Thyroid Disorder

THYROID is a butterfly shaped gland situated in the neck just above the collar bone, it is a endocrine gland which makes hormone namely Thyroxin (T4) and Tri-Iodothyronine (T3). T4 and T3 are released in the ratio of 4:1. T3 is more active form. T4 is converted by the liver to T3 hence liver disease can affect thyroid function.

Thyroid gland is controlled by pituitary gland, which is located in front of the brain behind the eyes. Pitutary gland secretes many hormone out of which one is Thyroid stimulating hormone (TSH) which directly stimulates the thyroid gland to released T3 and T4. Thyroid hormone controls various activities of the body ranging from, how fast you burn your calories to your heart rate.


If your thyroid is not active enough to maintain the body homoeostasis it is called hypothyroidism. It refers to any state in which the thyroid hormone production is below normal.


Symptoms depends on ageand how long you have hypothyroidism, mild hypothyroidism manifests with no symptoms or vague symptoms which may be attributed to aging such as dry skin, fatigue, memory weakness. Most of the symptoms of hypothyroidism are non specific i.e there are many other conditions that can cause these symptoms and hence blood investigation is necessary y to establish a diagnosis.

  • Fatigue/ Weakness
  • Increased sensitivity to cold
  • Constipation
  • Dry skin
  • Unexplained weight gain
  • Puffy face
  • Thinning hair
  • Slowed heart rate
  • Depression
  • Impaired memory
  • Elevated blood cholesterol level
  • Hoarseness
  • Muscle weakness
  • Muscle aches, tenderness and stiffness
  • Pain, stiffness or swelling in joints
  • Heavier than normal or irregular menstrual periods


  • Iodine deficiency is the most common cause
  • Hashimoto’s thyroiditis (Autoimmune)
  • Previous thyroid surgery
  • Radioactive iodine treatment
  • Medications – lithium, amiodarone, interferon


Diagnosis is usually suspected when certain symptoms are present and confirmed by blood investigation.

In most cases TSH is the most sensitive marker, T4 levels may be normal or low.

In rare cases where hypothyroidism is due to pituitary problems, TSH may be normal or low and diagnosis has to be established by low T4 and normal/low TSH.

In autoimmune thyroid conditions, antibodies in the blood against the thyroid may be detected.


  • Infertility
  • Birth defects
  • Myxedema – lethargy, drowsiness, unconsciousness
  • Peripheral Neuropathy (nerve affections)


Hyperthyroidism or overactive thyroid disease is a condition in which thyroid gland makes too much thyroid hormone. It can affect your metabolism. It tends to speed up every function of the body. It usually begins slowly but In some young patients it may begin abruptly.


  • Graves (Autoimmune, due to antibodies in the blood)
  • Nodular/Multi Nodular Goiter (one or more nodule tend to increase their function, producing too much hormone)
  • Thyroiditis , immune mediated , which causes the thyroid gland to get inflames and produced too much hormone


  • Weight loss
  • Increased appetite
  • Nervousness, irritability
  • Palpitations
  • Increased heartbeat, irregular heartbeat
  • Trembling of the hands and fingers
  • Fatigue
  • Muscle weakness
  • Increased bowel frequency
  • An enlarged thyroid gland (called a goiter)
  • Difficulty sleeping
  • Increased sensitivity to heat
  • Increased perspiration
  • Changes in menstrual patterns


Diagnosis is suspected when the symptoms are present and confirmed by blood investigation.

If the blood test is positive for hyperthyroidism then thyroid scan is done to see the type of hyperthyroidism. Eg in Grave’s whole gland is affected whereas in multinodular goiter, there are hyper functioning nodules.


  • Heart problems – atrial fibrillation
  • Bones – brittle bones (osteoporosis)
  • Eyes – Graves opthalmopathy
  • Thyrotoxic crisis – An emergency situation (Increased heart rate above 140/min, atrial fibrillation, hyperpyrexia, confusion, delirium, coma)

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