Diseases of Thyroid Gland



Broadly Thyroid diseases can be divided as

Endocrine abnormality hyper or hypo

Nodules in thyroid- benign or malignant

Infection or inflammation


How to test for thyroid disease

for endocrine abnormality - blood test of thyroid function is enough

For knowing about nodules Ultrasound scan along with FNAC needed

for thyroiditis - both bood tests and scan improtant


What are the warnings in thyroid disease

Hypothyoidism

Tiredness

Slow heart rate

Weight gain

Irregular periods

Increase sensitivity to cold

Dry skin

Puffy face


Hyperthroidism

Anxiety

Fine tremor

Weight loss

Protruding eyes

palpitaion

irregular heart rate

Thyroid nodule

feeling of nodule in neck

detected accidentally as it was seen out side

Change in voice is a bad sign

Thyroiditis

features of hypo of hyper thyroidism

.

May have pain in neck


Does all thyroid diseases need surgery

Thyroidectomy is done when there is high suspicion of cancer

or when its large enough to compress on air passage and food passage

in Hyperthyroidism - subtotal thyroidectomy removes need of medicines


Types of thyroid surgery

total thyroidectomy- complete removal high suspicion of cancer

subtotal thyroidectomy- in Hyperthyroidism to reduce the hormone production

Hemithyroidectomy- removal of half of thyroid -nodule only in 1 lobe and is suspicious

Hemithyroidectomy can be done as daycare surgery


Is there an option for keyhole thyroid surgery

Endoscopic Thyroidectomy can be done via armpit or through mouth

large size and confirmed cancer are not good canadate

Robotic Thyroidectomy via intra oral appraoch and trans axillary are being done


Advice to patients on Thyroid replacement medicines

Take it daily or regularly

take it in empty stomack min half hour before coffee or tea

If missed a dose take it on next day as twice the dose

if there is a dose change and you are keeping with dose change check TSH at 6 weeks and review

if you stopped medice by self or on advice check TSH after 6 weeks

All women in child bearing age need to have TSH between o.5 and 3mIU/L