The thyroid is a butterfly-shaped gland located in front of the neck. It produces thyroid hormones called T3 and T4 under the effect of Thyroid Stimulating Hormone (TSH) which is secreted by the pituitary gland. T3 and T4 act on virtually every organ in the body and maintain basal metabolic rate (BMR). Iodine is an essential element for the normal functioning of the thyroid gland. Disorders of the thyroid gland involve an underactive thyroid (hypothyroidism), an overactive thyroid (hyperthyroidism), an enlarged thyroid (goiter), and benign and malignant (cancerous) nodules of the thyroid gland. Endocrinology is the specialty that deals in detail with all the problems of the thyroid gland.
When to get tested for thyroid problems?
At birth, regardless of symptoms, all newborns should be screened for hypothyroidism.
If a child has poor height gain or delayed puberty, inattentiveness in school, poor academic performance, or the presence of goiter, vitiligo, or type 1 diabetes mellitus.
Adults should be screened when they have a nonspecific feeling of tiredness, lethargy, feeling constantly cold, unexplained hair loss or weight gain, constipation, unexplained infertility, goiter, or a family history of hypothyroidism.
A person should be screened for hyperthyroidism if they have tremors in their hands, sensation of rapid heartbeat, sweating, weight loss despite increased food intake, chronic diarrhea, increased anxiety, lack of sleep , easy irritability, goiter or infertility.
Some myths and facts about the thyroid gland.
- Myth: Hypothyroidism is a disorder of middle-aged women.
Made: Hypothyroidism can affect a person of any age and gender. In fact, congenital hypothyroidism can affect a child even before birth during intrauterine life. As normal thyroid function is essential for brain development. Thus, you must insist with your pediatrician for a thyroid screening of the newborn even if he has no problem at birth.
- Myth: All patients with thyroid problems develop goiter.
Made: In fact, most patients with thyroid problems do not develop goiter these days, thanks in part to the iodine fortification of salts. You should not wait for goiter to occur until you are tested. If you have symptoms indicating hypothyroidism or hyperthyroidism, you should get yourself tested.
- Myth: I can’t lose weight if I have hypothyroidism.
Made: If your hypothyroidism is well controlled, it does not affect the ability to lose weight.
- Myth: Once my TSH is normal, I can stop taking levothyroxine tablets.
Made: Your TSH ratio is normal because you regularly use levothyroxine tablets. Most patients with hypothyroidism require lifelong levothyroxine (T4) replacement with dose adjustment at intervals advised by your endocrinologist.
- Myth: Hypothyroidism can be managed with diet regulation.
Made: No diet change alone can bring your thyroid hormone back to normal. Hypothyroidism requires the replacement of levothyroxine and it has virtually no side effects if taken as advised by an endocrinologist.
- Myth: Consumption of Brassica family vegetables like cabbage, cauliflower, broccoli, etc. can cause goiter and hypothyroidism.
Made: A person with hypothyroidism or hyperthyroidism may have the same diet as any other person. The cooked consumption of these vegetables has no effect on the thyroid. Taken in moderation, even raw consumption of these vegetables would not cause thyroid problems.
- Myth: A lump or nodule in the thyroid means cancer.
Made: The majority of thyroid nodules are benign and, on average, only 5% of nodules turn out to be malignant. Depending on the needs, your endocrinologist may advise you to undergo an ultrasound of the thyroid nodule and, if necessary, a needle test of the nodule may be advised.
- Myth: Thyroid cancer is not curable.
Made: Most thyroid cancers, if caught early, are easily curable with thyroid surgery and radioactive iodine treatment. In general, a common type of thyroid cancer also has a benign course compared to other cancers.
- Myth: Being hypothyroid, I can’t get pregnant.
Made: With good control of hypothyroidism, you can easily plan pregnancy although during pregnancy it requires frequent monitoring.
- Myth: If I have goiter, surgery is necessary for me.
Made: Surgery is necessary in certain situations, such as when the goiter interferes with swallowing or breathing or can be performed for cosmetic purposes. Medically, it is not necessary in all cases of goiter. Goiter may shrink to some extent or not shrink at all with medication depending on how long it lasts.
The opinions expressed above are those of the author.
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