Thyroid disease: Symptoms and treatment

Most people have heard of the thyroid gland, but many do not know or understand what the thyroid gland does. The thyroid gland is an endocrine gland. It makes a hormone called thyroid hormone, which is involved in regulating the body’s metabolism. The gland is shaped like a butterfly and located in the front of the neck below the Adam’s apple.

HYPOTHYROIDISM

Problems can occasionally occur in the gland. One of the most common problems affecting the thyroid gland is hypothyroidism. This occurs when the gland stops making enough hormone. The most common cause of this condition is Hashimoto’s thyroiditis — an autoimmune disorder that ultimately causes the gland to stop working.

Symptoms of hypothyroidism may vary, and can include fatigue, weight gain, constipation and dry skin. Hypothyroidism is treated medically by replacing the body’s hormone with a medication that is taken daily for life.

HYPERTHYROIDISM

Some disorders of the thyroid gland cause it to be overactive and make too much hormone. Not surprisingly, this is called hyperthyroidism. Hyperthyroidism usually is caused by an autoimmune disease called Graves’ disease or by a metabolically active thyroid nodule that is making too much hormone.

Symptoms of hyperthyroidism also vary, and can include weight loss, rapid heart rate, sweating, diarrhea and nervousness. Graves’ disease can be treated with medication, radioactive iodine therapy or surgery.

OTHER THYROID DISORDERS

Other disorders of the thyroid gland require surgery for treatment. Thyroid lobectomy and hemilobectomy are surgeries that remove part of the gland, whereas a total thyroidectomy removes the entire gland. Thyroid cancer treatment usually requires total thyroidectomy and, in some cases, removal of lymph nodes in the neck. Some noncancerous nodules become large enough to cause pain, swallowing and breathing problems. When this occurs, partial or total thyroidectomy is recommended. A person who has part of their thyroid gland removed may or may not need to take hormone replacement after surgery. However, when a person has the entire gland removed, they will need to take replacement hormone for life.

WHEN TO SEEK TREATMENT

Consider seeing your primary care provider if signs and symptoms of hypothyroidism or hyperthyroidism are present, or if a nodule is noted in the lower front sides of your neck. Your provider will perform a detailed medical history and physical exam. Workup may include lab tests, X-rays and referral to an endocrinologist or ear, nose and throat specialist. If surgery is needed, you will be referred to an ear, nose and throat or general surgeon with expertise in performing thyroid procedures to evaluate and talk with you about your options.

Thyroid disorders are fairly common in adults. Fortunately, nearly all thyroid problems can be managed successfully when identified early.