Top 16 Causes of Thyroid Disorder

What is thyroid?

The thyroid gland is a small gland shaped like a butterfly and situated at the base of your neck, right below the larynx. This gland synthesises two critical hormones triiodothyronine (T-3) ) and thyroxine (T-4 that support various functions of the body. These hormones process carbohydrates and fats, maintain the body temperature by keeping you warm during cold, participate in synthesis of protein, keep the body’s metabolism going, and support and sustain your bone’s health. These hormones are also integral to your muscle, heart, and other organ’s health.

In addition to these hormones, there is a third hormone that the thyroid gland produces called calcitonin. The purpose of calcitonin is to regulate the calcium levels in your blood stream.

Your thyroid gland produces the hormones required to keep your body running on a regular basis. The hormone is secreted into the bloodstream, which carries it to all the cells and tissues of the body. When the thyroid gland malfunctions in any way, hormone production gets influenced, which can result in a thyroid disease. Thyroid hormones impact the functioning of nearly each cell in the body, but any disruption can throw the body off-kilter.

Causes of Thyroid

Two types of this disease most commonly afflict people: hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). The thyroid causes for both these types can be other conditions, diseases, and deficiencies, like:

• Autoimmune disorders like Hashimoto’s thyroiditis, which refers to the chronic inflammation of the thyroid gland. When the thyroid gland’s capacity to create thyroid hormones is compromised over time, it experiences a gradual loss of function that eventually results in an underactive thyroid (hypothyroidism). This is usually an inherited condition, which means that it runs in the family.
• Postpartum thyroiditis can lead to hyperthyroidism in women. This is usually a rare and temporary condition that can happen after pregnancy. Usually, women who have Type 1 diabetes and a history of thyroid disease in the family are at a risk of postpartum thyroiditis. The cause behind this condition has not been identified yet.
• Iodine deficiency is a big cause behind thyroid disease. This is because iodine is essential for the optimum function of the thyroid gland and the production of thyroid hormones. You cannot produce enough thyroid hormones if you do not get sufficient iodine in your body through your diet. As a result, iodine deficiency can cause thyroid enlargement. Goitre and hypothyroidism are some common consequences of severe iodine deficiency.
• Congenital hypothyroidism is a cause in children and infants because their thyroid gland does not function properly since birth. This condition happens when the thyroid gland does not develop properly during gestation.
• Graves’ disease is an immune system disorder that leads to excessive thyroid hormone production (hyperthyroidism). Although hyperthyroidism can be caused by a variety of conditions, Graves’ disease is the most common cause. Because thyroid hormones affect so many different body systems, the symptoms and indications of Graves’ disease can be quite diverse. Graves’ disease can affect anyone, but it is more common in women and people under the age of 40.
• Thyroid nodules are lumps formed by the overgrowth of thyroid cells inside the thyroid gland. Although the great majority of thyroid nodules are benign (noncancerous), thyroid cancer does exist in a small percentage of thyroid nodules. Most thyroid nodules require evaluation to identify and treat thyroid cancer in its earliest stages. Thyroid cancer is a grave concern when it comes to thyroid nodules, but so is hyperthyroidism. Often, these nodules end up producing their own thyroid hormone, leading to the hormone levels increasing to a great extent.
• Just like a severe deficiency of iodine can lead to hypothyroidism, excessive iodine is also bad for the thyroid gland. When your body has an excess of iodine (the mineral used to create thyroid hormones), the thyroid gland produces much more thyroid hormone than it requires.

Thyroid disease affects 42 million Indians and involves four major thyroid-related ailments: hypothyroidism, hyperthyroidism, goitre/iodine deficit disorders, and Hashimoto’s thyroiditis.

Risk Factors for Thyroid

Anyone can be affected by thyroid disease, including men, women, infants, teenagers, and the elderly. It can be a congenital or an at-birth (usually hypothyroidism) condition or develop as you get older (after menopause in women).

• Women are more prone to thyroid disease than men. Scientists are yet to find out the causes of thyroid in females. One reason is that there are more hormonal changes in women than in men; so, the thyroid gland may get affected along the way of female body changes. Adolescence, pregnancy, and menopause all create major hormonal leaps in a woman’s body.
• A family history of thyroid is considered the most common cause behind thyroid disease.
• Being over the age of 60 years increases your risk of having thyroid disorders because your body is going through many changes because of aging. Women over the age of 60 are especially in the vulnerable group.
• Women who have been diagnosed with polycystic ovarian syndrome (PCOS) are also more susceptible to having thyroid disease. This is because they have a higher level of thyroid antibodies present in their bodies.
• Other conditions like Type 1 diabetes, pernicious anaemia, primary adrenal insufficiency, lupus, rheumatoid arthritis can increase vulnerability to thyroid disease. Thyroid problems should be checked on a regular basis when you have these conditions.
• If you are already treated for any other thyroid issue like thyroid gland removal or radiation for thyroid cancer, then you are more prone to a thyroid disease than the regular population.
• Having medication with iodine can impair your thyroid function.
• Certain lifestyle factors can also lead to thyroid disease. If you smoke cigarettes, the tobacco present in the cigarettes can inflame and interfere in the iodine absorption from your diet. When there is not sufficient iodine absorption, your thyroid gland cannot function properly. Medications like lithium and mood stabilisers can also lead to thyroid gland impairment; so, it is always best to know the side-effects before you take such medicines.
• Psychological stress is known to have an adversarial impact on your health in different ways. So, it can also affect your thyroid gland.

Why do we need to know the causes of thyroid?

Thyroid issues can cause a variety of seemingly unrelated issues, like significant changes in your weight, energy, digestive health, or emotional state. If you recognise the symptoms of thyroid disease, then you can immediately seek treatment. Catching these symptoms early can also help you avoid the condition from worsening. This especially applies in the case of thyroid nodules and thyroid cancer.

Learning about your thyroid gland, the hormones it secrets, and the types and causes of thyroid diseases also become important if there is a family history of thyroid disease. The more you know, the easier it is to create preventive strategies and maintain your health.
Knowing the causes behind thyroid diseases can also direct you to the different treatment courses, medications, and drug therapies, among others.

Diagnosis of Thyroid

If you have thyroid disease symptoms, like depression or anxiety, intolerance to hot or cold temperatures, or unexpected weight changes, in addition to thyroid disease risk factors, such as a genetic history of autoimmune disease, you should be tested for thyroid disease.
You should attempt to balance the hormone levels to treat thyroid disorders caused by excessive or insufficient thyroid hormone production. Before deciding on the best treatment for you, your doctor will take into account your thyroid condition, age, overall health, and previous medical issues.

After taking your case history and physical symptoms, the doctor will suggest you undergo certain diagnostic tests to confirm the presence of the disease. Thyroid diseases can be difficult to identify at times since their symptoms are comparable to those of found in other conditions. When pregnant or ageing, you may experience symptoms like ones associated with a thyroid disease. Therefore, these tests are helpful in getting a true picture of your health issues.

These are the common tests that are usually ordered:

Blood tests: Blood tests are one of the most accurate ways to assess a thyroid problem. Thyroid blood tests are used to measure the level of thyroid hormones in your blood to determine whether your thyroid gland is operating properly. Blood is drawn from a vein in the arm for these tests. The types of thyroid tests you should know of are:
TSH: This test is employed to measure the thyroid-stimulating hormone, which is produced by the pituitary gland. This hormone influences the secretion of thyroxine (T-4) and triiodothyronine (T-3). If the levels of TSH are too high or too low, then there is an issue with your thyroid gland.

The normal range of TSH

T4 and free T4 test: This test is used to determine how well your thyroid gland is working. T4 or thyroxine exists in two forms–one binds itself to proteins and the other circulates freely in the bloodstream. The free test is employed to measure the level of this unbound T4 and will give you a much accurate picture. Low T4 levels usually mean hypothyroidism, while a high T4 level indicates hyperthyroidism. The normal range is usually between 4.6 mcg/dL and 11.2 mcg/dL.

T3 and free T3 test: T3 also has two forms like T4. This test is used to assess the severity of hyperthyroidism. This is because hyperactive thyroid patients have high T3 levels. However, the T3 test is not critical in the assessment of hypothyroidism.

The normal range of T3 and free T3
T3: 80–180 ng/dL
Free T3: 230–619 pg/dL

TSI test: This test is conducted for the thyroid stimulating immunoglobulins. These are antibodies that make the thyroid gland active and help produce thyroid hormones in the blood. This test can help diagnose hyperthyroidism, hypothyroidism, Graves’ disease, goitre, and thyroiditis. It is not commonly done because it can be expensive.

Discuss the normal ranges for these thyroid blood tests with your doctor. Your ranges may differ from those of others. That is frequently acceptable. Speak with your healthcare provider if you have any concern regarding about your blood test results.

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Imaging tests: Nuclear medicine, ultrasound, CT scans, and MRIs are helpful imagine test tools to diagnose thyroid disease.

An ultrasound is fairly straightforward and requires no preparation ahead of it. A water-soluble gel will be applied to the area your doctor wants to examine. This is a scent-free and colourless gel. They will run the ultrasound device over that area and the image will appear on a screen. This takes about 20 to 30 minutes.

A type of nuclear medicine you should know is the thyroid scan or thyroid scintigraphy where a radioactive tracer is used to assess the structure and function of your thyroid scan.

This test can help discover thyroid nodules and even diagnose hyperthyroidism. Another nuclear medicine is the radioactive iodine uptake test, in which you are given radioactive iodine in a capsule form to ingest. The scan will show how much of this radioactive iodine your thyroid gland can absorb to produce T4.

Physical exams: A physical exam is a quick way to check your thyroid. Your healthcare professional will feel your neck to check for any growths or thyroid enlargements. You will be made to sit in a comfortable position. You may be asked to extend your neck or asked to swallow a sip of water during this examination to observe the movement of the thyroid.

Treatment of Thyroid

Different thyroid diseases are treated in different ways because their symptoms, the intensity of the symptoms can vary. Your gender, your case specifics, your age, your overall health, and whether you are pregnant also influence treatment plans.

Here is an overview of the treatment plans:

Hypothyroidism: This is typically treated with levothyroxine hormone replacement pills taken daily. Levothyroxine replaces the thyroxine hormone, which cannot be produced in adequate amount by your thyroid gland. Routine blood tests will be performed until you reach the optimal levothyroxine dosage.

Hyperthyroidism: Thionamides will be prescribed to you to prevent your thyroid gland from producing extra thyroid hormone. Radioactive iodine treatment is a type of radiotherapy that destroys thyroid cells that are overproducing hormones or reduces the enlarged thyroid gland. The final option is thyroid gland removal surgery.

Goitre is usually treated by including iodine supplements in your routine. Only if there is difficulty in breathing and swallowing will surgery be recommended. Thyroid nodules don’t usually need any surgery unless they press against your voice box or windpipe. You might be given thyroid hormone pills to make the nodules go away.

For cancer, there are different therapies including chemotherapy. However, very few patients with thyroid cancer require chemotherapy. Surgery is a common rehabilitative option where the entire thyroid gland is removed. Radioactive iodine treatment wherein you have to take radioactive iodine pills that circulate in your bloodstream and kill all the cancerous cells is also a common route. External radiotherapy uses strong radiation beams to strike against the malignant cells.