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Thyroid

There is nothing like ‘thyroid in blood’ and ‘thyroid in neck’. All of us have thyroid gland in the neck, which secretes thyroid hormones named ‘T3 & T4’ under the effect of a hormone named ‘TSH’ (which is produced from pituitary gland in brain). These hormones have wide range of functions and affect every organ of the body.
(a) Hypothyroidism (b) Hyperthyroidism (c) Goiter (d) Thyroid cancers
When production of T3 & T4 hormones from the thyroid gland is less than the requirement of the body, it is called hypothyroidism. There are 2 types of hypothyroidism, primary & secondary hypothyroidism. When the problem is in the thyroid gland itself, TSH is usually high with normal/low T3 & T4 levels. This is known as primary hypothyroidism. Rarely, when pituitary gland is defective, TSH can be low/inappropriately normal with low T3 and T4 levels. This is known as secondary (central) hypothyroidism.
Dry skin, fatigue, lethargy, mood fluctuations, menstrual abnormalities, constipation, weight gain, increased sleepiness, excessive hair fall, etc. Symptoms may not be present always (at least in the initial stages of hypothyroidism). So, you need to be careful and get evaluated for hypothyroidism, if you are at risk of hypothyroidism.
Excessive sweating, palpitation, weight loss, frequency of stool, irritability, restlessness, menstrual abnormalities, lack of sleep, etc. Symptoms may not be present always (at least in the initial stages of hyperthyroidism).
It is a complex disorders occurring as a result of autoimmunity because of genetic & environmental factors. Females are more likely to get thyroid disorder. Also, those with family history of thyroid disorder are at risk of developing thyroid disorder. Risk of having hypothyroidism is approximately 30 % for those with family history of thyroid disorders. If you have a high risk of developing thyroid disorder then you cannot prevent it by any means.
There are 2 reasons for that. First of all, awareness regarding thyroid disorders has increased nowadays and TSH is a part of routine health check up as well. Hence, most of the people have their TSH level done at one point of time in their life. So, Thyroid disorders are detected at an early stage, which was not possible few decades back. Second reason could be possible association between autoimmune thyroid disorder and iodine supplementation. It has been observed in the past that prevalence of autoimmune thyroid disorder may increase after implementation of universal iodine supplementation. So, that could also be one of the reasons for increased prevalence of autoimmune thyroid disorder.
There is no relation with any particular type of food intake & autoimmune thyroid disorder. Iodine deficiency can lead to goiter. Individuals with iodine deficiency, who are eating raw vegetables (cauliflower/cabbage) in large quantities/on a daily basis, can develop goiter (enlarged thyroid gland). Hence, it is advisable to eat it in cooked form than raw form. Other than that there are no food restrictions for a patient with hypothyroidism.
No. In majority of the cases, thyroid disorder is permanent and patient will require medicines for whole life. In very few cases, thyroid disorder is transient (known as thyroiditis) and recovers without any treatment in few months.
There is no evidence that any form of alternative therapy cures thyroid disorder permanently.
Untreated hypothyroidism can lead to heart diseases & increase in blood pressure/cholesterol levels. It can also lead to mood fluctuations & poor quality of life. Fluctuating TSH levels can also be result in poor quality of life. Hence, it is very important to treat thyroid disorder and keep the TSH level in normal range.
Hypothyroidism is treated with a tablet which contains T4 hormone. The dose of the tablet should be adjusted based on TSH levels at regular intervals (at least 2-3 times per year). It should be taken in fasting. It should be taken at least 1 hour before tea/breakfast. It is always better to have 4 hour gap between thyroid medicines and any other medicines.
No. Thyroxine hormone therapy is basically a replacement therapy. You are taking hormone which is deficient in your body. If you are on appropriate dose of this tablet, there are no side effects. So, it is always advisable to be in touch with an Endocrinologist and keep TSH level in the normal range.
If hyperthyroidism is because of thyroiditis, which is a self limiting condition, no treatment is required (except monitoring of T3, T4 & TSH level at regular intervals). If hyperthyroidism is because of Grave’s disease or nodular goiter, then treatment is required. Treatment of hyperthyroidism is decreasing thyroid hormone levels to normal range. It can be achieved by medicines, radioiodine treatment or surgery. This should be treated aggressively by monitoring thyroid hormone level at regular intervals. Dose of these medicines needs to be adjusted based on blood reports (T3, T4 & TSH) at regular intervals to keep T3, T4 and TSH in normal range.
Untreated hyperthyroidism can lead to heart problems (arrhythmia, heart failure, etc.), liver failure or even sudden death. Hence, it is important to treat hyperthyroidism.
Free T3 & Free T4 levels are better indicators of thyroid hormone levels in the blood compared to T3 & T4 levels. Most of the times, T3 & T4 levels are sufficient for the diagnosis and management of thyroid disorders. But, in few cases (pregnancy, patients on contraceptive pills, during illness) Free T3 & Free T4 levels are required for accurate management of thyroid disorder.
It means that you have autoimmune thyroid disorders. It is an indicator of autoimmunity. No other meaning should be drawn from the levels.
(a) If you are not taking Tablet Thyroxine in the same manner as described above (b) If you are on inadequate dose/overdose of Thyroxine by your doctor (c) If you are on certain medicines (e.g. Tablets for Acidity, contraceptive pills), which are interfering with the absorption of Thyroxine or increasing the requirement of Thyroxine.