Thyroid Clinic

Thyroid Clinic

Thyroid gland is one of the most important endocrine glands of the body as it produces hormones that play vital roles in various systems throughout the body. When the thyroid gland produces less or excess of these vital hormones, a disease occurs. Thyroid diseases are of different types, including hypothyroidism, hyperthyroidism, Hashimoto’s thyroiditis, and De Quervian thyroiditis.

The thyroid is a small, butterfly-shaped organ located at the front of the neck. It is smaller in the middle and has two wing-like structures that extend around the side of the throat. The thyroid gland produces hormones that regulate many important functions and processes of the body. When the thyroid gland doesn’t function properly, your entire body can get affected. If the thyroid gland produces excess thyroid hormone, the condition is called hyperthyroidism. On the other hand, if it produces too little thyroid hormone, the condition is called hypothyroidism. Both conditions need to be treated by a healthcare provider as these can lead to serious consequences.

The thyroid gland has a vital role to play in the body - producing thyroid hormones that regulate metabolism. Metabolism is the process in which the food you consume is converted to energy. This energy is used up by the entire body to keep the different processes going.

The thyroid gland regulates metabolism with certain hormones - T3 (triiodothyronine, contains three iodide atoms) and T4 (thyroxine, contains four iodide atoms). These two hormones are released by the thyroid gland and they let the cells of the body know how much energy to consume. When the thyroid functions properly, the right amount of hormones required to keep the metabolism going at the right pace are maintained. As the hormones are exhausted, the thyroid creates replacements.

All this is supervised by another endocrine gland called the pituitary gland which lies in the centre of the skull beneath the brain. The pituitary gland regulates the amount of thyroid hormones released in the bloodstream. When it senses a high level of hormones or lack of thyroid hormones in the body, it adjusts the amounts by releasing its own hormone called thyroid stimulating hormone (TSH). This hormone is sent to the thyroid gland, where it lets it know what needs to be done to get the body back to normal state.

Thyroid disease refers to medical conditions that prevent the thyroid gland from producing the right amount of hormones. Typically, the thyroid produces hormones to keep the body working normally. When it produces excess thyroid hormone, the body utilizes energy too fast. This state is referred to as hyperthyroidism. Depleting energy too fast does more than making you feel tired. It can increase the heart rate, cause weight loss, and even make you nervous. On the other hand, when the thyroid produces too little thyroid hormone, the condition is referred to as hypothyroidism. This condition makes you feel fatigued, results in weight gain, and you may develop cold intolerance.

These two medical conditions related to the thyroid gland can occur due to a wide range of disorders. They can also be passed down in the families.

Anyone can be affected by thyroid disease - be it men, women, teenagers, infants, or the elderly. It can be congenital (present at birth) or acquired (developed later in life). Thyroid diseases are quite common and females are about 5-8 times more likely to be diagnosed with them than males. Following are some conditions that may increase your susceptibility to developing the disease:

  • Having medical conditions like Type 1 diabetes, pernicious anaemia, lupus, primary adrenal insufficiency, rheumatoid arthritis, Turner syndrome, and Sjögren’s syndrome.
  • Having a family history of thyroid disorders.
  • Taking a medication that contains high amounts of iodine.
  • Being more than 60 years of age, especially if you are a female.
  • Having undergone treatment for a past thyroid disease or disorder.

The two most common types of thyroid disorders are hypo- and hyper-thyroidism. Both disorders can occur due to other diseases that affect the way the thyroid gland functions.

Causes of hypothyroidism

Following are some of the conditions that can result in hypothyroidism:

  • Thyroiditis
    It refers to an inflammation of the thyroid gland that can reduce the amounts of hormones produced by the thyroid gland.
  • Hashimoto’s thyroiditis
    It is a painless autoimmune condition in which the cells of the body destroy the thyroid gland itself. It is inherited in nature.
  • Postpartum thyroiditis
    This disorder affects around 5-6% of women after childbirth. It is generally a temporary condition.
  • Iodine deficiency
    Iodine is a substance that is used by the thyroid gland to create hormones. An iodine deficiency is a problem that involves millions of people worldwide.
  • A non-functioning thyroid gland
    The thyroid gland sometimes does not function properly since birth. This condition affects around 1 in 4,000 newborns. If not treated adequately at the right time, the child could be suffering from both physical and mental problems in the future. All newborn babies are screened for thyroid diseases.

Causes of hyperthyroidism

Following are the conditions that lead to hyperthyroidism:

  • Graves’ disease
    This condition is characterised by an overactive thyroid gland producing excess amounts of hormones. This condition is also referred to as diffuse toxic goitre.
  • Nodules
    Hyperthyroidism may occur due to overactive nodules within the thyroid gland. A single nodule is referred to as a toxic autonomously functioning thyroid nodule. On the other hand, a gland with several nodules is referred to as a toxic multinodular goitre.
  • Thyroiditis
    This condition is either painful or not perceived at all. It is characterised by release of the stored hormones from the thyroid gland. This can persist for weeks to months.
  • Excessive iodine
    Having excess amounts of iodine in the body makes the thyroid gland produce more thyroid hormones that it actually needs. Excess iodine is found in some medications and cough syrups.

Having diabetes puts you at a higher risk of developing thyroid-related medical conditions. Type 1 diabetes is an autoimmune condition. If you already suffer from an autoimmune condition, you are more susceptible to developing another one. The risk is lower for people with Type 2 diabetes but it is still there. If you are suffering from Type 2 diabetes, you are more susceptible to developing a thyroid disorder later in life.

Regular testing is recommended to determine if you have a thyroid disease. Those who are suffering from Type 1 diabetes may be tested more frequently - immediately post-diagnosis and then every year, than those suffering from Type 2 diabetes. There is no regular schedule for testing for people with Type 2 diabetes. However, your doctor may suggest a schedule on the basis of your medical conditions and overall health.

If you already have diabetes and test positive for thyroid disease, there are a few steps you can take to help feel the best possible. Following are some of them

  • Exercising regularly.
  • Getting enough sleep.
  • Taking all of your medications as prescribed by your healthcare provider.
  • Getting tested regularly as directed by your healthcare provider.
  • Watching your diet and maintaining a healthy weight.

A variety of symptoms can occur in people with thyroid disease. However, the symptoms of thyroid disorders are quite similar to those of other medical conditions. This can make diagnosis quite challenging in the beginning.

Generally, the symptoms of thyroid disorders can be divided into two categories— those related to having too little thyroid hormone (hypothyroidism) and those related to having too much thyroid hormone (hyperthyroidism).

Symptoms of hyperthyroidism

Following are the symptoms of hyperthyroidism or an overactive thyroid:

  • Having trouble sleeping
  • Experiencing irritability, anxiety, and nervousness
  • Having an enlarged thyroid gland or a goitre.
  • Losing weight.
  • Experiencing irregular menstrual periods or having your menstrual cycle stop.
  • Having muscle weakness and tremors.
  • Having vision problems or eye irritation.
  • Feeling sensitive to heat.

Symptoms of hypothyroidism

Following are the symptoms of hypothyroidism or an underactive thyroid:

  • Gaining weight.
  • Feeling tired (fatigue).
  • Having frequent and heavy menstrual periods.
  • Experiencing forgetfulness.
  • Having a hoarse voice.
  • Experiencing an intolerance to cold temperatures.
  • Having dry and coarse hair.

Loss of hair is a symptom of a thyroid disorder, especially hypothyroidism. If you start noticing loss of hair that is making you feel worried, you must talk to an expert doctor. If you are based in Indore, you must consult thyroid specialists at Kokilaben Dhirubhai Ambani Hospital, Indore for further diagnosis and care.

Generally, thyroid disorders do not lead to seizure. However, in very severe cases of hypothyroidism that hasn’t been treated, your risk of developing hyponatremia increases. This can result in seizures.

Thyroid disease can be challenging to be diagnosed sometimes as the symptoms can easily be confused with those of other related disorders. You may notice similar symptoms during ageing or pregnancy. However, there are tests that help doctors to find out if your symptoms are secondary to a thyroid disorder. These tests include physical examination, blood tests, and imaging tests.

Blood tests

One of the most reliable methods to diagnose a thyroid disease is by carrying out blood tests. Blood tests are used to determine if the thyroid gland is working normally. This is done by measuring the amount of thyroid hormones in the blood. These tests are performed by taking blood from a vein and checking it for hypothyroidism, hyperthyroidism, and other thyroid disorders. Other thyroid disorders like Grave’s disease, thyroiditis, Hashimoto’s thyroiditis, goitre, thyroid cancer, and thyroid nodule can also be excluded.

The specific blood tests performed to diagnose thyroid diseases include:

  • Thyroid-stimulating hormone (TSH) levels
    This hormone is released by the pituitary gland and it regulates the balance of the thyroid hormones - T3 and T4 in the blood. Usually, this is the first test that the healthcare providers perform to check for thyroid disorders. Majority of the times, thyroid hormone deficiency is linked to an elevated level of TSH, while hyperthyroidism is associated with a low level of TSH. If the TSH level is found to be abnormal, measurement of the thyroid hormones, T3 and T4 directly may be done to evaluate the problem further. For adults, the normal TSH range in blood is considered to be 0.40 - 4.50 mIU/mL.
  • T4 levels
    T4 hormone is also referred to as thyroxine. Its levels are measured to diagnose hypothyroidism and hyperthyroidism. In hypothyroidism, low T4 levels are seen. On the other hand, high T4 levels may indicate hyperthyroidism. For adults, the normal T4 range in blood is considered to be 5.0 – 11.0 ug/dL (micrograms per deciliter of blood).
  • FT4
    Free thyroxine is a method of measuring thyroxine that eliminates the effect of naturally-binding proteins to T4. This ensures accurate measurement. For adults, the normal range of FT4 in the blood is considered to be around 0.9 - 1.7 ng/dL (nanograms per deciliter of blood).
  • T3
    T3 hormone is also referred to as triiodothyronine. Measurement of this hormone may show the severity of hyperthyroidism. Low levels of triiodothyronine can be seen in hypothyroidism. However, this test is more often useful for diagnosing and managing hyperthyroidism where the levels of triiodothyronine are elevated. For adults, the normal range of triiodothyronine in blood is considered to be around 100 - 200 ng/dL (nanograms per deciliter of blood).
  • FT3
    Free triiodothyronine is a way of measuring triiodothyronine that eliminates the effect of naturally-binding proteins to triiodothyronine. This ensures accurate measurement. For adults, the normal range of triiodothyronine in blood is considered to be around 2.3 - 4.1 pg/mL (picograms per millilitre of blood). These are not the only tests your healthcare provider may perform to establish a diagnosis. Additional testing may sometimes be required to evaluate for a possible thyroid disorder.

Additional Blood Tests

Following are the additional blood tests performed:

  • Thyroid antibodies
    These tests help to recognise different types of autoimmune thyroid conditions. Common tests for detecting thyroid antibodies include thyroglobulin antibodies (also known as TG antibodies), thyroid peroxidase antibodies or TPO antibodies), thyroid blocking immunoglobulins [TBI]), and thyroid receptor antibodies.
  • Calcitonin
    This test can be used to diagnose medullary thyroid cancer, which is quite a rare disorder.
  • Thyroglobulin
    This test can diagnose thyroiditis so that the treatment of thyroid cancer can be monitored. You can talk to your doctor about the normal ranges for these thyroid tests. Even if your ranges are not similar to that of someone else’s, it’s ok. It is often right. If you have worries or concerns about the results of your blood tests, talk to your doctor.

Imaging tests

Examination of the thyroid gland can answer a lot of questions in many cases. Your doctor might perform an imaging test called thyroid scan, which allows him to visualise the thyroid for increased shape, size, or growth. He might also suggest an imaging test called an ultrasound, which is a diagnostic procedure that involves transmission of high-frequency sound waves through the body tissues. The echoes are recorded and converted into photographic or video images. Unlike with X-rays, no radiation is used with ultrasounds.

Before ultrasound, there is typically little or no preparation needed. Your diet needs not to be changed before it. During the procedure, you will be asked to lie flat on a padded examination table with your head placed on a pillow so that it is tilted back. A warm, water-soluble gel is rubbed over the skin that has to be examined. It takes around 20-30 minutes.

Physical exam

Another way to check for abnormalities in your thyroid gland is with a physical examination at your doctor’s clinic. Your doctor will feel your neck for any growths or enlargement of the thyroid.

Our thyroid specialist doctor in Indore aims to return your thyroid hormone levels to normal. This can be done in a variety of ways and each specific treatment will depend on the underlying cause of your thyroid condition. If you have high levels of thyroid hormones (hyperthyroidism), treatment options can include anti-thyroid medications, radioactive iodine, and surgery.

Regular exercise is an essential part of a healthy lifestyle and does not interfere with the normal functioning of your thyroid gland. It is important to talk to your healthcare provider before you start a new exercise routine to make sure that it’s a good fit for you.

A thyroid disease is often a life-long medical condition that will need constant medical care. It often involves daily medication. Our thyroid specialist in Indore will supervise your treatment and make adjustments over time. However, you can usually live a fulfilled life with a thyroid disease. It may take some time to find the right treatment option for you and manage your hormone levels, but then people with these types of conditions can generally live life without many limitations.

If you have a thyroid disease and are located in Indore, you can visit Kokilaben Dhirubhai Ambani Hospital and get an appointment with the best thyroid specialists in Indore. The endocrinologists at Kokilaben Dhirubhai Ambani Hospital, Indore are highly talented and have years of experience in the field. They formulate tailored treatment plans for every patient that suit their medical needs and overall condition.