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Types of Thyroid Disorders

Monday 11 May 2020
Thyroid Disorders

Table of Contents


I. The importance of the thyroid

II. Graves’ disease

III. Hashimoto’s disease

IV. Goiters

V. Cancers

VI. Treatment


The importance of the thyroid

The thyroid is a small, butterfly-shaped gland located at the base of the neck and is responsible for many important metabolic functions. It may be a small gland, but when something goes wrong with the thyroid, there are several side effects that can affect everyday life. Over 20 million people in the United States have a thyroid issue and up to 60 percent of those people are undiagnosed. Luckily, there are medications like Synthroid (levothyroxine) that can help control symptoms of thyroid disorders.

The thyroid is responsible for regulating the metabolic rate that controls the heart, muscle and digestive function, brain development, and bone maintenance. The two thyroid hormones are responsible for regulating your metabolism, which involves the breakdown of what you eat to make energy. This process affects how fast your heart beats, how deep you breathe, as well as whether you lose or gain weight. [1]  

a plastic model of a human heart

Sometimes the thyroid malfunctions and produces too little or too much of its hormones. This leads to the two most common thyroid disorders: 

Hyperthyroidism: Hyperthyroidism occurs when the thyroid gland is overactive and produces too much of its hormone. Some symptoms of hyperthyroidism include restlessness, increased sweating, shaking, anxiety, trouble sleeping, and weight loss. 

Hypothyroidism: Hypothyroidism occurs when the thyroid is underactive and does not produce enough of its hormones. Symptoms of hypothyroidism include dry skin, weight gain, weakness, slow heart rate, and dry skin. 

Several thyroid disorders fall under the umbrella of hypothyroidism and hyperthyroidism. Read on to learn more about disorders that can affect the thyroid. [2]  

Graves’ Disease

This disorder is named after Robert J. Graves, who first described this disorder in a patient in 1835. Graves’ disease is an autoimmune problem that makes the thyroid produce too much thyroid hormone. Graves’ disease is the leading cause of hyperthyroidism. 

Scientists do not know exactly what causes Graves’, but researchers have found that it runs in families and tends to affect more women than men. This disorder occurs when the body creates antibodies that make the thyroid grow. These antibodies are called thyroid-stimulating immunoglobulins (TSIs) and they trick the thyroid into growing and producing too much thyroid hormone. 

Diagnosing Graves’ disease can be difficult because many of its symptoms can be confused with other conditions. Some common symptoms of Graves’ disease can include: 

  • Prominent, bulging eyes
  • Anxiety and feelings of restlessness
  • Difficulty controlling diabetes
  • Chest pain 
  • Weight loss, despite an increased appetite
  • Muscle weakness

a closeup of a man’s eyes

Graves’ can also lead to more severe symptoms which can include: 

Eye problems: Eye disease related to Graves’ is called Graves’ ophthalmopathy. Symptoms can include red eyes, tearing, sensitivity to light, and a feeling of sand or dust in the eye. These symptoms can be mild or severe. In severe cases, the eyes can protrude from the eye sockets and can cause an inflammatory response in the eye muscles. 

Skin thickening: Some patients with this disorder may develop a thickening of the skin over the front of the lower leg (tibia). This leads to skin lesions that are patchy and pink. This disorder is called pretibial myxedema. [3] 

Hashimoto’s disease

This disease is named after the Japanese surgeon who discovered it in 1912. Hashimoto’s disease is also an autoimmune disorder that involves damaged immune cells attacking the healthy thyroid tissue, which causes the gland to become inflamed. This disease is also more likely to affect women. 

When the thyroid is being attacked by immune cells, it cannot make the thyroid hormone as well, which results in hypothyroidism. Hashimoto’s is the most common thyroid disorder in the United States and is the leading cause of hypothyroidism. 

You are at risk for developing Hashimoto’s disease if you have a pre-existing autoimmune condition. Some disorders that may lead to Hashimoto’s can include Addison’s disease, type 1 diabetes, and rheumatoid arthritis. If you have one of these autoimmune disorders, you should occasionally get your thyroid checked for signs of Hashimoto’s disease.

Some common symptoms of Hashimoto’s can include: 

  • Fatigue
  • Weight gain
  • Drowsiness
  • Constipation 
  • Increased menstrual flow 
  • Increased sensitivity to cold [4] 

Goiters

A goiter is an abnormally large thyroid gland. Goiters can occur due to an overactive or underactive thyroid. In some cases, a person with goiter may have no symptoms and not realize they are experiencing thyroid problems until the goiter grows large enough to bulge from the neck. 

a diagram explaining what a large goiter looks like

The cause of goiter can include: 

  • Iodine deficiency: The thyroid requires iodine from your diet to make the thyroid hormones. Thyroid deficiency is prevalent in many parts of the world, but you can supplement your iodine intake through foods like eggs, cheese, and vegetables. In the U.S. salt is supplemented with iodine to provide higher levels of iodine in your diet. 
  • Hashimoto’s disease
  • Graves’ disease
  • Thyroid nodules: Thyroid nodules are overgrowths of tissue that overproduce the thyroid hormones. They typically do not cause any symptoms. In rare cases, these nodules contain cancer cells. [5] 

Cancers

There are around 56,000 cases of thyroid cancer every year in the United States. This cancer can occur at any age but is most common in women over the age of 30. This condition can be hard to diagnose because it often presents without any symptoms. The first symptom noticed is typically a lump in the neck (goiter). 

Thyroid nodules are generally not harmful, but around 1 percent of thyroid nodules are cancerous. They can be identified through physical exams, x-rays, or an MRI. There are four main types of thyroid cancers and the majority of cases are typically curable. [6] 

The types of thyroid cancers can include: 

Papillary thyroid cancer: Papillary is the most common type of thyroid cancer. Papillary carcinoma arises as a solid mass on the thyroid tissue. This type is highly curable but can become more deadly if the masses spread to the lymph nodes. This type of cancer most often occurs in people 30 to 50 years old. This cancer also accounts for 85 percent of thyroid cancers due to radiation exposure. [7] 

Follicular thyroid cancer: This is the second most common type of thyroid cancer and accounts for 15 percent of all thyroid cancer cases. It also affects a slightly older age group and is less common in children. The lungs, bone, brain, liver, bladder, and skin are potential sites of spread for this cancer. The cure rate is still high but decreases with age. [8] 

an IV pole with a fluid bag

Medullary thyroid cancer: People typically do not experience symptoms of hypothyroidism and hyperthyroidism with this type of cancer. In most cases, it is only diagnosed once a mass (goiter) is felt in the neck. This type often originates in the upper central lobe of the thyroid and, in some cases, can spread to the liver, bone, brain, and adrenal medulla (inner part of the adrenal gland). Medullary cancer is rare and has a low cure rate. [9] 

Anaplastic thyroid cancer: This is the least common type of cancer and occurs in only 1 percent of thyroid cancer cases. Those diagnosed with this cancer do not typically live more than a year after diagnosis. Anaplastic cancer is also diagnosed by a mass in the neck, but it is typically large and very hard. These tumors grow rapidly and often spread to cervical lymph nodes and distant organs. [10] 

Treatment

Treatment for your thyroid disorder depends on the severity of your symptoms, so your doctor will create the proper treatment plan for you. The first course of treatment typically involves medications. When hyperthyroidism is present, like in the case of Graves’ disease, medications like Tapazole (methimazole) are prescribed to decrease the production of thyroid hormone or prevent its release from the gland. If you have hypothyroidism, especially as a result of Hashimoto’s disease, then you will receive medications like Synthroid (levothyroxine) to replace thyroid hormones in the body.

In severe thyroid cases, like those involving cancers, you may have to undergo a thyroidectomy (removal of the thyroid). This procedure typically cures thyroid problems, but you will need thyroid hormone replacement drugs for the rest of your life. [11] 

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis or treatment.