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Thyroid Gland And its Disorders – January 1st, 2009
Dr.S.Lakshmanan (General & Colon Rectal Surgeon)
Salem, Illinois ,USA.
The thyroid gland is located in the front part of the neck. It is closely attached to the windpipe. The thyroid gland helps to secrete hormones called thyroid hormones, which will help the body metabolism. When the thyroid gland under secretes or over secretes the thyroid hormone, the patient develops symptoms according to the level of the hormone in the blood. People can develop swelling of the neck, called goiter, which can cause pressure symptoms, like difficulty in swallowing, or difficulty in breathing or change in the voice can occur. Sometimes the swelling in the thyroid gland may turn out to be cancerous nodules.
THE CONDITIONS ASSOCIATED WITH THYROID HORMONE SECRETION
#1. Hypothyroidism
With this condition, people have low thyroid hormone level, which can cause tiredness, weight gain, dry hair and skin, cold intolerance, hair loss, difficulty in concentration, poor memory, constipation, hoarse voice, muscle cramps and irregular menstrual periods. When the blood test is done, it reveals that the thyroid hormone level will be low. The causes for the low thyroid hormone is insufficient iodine intake explains a large percentage of the low thyroid conditions. The other causes are previous radiation treatment to the neck, previous surgery to the thyroid gland or a condition called Hashimotos thyroiditis.
#2. Hyperthyroidism.
With this condition, there is over secretion of hormones, which causes nervousness, irritability, heat intolerance, excessive sweating, heart palpitations, fatigue, weakness, weight loss, frequent bowel movement and irregular menstrual periods. Patients are usually anxious, restless. Following are the causes for over active thyroid gland. Grave�s disease (diffused toxic goiter). Toxic adenoma, toxic multi nodular goiter or iodine excess. This condition is confirmed by blood test, which includes T3, T4 and TSH and thyroid scan with uptake. The treatment is tailored according to the patients profile, which includes radiotherapy and medical treatment and thyroid surgery.
CONDITIONS ASSOCIATED WITH THYROID SWELLING
#1. Goiter means swelling of the thyroid, which most commonly is due to multi nodular goiter, where there are several nodules in both lobes of the thyroid gland noted. Iodine deficiency or Hashimotos disease or nodular disease can lead to goiter. The treatment of the multi nodular goiter depends on the thyroid function as well as the pressure symptoms. There is a variant called substernal goiter, which is an unusual presentation of the thyroid gland extending into the chest.
#2. Nodules in the thyroid gland; the nodules in the thyroid gland can be benign or malignant or it could be hyper functioning nodules called toxic nodules. A thyroid function test, thyroid scan, sonogram of the neck and Fine needle aspiration are performed as part of the evaluation of the nodules. The treatment will be tailored according to the thyroid function as well and the fine needle aspiration cytology report.
3#. Thyroid cancer; the cause of most cases of thyroid cancer is unknown, although people who have had previous radiation to the head and neck or who have been exposed to nuclear accident are at a high risk of developing thyroid cancer.
FOLLOWING ARE THE TYPES OF THYROID CANCER
#1. Papillary cancer. #2. Follicular cancer. #3. Medullary cancer. #4. Hurthle cell cancer. $5. Undifferentiated cancer. #6. Lymphoma. #7. Metastasis to the thyroid gland.
Patients may have the following symptoms, and at times they may not have any symptoms. It is found on a routine physical exam by the physician or when they do thyroid sonogram or CT scan of the neck. If anyone develops swelling in the region of the thyroid gland or previous history of radiation to the neck, or develops symptoms of nodules in the region of the thyroid or the neck, or anyone experiences pressure symptoms in terms of difficulty breathing, swallowing or hoarseness, should seek medical attention without delay for further evaluation and management. The test will include to identify the cancer of the thyroid gland will be thyroid function blood test, ultra sound of the thyroid, thyroid scan and fine needle aspiration of the suspected nodules. Depends upon the findings, the extent of the treatment will be tailored, which will include surgery, and/or radiation therapy.