Thyroid and parathyroid
Thyroid is a butterfly shaped endocrine gland that is responsible for producing thyroid hormones to provide energy to cells as well as regulate body's metabolism. The thyroid gland is located below the Adam's apple in the lower part of neck and wraps around the windpipe (trachea). While Parathyroid glands (small glands of endocrine system) are located in the neck behind the thyroid. An imprper functioning of parathyroid glands can cause hyperparathyroidism thereby increasing levels of calcium in the blood.
The function of thyroid gland is regulated by a feedback mechanism, which involves the brain. When thyroid hormone levels are significantly low, the hypothalamus in brain produces a hormone known as thyrotropin releasing hormone (TRH), causing the pituitary gland (located at the base of brain) to release thyroid stimulating hormone (TSH). Thus,TSH stimulates the thyroid gland to release more T4. Since the thyroid gland is controlled by pituitary gland and hypothalamus, any disorder of these tissues can affect functioning of thyroid.
Common Thyroid Disorders
Thyroid disorders are conditions that affect the thyroid gland, a butterfly-shaped gland in the front of the neck. The thyroid has important roles to regulate numerous metabolic processes throughout the body. Different types of thyroid disorders affect either its structure or function. The thyroid disorders affect the thyroid gland, a butterfly-shaped gland located in front of the neck. It is responsible for regulating numerous metabolic processes throughout the body. Thyroid disorders can severely affect the structure or function of thyroid glands.
There are specific kinds of thyroid disorders that include:
- Hypothyroidism (An underactive thyroid)
- Hyperthyroidism (An overactive thyroid)
- Goitre (An enlarged thyroid)
- Thyroid nodules (Lumps in the thyroid gland)
- Thyroid cancer
- Thyroiditis – Inflammation of the thyroid
Symptoms of Thyroid
Losing or gaining weight: Extreme change in weight signal an abnormal function of thyroid gland. Low levels of thyroid hormones (hypothyroidism) can cause weight gain, while unexpected weight loss can signal that too many thyroid hormones are being produced (hyperthyroidism). Hypothyroidism is much more common than hyperthyroidism.
Swelling in the neck: A goitre is an enlargement of the thyroid gland. A goitre can occur both as a result of hypothyroidism and hyperthyroidism. It can sometimes also result from tumors or nodules that develop within the thyroid gland.
Changes in heart rate: The hormones made in the thyroid gland affect almost every organ in the body, including the heart. Hypothyroidism can cause the heart to beat slowly while hyperthyroidism causes a fast heartbeat. Elevated levels of thyroid hormones also can lead to increase in blood pressure and a feeling that your heart is pounding (palpitations).
Changes in mood or energy:Thyroid disorders can affect emotions, energy, and mood. Hypothyroidism can cause symptoms like depression, tiredness, and feeling sluggish. Hyperthyroidism is associated with sleep disturbances, irritability, anxiety, and restlessness.
Hair loss: Hair loss is a common sign of a thyroid problem. Both too high and too low levels of thyroid hormones can lead to hair loss. The hair typically grows back once the condition is treated.
Body temperature too cold or hot: The thyroid affects regulation of body temperature, So, those with hypothyroidism often report feeling cold. In contrast, people with hyperthyroidism tend to have excessive sweating and an aversion to heat.
Which is more common? Hyperthyroidism or hypothyroidism?
Hypothyroidism is much more common than hyperthyroidism. Hypothyroidism, also called as underactive thyroid disease, is a common disorder. It is a condition in which the thyroid gland is overactive and makes excessive amounts of thyroid hormone. While Hyperthyroidism is a condition in which the thyroid gland is overactive and makes excessive amounts of thyroid hormone.
Diagnosis of Thyroid
A physical examination and laboratory tests that measure the amount of thyroid hormone (thyroxine, or T4) and thyroid-stimulating hormone (TSH) in your blood are necessary. Measurement of antibodies in the blood that attack the thyroid (antithyroid antibodies) may help in diagnosing the cause of hypothyroidism or hyperthyroidism.
What are the Treatment Options of Thyroid
Two types of surgeries are available for treatment:
- Open surgery
- Endoscopic surgery
Thyroidectomy is the surgical removal of part or all of the thyroid gland. Depending on the reason for a thyroidectomy, all or part of the thyroid gland will be removed. The various types of thyroidectomy include:
Partial thyroid lobectomy: Only one of thyroid lobe is removed.
Thyroid lobectomy: Only one of two lobes of thyroid lobe is removed.
Thyroid lobectomy with isthmusectomy: Only one thyroid lobe is removed, together with the section between the two lobes (called the thyroid isthmus).
Subtotal thyroidectomy: One thyroid lobe, the isthmus and part of the second lobe are removed.
Total thyroidectomy: The entire thyroid gland is removed.
- A viewing instrument called an endoscope and small surgical instruments will be inserted into your neck through three or four small incisions.
- Each incision is about 3 millimeters to 5 millimeters long.
- The surgeon uses a tiny camera on the endoscope to guide the instruments and remove thyroid tissue.
- At the end of the procedure, neck incisions are closed with tiny stitches or surgical tape.
Changes in Lifestyle
Dietary changes: Reduce the consumption of iodized salt. Also, avoid vegetables such as cabbage .
For hypothyroidism: Hypothyroidism is treated with synthetic hormone tablet that replaces missing thyroid hormone in the body. With careful monitoring, your doctor will adjust your dosage accordingly, and you'll soon be able to return to your normal lifestyle.
For hyperthyroidism: Hyperthyroidism is generally more difficult to treat as requires normalization of thyroid hormone production. Treatment involves drug therapies to block hormone production and radioactive iodine treatment for disabling the thyroid. The medications gradually reduce symptoms of hyperthyroidism and prevents thyroid gland from producing excess amounts of hormones. Antithyroid medications are a common treatment for hyperthyroidism, particularly if you have an ongoing form of hyperthyroidism caused by Graves' disease. This disease is the most common cause of hyperthyroidism and caused due to an abnormal immune system response, causing the thyroid gland to produce too much thyroid hormone.
The parathyroid glands release a hormone called parathyroid hormone. This hormone helps to control the levels of three minerals in the body: Calcium, Phosphorus and Magnesium. Parathyroid hormone has several effects in the body:
- It causes the release of calcium from bones.
- It causes calcium to be taken up (absorbed) into the blood from the intestine.
- It stops the kidneys from getting rid of (excreting) calcium in the urine.
- It causes the kidneys to excrete phosphate in the urine.
- It increases blood levels of magnesium
Hyperparathyroidism and It's Causes
Improper functioning of the parathyroid glands causes hyperparathyroidism, which increases calcium levels in the blood. Primary hyperparathyroidism is caused by a condition that affects one or more parathyroid glands, causing exaggerated release of its hormone (parathyroid hormone or PTH). This condition could be a benign tumor of the parathyroid gland called an adenoma, benign enlargement affecting multiple glands (hyperplasia) or very rarely carcinoma (malignant tumor). The cause of those tumors are unknown with certain theories being exposure to radiation of head and neck area in the past, lithium use and, rarely, a syndrome that runs in the patient’s family.
Symptoms of Hyperparathyroidism
Nearly all patients with parathyroid problems have some symptoms. Sometimes they are really obvious, like kidney stones, frequent headaches, fatigue, and depression. Sometimes they may not be so obvious, like high blood pressure and the inability to concentrate.
Diagnosis of Hyperparathyroidism
Adenoma or Carcinoma of parathyroid gland releases high levels of parathyroid hormone (PTH). Through PTH’s action in the bones, intestines and kidney, there is an increase in the level of calcium. So the blood is examined for both PTH level and calcium level. Elevated levels of calcium and PTH can cause renal failure.
Treatment for Hyperparathyroidism
Surgery is the only way to treat parathyroid disease (hyperparathyroidism). There are no medications or pills that work to cure or treat parathyroid problems or high calcium. Two types of surgeries available for parathyroid treatment:
- Endoscopic surgery
- Open surgery
Endoscopic technique for parathyroid removal is preferred as the surgeon makes tiny incisions to remove the affected gland under sedation. The endoscopic approach has excellent cosmetic results as there are no scars. Also, the recovery is much faster with minimal post-operative pain.