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With early diagnosis and proper treatment, most people with thyroid conditions can lead healthy, normal lives.

THE thyroid gland is a butterfly- shaped gland located at the base of the neck, and it is one of the most important glands in the human body.

Though small and seemingly insignificant, it secretes hormones that play a crucial role in regulating many body functions, including metabolism, heart rate, body temperature and energy levels. When something’s awry with the thyroid, it can lead to a range of health conditions that impact these functions.

According to consultant endocrinologist Dr Sharmila Sunita Paramasivam, thyroid gland disorder may affect thyroid hormone production – either causing low levels (hypothyroidism) or high levels (hyperthyroidism).

However, not all thyroid problems lead to hormonal disruption.

Consultant breast and endocrine surgeon Dr Normayah Kitan said: “Some patients may come to us with neck swelling.

One of the symptoms of hyperthyroidismis the unexplained weightloss despite eating a lot, Dr Normayah said.

“The swelling may be diffuse, which affects the whole thyroid, or present as a lump due to a nodule or a few nodules in the gland.

“Commonly, these do not interfere with hormone production. So such patients do not have any symptoms except for neck swelling.”

Dr Sharmila added: “Many patients have the misconception that if you have a neck swelling, you will have thyroid hormone abnormalities.

“That’s not true. Not all neck swellings affect thyroid hormone level. Conversely, you may have abnormal thyroid hormone levels without any neck swelling.”

Types of thyroid problems

There are several types of thyroid conditions, and the most common include: > Hypothyroidism: This occurs when the thyroid gland does not produce enough thyroid hormones. These hormones are primarily thyroxine (T4) and triiodothyronine (T3). When levels of these hormones drop, metabolism slows down, which will lead to a variety of symptoms.

Dr Sharmila: Thyroid disease doesn’t only affect women; men can be affected too.

According to Dr Sharmila, symptoms may include fatigue and sluggishness, unexplained weight gain despite eating very little, cold intolerance, depression or mood changes, memory problems and difficulty concentrating, and menstrual irregularities in women. > Hyperthyroidism: It is the opposite of hypothyroidism, where the thyroid produces an excess of hormones, leading to an increase in the body’s metabolism.

One symptom of hyperthyroidism is unexplained weight loss despite increased appetite.

According to Dr Normayah, weight loss can be significant – about 5kg to 10kg within two to three months despite eating a lot.

Other symptoms include rapid or irregular heartbeat; nervousness, anxiety and irritability; excessive sweating and heat intolerance; frequent bowel movements or diarrhoea; and sleep disturbances. > Goitre: The enlargement of the thyroid gland, which can occur for a variety of reasons, including iodine deficiency, autoimmune diseases or thyroid cancer.

While a goitre may not always cause symptoms, it can lead to visible swelling in the neck and may interfere with breathing or swallowing if it grows large enough. > Thyroid nodules: Thyroid nodules are lumps that can develop in the thyroid gland.

These nodules are often benign, but some may be cancerous or cause thyroid dysfunction.

The nodules may not cause symptoms unless they are large enough to be visible or cause difficulty swallowing. > Thyroid cancer: It is relatively uncommon but can occur when abnormal cells begin to grow uncontrollably in the thyroid gland.

The four main types of thyroid cancer are papillary, follicular, medullary and anaplastic.

Papillary thyroid cancer is the most common and generally has a favourable prognosis, especially when detected earlier.

Symptoms of thyroid cancer include a lump in the neck that grows rapidly, difficulty swallowing, hoarseness or changes in voice, and swollen lymph nodes.

Risk factors for thyroid disorders

According to Dr Sharmila, women are more likely to develop thyroid issues than men.

Thyroid conditions commonly occur at 20 to 40 years old, though it can affect teenagers and the elderly as well.

“There is a genetic predisposition in thyroid disease.

“Hence, if someone in your family has the disease, the chances are higher that you may be affected by the disease.

“Other factors that may predispose you to thyroid disorders include environmental factors such as previous viral infections. One such recent example is Covid-19.

“We are now finding that previous Covid-19 infection can trigger an autoimmune response that attacks the thyroid gland.

“Autoimmune conditions are a leading cause of thyroid problems.

“Grave’s disease causes the immune system to overstimulate the thyroid while in Hashimoto’s thyroiditis, the body’s immune system mistakenly attacks the thyroid gland, leading to inflammation, and over time, an inability to produce enough hormones, resulting in hypothyroidism,” revealed Dr Sharmila.

Treatments for thyroid conditions

The treatment for thyroid conditions depends on the specific type of disorder and its severity.

Fortunately, many thyroid conditions are manageable with the appropriate medical intervention. > Hypothyroidism treatment: The primary treatment for hypothyroidism is to give thyroid hormone replacement pills called Levo-thyroxine.

It is taken daily and helps to restore normal hormone levels.

This is a lifelong treatment that demands consistent compliance from the patient. > Hyperthyroidism treatment: There are several treatment options for hyperthyroidism, including anti-thyroid medications that are used to reduce the production of thyroid hormones.

Another alternative is radioactive iodine therapy, which involves taking a radioactive iodine pill or solution that destroys overactive thyroid cells, reducing hormone production.

This treatment is effective but can result in hypothyroidism, requiring lifelong hormone replacement therapy.

Dr Sharmila said: “Normally, patients with hyperthyroidism require anti-thyroid medication for at least 12 to 18 months, with most recovering after this.

“However, regular monitoring is needed as the disease can relapse.

“If the patient doesn’t respond well to medication or relapses when treatment is withdrawn, then there is a need to consider definitive therapy options such as radioactive iodine or surgery.”

Dr Normayah added that it all depends on the patient and the treatment they choose.

“Thyroid surgery is considered major surgery. There are a few possible complications, such as hoarseness of voice, difficulty swallowing, even vocal cord paralysis, and the injury can be temporary or permanent.

“Another possible complication is low calcium due to the inadvertent removal of the parathyroid glands when the thyroid gland is removed.

“This can cause symptoms such as cramps, and tetany.

“In general, thyroid surgery is a safe procedure, but we have to be wary of complications,” she said. > Goitre and thyroid nodule treatment: Small goitres and nodules that don’t cause symptoms often require no treatment but will be monitored for changes.

For suspicious nodules or large goitres causing symptoms, surgical removal may be indicated.

Another treatment option for certain symptomatic benign thyroid nodules is microwave ablation therapy – where heat is used to destroy the nodule. > Thyroid cancer treatment: Treatment for thyroid cancer typically involves surgery to remove part or all of the thyroid, followed by radioactive iodine therapy to destroy any remaining cancerous cells.

In some cases, chemotherapy or external beam radiation may be necessary for more aggressive or advanced cancers.

After treatment, patients often need lifelong thyroid hormone replacement therapy.

Dr Normayah said: “Thyroid cancer is not very common, although the incidence is increasing. In terms of occurrence, it’s the seventh or eighth most common cancer.

“The prognosis for thyroid cancer is usually good because the main type of thyroid cancer is slow growing.”

Living with a thyroid disorder

Thyroid conditions are common but can often go undiagnosed, especially among the younger age group, because their symptoms can be subtle and easily mistaken for other health issues.

Understanding the types and risk factors for thyroid disorders can help us recognise potential problems early and seek appropriate care.

Dr Sharmila reminded: “If you have symptoms, it’s important to get yourself checked. Once diagnosed, you must persist with treatment, and make sure you attend follow-ups.

“Treatment is easily available and very effective.

“And thyroid disease doesn’t only affect women. Men can be affected too, so get it checked if you have any symptoms.”

She added, “There’s also a common misconception that diet can cause thyroid problems.

“Most thyroid disorders are autoimmune, hence unaffected by diet. One possible diet-related cause of goitre is iodine deficiency. However, that is not an issue in Malaysia as our salt and food are fortified with iodine.

“Sometimes, patients with a lump in the neck dismiss the swelling after they get a normal thyroid function blood test.

“If you have a lump, you have to exclude the possibility of cancer, and that’s done with an ultrasound, which can be carried out easily, isn’t expensive, and is not painful,” cautioned Dr Normayah.

With early diagnosis and proper treatment, most people with thyroid conditions can lead healthy, normal lives.

If you experience symptoms like unexplained weight changes, fatigue or changes in heart rate, consider talking to your healthcare provider about the possibility of a thyroid disorder.

For more information, visit www.hospitalpicaso.com or call +603-7457 2888 to make an appointment. Recovery is a battle worth fighting for.

KKLIU 0862 / Exp 31.12.2027

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