World Wide
THYROID GLAND

WHAT IS THYROID GLAND?

It’s a small endocrine hormone organ which is located in the front of the neck, it is made up of two lobes connected by an isthmus which secret two hormones “thyroxine (T4) and triiodothyronine (T3)” , these hormones have a major role in the metabolism of your body.

WHAT IS ENLARGED THYROID GLAND ?

enlarged thyroid gland is called (goiter) which may be refer to several diseases like (hyperthyroidism, hypothyroidism or thyroid cancer).

What should we do when we notice a goiter?

1- TSH hormone test
2-ultrasonography to follow goiter size
3-fine needle biopsy if the goiter is nodularity.
The management is depending on results of these investigations , if the goiter is benign with no compressive symptoms it’s need no treatment But if the biopsy shows malignant cells here surgery is required and the patient have to take levothyroxine for long life after the surgery. if your gland overactive it means too much hormones are produced, then you have hyperthyroidism which happens because of (immune disease “grave disease which is the common reason”, nodules on the thyroid gland which produce thyroid hormone , and some medicines)

WHAT ARE THE COMMON SYMPTOMS OF HYERTHYROIDISM?

•increased metabolic rate
•compressive local symptoms
•fast heartbeat
•anxiety
•losing weight
•insomnia
•trembling hand
•enlarged thyroid gland
•nervousness
•eye problems
•always feeling hot
here you have to do blood test : cbc , alt , ast , albumin and TSH hormone(the normal range is between 0.4 to 4.0 mIU/L).

This case could be treatable by:

•medicine(which stop producing too much hormones like antithyroid drugs “ATDs” ).
•radioactive iodine ablation
•surgery when it’s necessary when the goiter causes local compression symptoms.

On the other way if the gland is unable to produce thyroid hormones well then this disease is called(hypothyroidism) and hashimoto disease is the common cause of it, it develops slowly.

WHAT ARE THE SYMPTOMS OF IT?

•tiredness
•dry skin
•thinning hair and hair lose
•inability to concentrate
•enlarge thyroid gland
•muscle weakness
•depression
• constipation
•blurred vision
•exhaustion
The diagnosis is based on signs, symptoms and the results of blood test of TSH hormone, T3 isn’t recommended. The treatment involves correction of thyroxine level and here the patient have to take levothyroxine for longlife and do TSH test each 6 months to determine the dosage.

As we said ECHO is the primary method to investigate the thyroid gland , it shows the size of lobes, the size of nodules if exist and preliminary look at the benign or malignant of the goiter.
So the enlargement of thyroid gland sometimes indicates a malignant lesion.
If the goiter is nodularity we have to take a biopsy by fine needle, these taken cells are checked to see if they have cancer or not. Fine needle procedure has predictive value and improved clinical significance, it can be done at 5 minutes at a local radiology centre.
It may causes a little pain. After doing FNA the decision is depending of the types of cells :
•malignant (here the thyroid gland should be resected).
•benign cells, here you have to monitor nodules every 3 months to check the size and if there is any changes in the gland.
•unclear cells.
The decision is depending on the size of nodules, the speed of the development of its size, sings , symptoms, family and medical history of the patient.

All these discussions are depending on Bethesda classification(the results of FNA):
•l Bethesda : nondiagnostic
•ll : benign
•lll : atypia of undeterminated sign significance follicular neoplasm suspicious for follicular neoplasm
•V: suspicious for malignancy
•VI : malignant 2-8 %

WHAT ARE THE COMPLICATIONS AFTER THYROIDECTOMY?

•hypokalaemia(20-30%) which could be managed by calcium plus vitamin D for 10 days
•recurred laryngeal nerve injury(5-10%) but it can get better during 6 months.
•Bleeding
•inflection
These complications can be prevented by carful operative technique.
After thyroidectomy you have to take levothyroxine for long life it’s taken on an empty stomach.So What are side effects of levothyroxine ?
Heart palpitation , insomnia , nervousness, worry, shakiness, shiver , fever ,headache......

KEFIR AND THYROID GLAND ?

The fermented milk of kefir helps to regulate the immune system by improving the gut bacteria also it is rich of probiotics which can also help remedy some symptoms of hypothyroidism.
So when drinking kefir milk regularly hypothyroidism is being probably treated.