Thyroid is a butterfly-shaped gland, a small organ, located in the front of the neck. (Source: Getty/Thinkstock) It is estimated that around 42 million people in India suffer from some kind of thyroid issue. As January is observed as thyroid awareness month, Dr Pranjali Sharma, who received her medical degree from Pune’s B J Medical College and is now a US-based endocrinologist, tells The Indian Express about the significance of early diagnosis and effective treatment of disorders related to the thyroid gland.
How are thyroid issues detected early and managed?
The thyroid is a butterfly-shaped gland that sits in your neck. It is a small endocrine gland meaning it releases its hormones (the thyroid hormone) directly into the blood. It plays an integral role in maintaining one’s body temperature, metabolic rate and weight. The main disorders of the thyroid happen when it is overactive (hyperthyroidism) or underactive (hypothyroidism).
Symptoms will depend on the kind of thyroid disorder one has. For example, if there is an overactive thyroid, it will feel like the body is in overdrive – fast heart rate, skipping beats or palpitations, tremors or shakiness, diarrhoea, high anxiety or nervousness, being hungry all the time but losing weight due to high metabolism, raised body temperature.
Women could have menstrual cycle changes and older women could have a higher risk of fractures and osteoporosis.
With the underactive thyroid, the body metabolism slows down – so it is easier to gain weight, feel very tired and sleepy, feel cold all the time, have constipation, feel depressed or low. If there is a family history of thyroid disease, then one should have their thyroid function checked at least once every 1-3 years.
Can thyroid disorders be managed with lifestyle changes like exercise, diet?
Thyroid disorders are caused by underactivity or overactivity of the gland. It is not possible to control these with only lifestyle changes or diet. Vegetables like cauliflower, broccoli, kale, radishes, turnips etc are called goitrogenic vegetables. They can cause slowing of the thyroid if eaten in large amounts all day every day. But in regular amounts, they do not affect the thyroid. It is essential to stay physically active and eat healthy to avoid feeling worse.
In fact, if you have hyperthyroidism, make sure you talk to your doctor to see if it is fine for you to exercise. The added stress to your heart could be dangerous. But for hypothyroidism, regular exercise is advised.
Can thyroid disorders cause obesity and infertility? Is the incidence of thyroid cancer increasing?
Hypothyroidism does lead to weight gain by slowing your metabolism. It could also lead to weight gain due to overeating. Once on the appropriate medication and your thyroid level has been optimised, the thyroid abnormality should not contribute to weight gain. Infertility can be a consequence of thyroid issues. Thyroid nodules, not thyroid cancer, are very common. Nodules increase in proportion to age. Women tend to have a higher predisposition for thyroid nodules. But even men can have them. Only 5-10 per cent of the nodules tend to be cancerous. So it can be said that the thyroid cancer incidence is low.
Usually, thyroid cancer nodules are indolent and fairly small when diagnosed. But a lump in your neck, trouble in swallowing, new-onset hoarseness of voice are all symptoms you should check with your doctor. We can diagnose thyroid cancers with advanced imaging tests. Most thyroid nodules are now found incidentally when patients get imaging for their neck, back or chest issues.
Explain early detection and management of thyroid cancers. What are recent advances in diagnosis and treatment?
We still do not recommend screening for thyroid cancer. This is mainly because the cancer is very slow-growing for the most part. So screening will only lead to the diagnosis of microscopic cancers that will not grow to the point of spreading.
In fact, pursuing treatment may lead to complications. Thyroid cancers are primarily managed by surgery to remove part or whole of the thyroid. Sometimes, one may require oral radioactive iodine treatment after the surgery. But the decision of how much thyroid gland to remove and whether or not one would need the iodine treatment is decided by your endocrinologist and surgeon based on cytology and imaging.
Over time, we have gotten better and better at using the tests at our disposal to diagnose thyroid conditions. The main advances are occurring in the realm of widespread thyroid cancers that do not respond to surgery and iodine only. Newer drugs are entering the field, directed against specific mutations of thyroid cancers.
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