Thyroid Disorders

The thyroid gland produces hormones that regulate metabolism, energy levels, and body temperature. Thyroid disorders occur when the gland produces either too much hormone (hyperthyroidism) or too little (hypothyroidism). These conditions affect multiple body systems and may interfere with daily activities, but they respond well to appropriate medical management.

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Dr Adrian Mondry
Physician (FRG) | MD (HHU Düsseldorf) | MRCP (London) | IM Specialist (ÄKNo) | Hypertensiologist (DHL)

Symptoms of Thyroid Disorders

The manifestations of thyroid disorders vary depending on whether the gland is overactive or underactive, with symptoms developing gradually over time.

  • Hyperthyroidism (Overactive Thyroid)

    Weight loss despite normal or increased appetite, rapid heartbeat, increased sweating, nervousness, tremors in the hands, and heat intolerance occur with an overactive thyroid. Additional symptoms may include increased bowel movements and muscle weakness.

  • Hypothyroidism (Underactive Thyroid)

    Fatigue, weight gain, cold sensitivity, dry skin, and muscle weakness indicate an underactive thyroid. These symptoms often develop slowly over months or years, accompanied by constipation, hair thinning, and fluid retention.

  • Sleep Disturbances

    Both conditions affect sleep patterns – hyperthyroidism can cause difficulty sleeping and restlessness, while hypothyroidism may result in excessive daytime sleepiness and prolonged fatigue.

  • Mood Changes

    Hyperthyroidism often leads to anxiety, irritability, and emotional instability, while hypothyroidism may contribute to depression, cognitive slowing, and reduced mental clarity.

  • Physical Changes

    Skin, hair, and nail changes occur in both conditions. Hypothyroidism causes dry, coarse skin and brittle nails, while hyperthyroidism may lead to warm, moist skin and hair thinning.

Causes and Risk Factors

Multiple factors can lead to thyroid dysfunction, ranging from autoimmune conditions to environmental influences.

  • Autoimmune Disorders

    Graves’ disease causes hyperthyroidism, while Hashimoto’s thyroiditis leads to hypothyroidism through immune system attacks on thyroid tissue. These conditions often run in families and may progress gradually.

  • Medical Treatments

    Certain medications (e.g., amiodarone, lithium) and radiation therapy to the neck can disrupt thyroid function. Previous thyroid surgery may also result in hormone imbalances.

  • Genetic Factors

    Family history increases the likelihood of developing thyroid disorders, particularly autoimmune types.

  • Gender and Age

    Women face higher risks of thyroid disorders, with increased incidence after pregnancy or later in life.

  • Pregnancy

    Hormonal changes during and after pregnancy can trigger temporary or permanent thyroid dysfunction. Regular monitoring throughout pregnancy helps detect and manage these changes.

Diagnostic Methods

  • Blood Tests: These measure thyroid hormone levels (T3 and T4) and thyroid-stimulating hormone (TSH) to check if the thyroid is overactive or underactive. Additional blood tests may check for antibodies that indicate autoimmune thyroid conditions, such as Graves’ disease or Hashimoto’s thyroiditis.
  • Thyroid Scan: This imaging test shows how well the thyroid is functioning. A small amount of radioactive material is used to create detailed images of the gland, helping doctors assess any overactive or underactive areas and evaluate nodules.
  • Ultrasound Examination: This scan creates images of the thyroid gland. It helps doctors detect nodules, cysts, or other abnormalities that may require further evaluation.

Treatment Options

Thyroid disorders are managed with medication to maintain stable hormone levels. Treatment requires regular blood tests and symptom assessment to ensure effectiveness.

Hormone Replacement Therapy

For hypothyroidism, levothyroxine replaces missing thyroid hormones. The dosage is adjusted based on blood test results and symptom monitoring. Most individuals require lifelong treatment, with periodic dose adjustments to maintain proper thyroid function.

Anti-thyroid Medications

For hyperthyroidism, medications such as carbimazole or propylthiouracil reduce excessive hormone production. Treatment typically lasts 12-18 months, with regular monitoring to adjust dosage as needed.

Experiencing Symptoms of Thyroid Imbalance?

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Prevention and Management

Regular thyroid function monitoring allows early detection of changes. A balanced diet provides essential minerals such as iodine and selenium, which support thyroid health. Patients with diagnosed thyroid conditions should maintain a consistent medication schedule, undergo routine blood tests, and attend follow-up appointments. Physical activity and stress management techniques can help reduce symptoms. Keeping a record of symptom changes assists doctors in adjusting treatment plans.

Frequently Asked Questions (FAQ)

How long does it take for thyroid medication to work?

Thyroid hormone replacement typically shows initial effects within 2-3 weeks. However, achieving optimal hormone levels and full symptom resolution may take 3-6 months. Regular blood tests help fine-tune the dosage.

What happens if thyroid disorders go untreated?

Untreated hypothyroidism can lead to high cholesterol, heart disease, and in severe cases, myxoedema coma. Uncontrolled hyperthyroidism may cause irregular heart rhythms, bone loss, and thyroid storm, a life-threatening condition requiring emergency care.

Can thyroid disorders resolve on their own?

Some forms of thyroid dysfunction, particularly postpartum thyroiditis, may resolve spontaneously. However, most chronic thyroid conditions require ongoing medical management, or at least monitoring of thyroid function.

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Dr Adrian Mondry

Physician (FRG)|MD (HHU Düsseldorf)|Specialist for Internal Medicine (ÄKNo)|Hypertensiologist (DHL)|MRCP (London)

Dr. Mondry has over 30 years of experience as an internal medicine & hypertension specialist.

  • Previously a Senior Consultant in the Department of Medicine at the National University Hospital and Ng Teng Fong General Hospital, where he is currently a visiting consultant.
  • Hypertension Specialist accredited by the German Hypertension League (DHL)

  • Contributed to the latest Singapore ACE Clinical Guidance on “Hypertension – Tailoring the Management Plan to Optimise Blood Pressure Control” as a committee member.

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