HEALTH: Know more about Thyroid

This article is reviewed by Dr. RAVIKUMAR MUPPIDI 

Thyroid Swelling

Thyroid Swellings can occur in  -

• Hypothyroidism ,

• Hyperthyroidism ,

• Euthyroid State ,

• Thyroid Cancers / Benign Adenomas 

The Thyroid gland , located at the front of your neck, is a small butterfly shaped gland that is part of the body's endocrine system.

An enlarged thyroid is called Goitre.

Large goiters, seen or felt at the base of the neck, may cause tightness in the throat, hoarseness, and difficulty breathing or swallowing. A swollen thyroid can increase or decrease the production of thyroid hormone and can present additional symptoms.

Autoimmune Thyroid Disease

In AutoImmune Thyroid Disease, the  Immune cells attack Thyroid Gland and damage it resulting in Under Production of Thyroid hormone  causing a disease called Hypothyroidism  (Hashimoto Thyroiditis)

In AutoImmune Thyroid Disease, the  Immune cells attack Thyroid Gland and damage it resulting in Over Production of Thyroid hormone  causing a disease called Hypethyroidism (Graves Disease)

In Graves Disease the excess hormones and increased stimulation of the gland causes the Thyroid to swell.

Hashimoto's disease is when the immune system causes damage to the thyroid and does not produce enough thyroid hormone. The pituitary gland produces more TSH, or thyroid stimulating hormone, to try to stimulate the thyroid, which can cause a goiter.

Thyroid Cancer

Thyroid cancer may present itself with a swollen nodule on one side of the neck.
Only around one in 15 of such  nodules are found to be cancerous.

Thyroiditis

Thyroiditis can cause temporary Hyperthyroidism followed by Hypothyroidism. It is an inflammation of the Thyroid gland, which may cause tenderness or pain to the neck, jaw or ears. Viruses, fever, medication, pregnancy or immune disorders may cause Thyroidtitis.

Nodules

Nodules are lumps and bumps in the Thyroid gland.

Singular nodules, found on only part of the Thyroid, are often found to be benign.

A multinodular Goiter is when multiple bumps develop on the Thyroid, causing the entire gland to swell.

Iodine Deficiencies

Iodine, found in seawater and the soil of coastal areas, is needed to produce thyroid hormones. A diet deficient in iodine can cause an enlarged goiter. The Thyroid swells in an effort to obtain more iodine from the body.

How are thyroid swellings diagnosed?

Most Thyroid nodules are found during a routine physical exam.
Your doctor might do one or more of the following tests:
Thyroid function tests( T3 , T4 & TSH )
Fine-needle aspiration biopsy uses a thin needle to remove cells or fluid samples from the nodule.
Thyroid ultrasound is used to get an exact picture of the thyroid

How are thyroid swellings  treated?

Treatment depends on the type of thyroid swelling :

• EUTHYROID GOITRE

Small size diffuse non malignant asymptomatic swelling can be left as such without any treatment. Large size diffuse swelling with obstructive symptoms has to be operated. THYROIDECTOMY is the surgery performed. If the swelling is malignant additionally lymph node dissection will also be done in the same sitting.

• HYPERTHYROID GOITRE

Medically thyroid hormone level should be controlled by giving anti - thyroid drugs like neomercazole, propylthiouracil. Follow up investigations should be done till the thyroid become euthyroid. Followed by Thyroidectomy  or Radio Active Iodine Ablation .

• HYPOTHYROID GOITRE

This can be corrected by giving Tablet .
Occasionally patient requires surery.
Surgery depends on the size of the swelling, obstructive symptoms and nature of malignancy.

Experts recommend surgical removal of the Thyroid for nodules that are Cancerous or suspicious.
Nodules, even when they are not cancerous, may need to be removed when they get too big and cause problems with swallowing or breathing.

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