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• Abnormalities of the thyroid gland
• Treatment

Thyroid disease

The thyroid gland secretes thyroid hormones to control the body’s metabolism, blood pressure, temperature, heart rate, and weight. It is located in the neck in front of the trachea.

Abnormalities of the thyroid gland

1. Thyroid function disorders can be classified into:
   • Hypothyroidism is due to the underproduction of thyroid hormone. The most common cause is Hashimoto’s thyroiditis, an autoimmune disease damaging the thyroid gland and reducing its hormone production. Symptoms include tiredness, muscle pain and fatigue, weight gain, constipation, dry skin, cold intolerance, sluggishness, sleepiness or even heart failure, edema, hoarseness, and hand numbness. If you experience the foregoing symptoms, blood tests for thyroid hormone levels and specific thyroid autoantibodies should be obtained.
   • Hyperthyroidism can be a result of acute or subacute inflammation of the thyroid gland, overproduction of thyroid hormone triggered by the immune system, or large thyroid nodule overproducing thyroid hormone. Blood tests to measure thyroid hormone and specific antibodies should be undertaken.

2. Thyroid nodule Thyroid nodules often are benign and solid or fluid-filled cysts. Sometimes, it can be cancerous, especially in patients with a history of familial thyroid cancer, head and neck radiation therapy, male gender, or nodule developed during pregnancy. Thyroid nodules will visibly move with swallowing, and sometimes it may cause swallowing difficulty or be associated with enlarged lymph nodes. If you have the preceding symptoms or have history of familial thyroid cancer, make an appointment with a healthcare professional for a thyroid ultrasound examination. If a suspicious lump is identified, a needle biopsy is mandatory for a confirmatory diagnosis.

Treatment

1. Hypothyroidism: Patients need to take lifelong thyroid hormone replacement therapy if they have Hashimoto’s thyroiditis.
2. Hyperthyroidism: If patients have an overproduction of thyroid hormone triggered by the immune system or Graves’ disease, they will be treated with antithyroid medications to reduce thyroid hormone production. In patients who do not respond to medications, experience relapse after stopping medications, or have markedly enlarged glands, treatment can be with oral radioiodine I-131 or surgery.
3. Thyroid nodule: If it is a solitary hyper-functioning nodule, oral radioiodine I-131 is preferable. If many nodules are present, thyroidectomy is more appropriate.
4. Thyroid cancer: It is usually treated with total thyroidectomy. However, if cancer responds to oral radioiodine I-131, the treatment will be followed by lifelong thyroid hormone replacement therapy.