyroid cancer. They can be cancerous or produce excess amounts of thyroid hormones, causing hyperthyroidism.
• Postpartum thyroiditis: A temporary inflammation of the thyroid that can occur in women after childbirth. It typically starts with a phase of hyperthyroidism (excess thyroid hormones) followed by hypothyroidism (low thyroid hormones). While it often resolves on its own within 12-18 months, some women may require long-term treatment if hypothyroidism persists.

What are the symptoms of Thyroid Disorders?

Symptoms vary depending on the type of disorder, but can include:

• Unexplained weight gain or weight loss
• Tiredness
• Poor concentration
• Anxiety or nervousness
• Sleep disturbances
• Bowel disturbances
• Constipation
• Dry skin
• Mood changes
• Feeling overtly hot or cold or sometimes excessive sweating
• Hair loss
• Low sex drive
• Menstrual cycle changes
• Irregular heart beat
• Bulging of the eyes 
• Goiter (swelling in front of the neck).

The most common symptoms of hypothyroidism are fatigue, weight gain and cold sensitivity whereas those who suffer from symptoms of hyperthyroidism may experience an increased heart rate and unexplained weight loss. If an autoimmune disorder is suspected, an endocrinologist will take a detailed medical history and book you in for a physical exam to ascertain whether these symptoms are indeed due to the thyroid. Thyroid issues can also cause an enlargement at the front of your neck, which is commonly referred to as a goiter. A goiter is an abnormal swelling of the thyroid gland. In these cases, scans of the thyroid are often arranged.

A team of medical professionals will likely take blood tests to check the levels of thyroid hormones and antibody status. The thyroid-stimulating hormone is a vital hormone produced by the pituitary gland that regulates the thyroid’s production of thyroid hormones (T3 and T4).

• TSH testing is used to evaluate thyroid function and guide treatment decisions for conditions like hypothyroidism and hyperthyroidism.
• It is the first-line test to determine whether the thyroid is underactive (high TSH) or overactive (low TSH).

What are some key causes and risk factors for Thyroid Illness?

Key causes of thyroid illness can include:

• Autoimmune condition, antibody production
• Iodine deficiency
• Issues following surgery
• Viral infections that cause inflammation of the thyroid 

Risk factors for developing thyroid conditions often include:

• Being of the female sex
• History of radiation treatment to the neck or throat
• A previous or current history of a different autoimmune condition like Type 1 diabetes, rheumatoid arthritis or vitamin B12 deficiency.
• Family history of thyroid disease or a different autoimmune condition 

Can Thyroid Diseases be prevented?

In most cases, thyroid disease cannot be prevented. However, there are certain measures like quitting smoking that can reduce risks of complications from an overactive thyroid. The most common cause of thyroid disease is autoimmune and in many cases, thyroid diseases are congenital so cannot be prevented.

Is there a treatment for Thyroid Disease?

The treatment varies according to the cause of the thyroid disorder as well as important results from imaging tests like a thyroid uptake and scan. An underactive thyroid generally requires life-long thyroid hormone replacement.

An overactive thyroid due to Grave’s disease requires medications to control thyroid hormone production. Sometimes surgery to remove the whole or a portion of the gland is advised. Other modalities of treatment for an overactive thyroid include radioiodine treatment. Radioactive iodine (RAI) is a common and effective treatment for certain thyroid diseases. It leverages the thyroid gland’s natural ability to absorb iodine to target and manage thyroid dysfunctions.

An overactive thyroid due to simple inflammation usually requires no specific treatment apart from symptom control, and usually settles within a few weeks.

How will I know if I need surgery for my Thyroid Disease?

The majority of thyroid disorders do not require thyroid surgery.

Tumours or nodules in the thyroid which are suspicious for cancer may require further investigation. If an overactive thyroid cannot be controlled with medical treatment, then surgery would be one of the options.

Depending on test results, a thyroidectomy may need to be performed. However, it is much more common to address these disorders with a treatment like radiation therapy first.

Are there any circumstances of special consideration for Thyroid Disorders?

If you are a woman of reproductive age and are planning to conceive, it is very important to rule out a thyroid problem before conceiving. If a thyroid disorder is diagnosed, it’s vital the mother gets adequate monitoring and care from an experienced endocrinologist. 

If you have risk factors for thyroid disorders, it’s advisable to have your thyroid checked before conceiving or as soon as pregnancy is confirmed.