Thyroid Disease

Dear Dr. B: I am requesting from you an article about thyroid disease whose purpose would be to educate the community on this life long illness. I have a thyroid problem. Sometimes I have been told that I am lazy, depressed, having panic attacks, jittery, weird looking etc. Is there anyway you can assist in educating the people who do not understand my problem? Yours, Ms. Frustrated

Dear Ms. Frustrated: Sure we can do something about this issue. Let me start by explaining where the thyroid gland is and what is its normal function. Then we will discuss the symptoms and signs of abnormal thyroid function.

The thyroid gland is shaped like a butterfly. It has two lobes, one on each side of the neck (resembling butterfly wings) weighing about 20g. The lobes are connected in front of the neck, below Adam’s apple, by a narrow band of tissue called isthmus (resembling body of a butterfly). When the gland is enlarged, it can be seen to move with swallowing.

What does the thyroid gland do?

The normal function of the thyroid gland is to secrete hormones which are two closely related chemical substances: T3 (triiodothyronine) and T4 (thyroxine). These hormones have multitude of functions and are vital to metabolism in adults and for normal growth and development of children. Deficiency of thyroid hormone in children leads to dwarfism and mental retardation.

Formation of normal quantities of thyroid hormone requires the availability of adequate quantities of iodine from outside sources. Given the fact that at least 1 billion individuals live in iodine-deficient areas of the world, it is not surprising that iodine-deficiency disorders (IDD), including endemic goitre and cretinism (stunted growth), are the most common thyroid-related human illnesses, indeed the most common endocrine disorders worldwide, says one textbook of endocrine diseases.

Normally iodine balance is maintained from dietary sources, i.e., food and water, but iodine may enter the body via medications, diagnostic agents, dietary supplements, and food additives, says the textbook.

The Thyroid Foundation of Canada estimates that thyroid disorders affect one in twenty Canadians and that most thyroid disorders are five to seven times more common in women.

Under-active thyroid (hypothyroidism) causes many symptoms: weight gain, lethargy, cold intolerance, menstrual irregularities, depression, constipation, dry skin etc. Overactive thyroid (hyperthyroidism) results in: palpitations, nervousness, tremor, heat intolerance, weight loss, muscular weakness and usually there is a presence of a goitre.

Diagnosis is made by history, physical signs and blood tests.

There are many causes of hypothyroidism. Anywhere from congenital development defect to acquired conditions like radiation therapy or autoimmune disease. But the cause of hyperthyroidism is not very clear.

Who is at increased risk for thyroid disease?

Women over 45, postpartum women, patients on lithium and amiodarone, patients with autoimmune diseases like type 1 diabetes, and patients with a strong family history of thyroid disease.

Ms. Frustrated, I hope this information will be of help. But as you may know, educating and changing people’s attitudes is not easy. Ignorant, prejudiced, shallow, self-centred people are hard to deal with. They get their strength by making life difficult for others. You will just have to ignore them. Try and get your strength from people who care about you. And I am sure they outnumber the shallow and the self-centred ones.

Good luck and good health!

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