Are You at Risk for One of These Lesser-Known Thyroid Diseases?

Beyond Hypothyroidism

Hypothyroidism -- the clinical description for an under-functioning thyroid gland -- is the most widely recognized form of thyroid disease. However, there are also many other thyroid conditions that can impact the metabolism and adversely effect one’s general health. Some of the lesser-known forms of thyroid-related conditions include hyperthyroidism, thyroiditis, and growths such as goiters, lumps, and nodules. In this article, we’ll take a look at these conditions and talk about symptoms, the diagnostic process, and new and emerging treatments.

Hyperthyroidism

In patients with hypothyroidism, the functioning of the thyroid gland slows down to a dangerously reduced pace, disrupting a broad range of metabolic processes and destabilizing the entire endocrine system. Hyperthyroidism, on the other hand, is the exact opposite of hypothyroidism -- it occurs when a patient’s thyroid functions too rapidly.

In contrast to the sluggishness, lack of mental focus, and weight gain that are the hallmark symptoms of hypothyroidism, patients with hyperthyroidism experience symptoms that are the consequence of excessively rapid thyroid function.  In effect, the body speeds up, and many of the most troubling symptoms of the hyperthyroidism result from the artificially increased pace of the body’s functions. Some of the chief symptoms associated with hyperthyroidism include:

• Anxiety, irritability, and nervousness
• Muscle weakness
• Light sleeping or insomnia
• Irregular, light menstrual periods
• Inexplicable weight loss
• Vision problems or eye sensitivity
• Increased sensitivity to temperatures, especially heat
• Enlargement of the thyroid gland
• Frequent urination and/or bowel movements

Once hyperthyroidism is suspected, an accurate diagnosis can usually be made with just a few tests that assess the level of the thyroid hormones in the blood stream.  Then, further tests are administered to determine the precise cause of the increased thyroid activity. Based on the findings from these assessments, a course of treatment is devised that will address the underlying causes of the thyroid’s hyperactivity.

By far the most common cause of hyperthyroidism is Grave’s disease. This condition, named for the Irish physician who first described the disease in the scientific literature, is caused by an enlargement of the thyroid gland that results in an overproduction of thyroid hormone in the bloodstream.

Other non-Grave’s causes of hyperthyroidism can include nodules or growths in and around the thyroid gland; thyroiditis or other types of inflammation of the thyroid gland; or the consumption of excessive doses of thyroid medication.

Based on the causes and characteristics of the patient’s case of hyperthyroidism, one of several treatments for the condition will be prescribed. Recent advances have led to the development of a wide array of pharmaceutical treatments for hyperthyroidism that treat both the condition itself, as well as its most prevalent symptoms.

For persistent cases of the condition, therapeutic doses of radioactive iodine may be administered. This therapy can effectively reduce extra thyroid cells without harming the rest of the body. For some patients with severe hyperthyroidism, a surgical removal of some or all of the thyroid gland may be necessary, although this is usually limited to patients with intractable Grave’s disease.

Thyroiditis

Another fairly common form of thyroid disease is thyroiditis, which refers to a swollen, engorged, or otherwise inflamed thyroid gland. In some cases, thyroiditis is seen in tandem with hypo- or hyperthyroidism, although it can also occur as a stand-alone diagnosis. Unlike many other conditions that involve inflammation, thyroiditis is not typically associated with an infection of the gland.

The three main subtypes of this condition are Hashimoto’s thyroiditis, De Quervain's thyroiditis, and silent thyroiditis. All involve varying degrees of swelling in the thyroid gland, which is sometimes visible to the naked eye and associated with varying degrees of discomfort. The preferred treatments for thyroiditis differ according to the causes and severity of the condition. In most cases of thyroiditis, the prognosis is good as long as the prescribed treatment is adhered to.

Thyroid Nodules and Goiters

Both thyroid nodules and goiters are relatively common thyroid disorders. While these conditions have different causes, they both involve abnormal growth patterns in and around the thyroid gland.

Thyroid nodules are small lumps of abnormal tissue growth that most frequently can be found on the outside edges of the thyroid gland.  In some cases, they can be sensed by external palpitation with the hand; in rarer cases, they can be visually detected.

Thyroid nodules are extremely common, occurring in the majority of the population, especially in the 50+ age group. Nearly all thyroid nodules are benign, escape detection, and require no treatment. For those that are cancerous or require treatment for other reasons, surgery is the most common form of treatment.

The term ‘goiter’ refers to a thyroid that is abnormally enlarged over the full span of the gland. A goiter causes profuse swelling over the entire neck area and can often be visually detected. Iodine deficiency was once a major cause of goiters. Today, adequate iodine can now readily be found in table salt and other processed food products, and problems with the regulation of the thyroid hormone have now eclipsed iodine deficiency as the leading cause of goiters. Once detected, most goiters can easily be treated with a course of prescription drugs, although in serious or severe cases, surgical removal of all or part of the gland may be indicated.

What You Can Do

As with all health conditions, thyroid problems that are detected early stand the best chance of responding well to treatment. Keep on the lookout for any signs of abnormality in the thyroid and neck region, including:

• tenderness in the area
• a feeling of pressure or fullness in your windpipe or throat
• prolonged coughing not associated with an illness
• respiratory difficulties
• shortness of breath
• difficulty swallowing

If you notice any of these symptoms, it’s important to consult with a physician to discuss the possibility that you may have a thyroid problem. Even if hypothyroidism has been ruled out, remember that there are a number of other thyroid conditions that could be causing the symptoms.

To Learn More

• http://www.nlm.nih.gov/medlineplus/ency/article/000356.htm
• http://www.mayoclinic.com/health/thyroid-nodules/DS00491
• http://www.emedicine.com/MED/topic916.htm