Thyroid disorders most commonly present either as a problem of thyroid function or what we term thyroid morphology (shape or size) of the gland. Sometimes both features may be present in the same individual.
If you think you have a problem talk to your doctor! Testing is simple!
As previously discussed thyroid function may be under (hypothyroidism) or over active (hyperthyroidism). The symptoms of thyroid dysfunction (that is abnormal function) may be non specific and your doctor will often consider thyroid disease in a range of clinical situations.
More often than not thyroid disease will not be the cause of your problems. Testing for thyroid disease is easy and relatively inexpensive.
The term used for normal thyroid status is euthyroid or euthyroidism. If you see this term at the bottom of a pathology blood test result, do not panic, it means normal thyroid function.
The commonest symptoms of hypothyroidism are:
- tiredness, lethargy
- fatigue
- weight gain
- dry skin
- dry hair
- yellow discolouration of the skin, termed carotenemia
- pins and needles in the hands or feet
- heavy periods
- loss of memory
- depression
- slow heart rate
- constipation
- intolerance of the cold
- lowered body temperature
- muscle weakness
- raised cholesterol
- enlarged thyroid or goitre
In most cases the disorder is detected on routine testing often before the symptoms are severe. There is evidence to indicate that treating early with thyroid hormone is beneficial even before the onset of many of the symptoms.
The commonest symptoms of hyperthyroidism are:
- tiredness, lethargy
- fatigue
- weight loss
- excess sweating
- loss of scalp hair
- pins and needles in the hands or feet
- absent or light periods
- depression
- anxiety and agitation
- fast heart heart rate
- tremor and shaking
- loose bowel motions
- intolerance of the heat
- raised body temperature
- muscle weakness
- enlarged thyroid or goitre
As in cases of hypothyroidism, patients with hyperthyroidism are often detected at early stages of the disorder.
Not all symptoms are present in the same individual. Furthermore, even if you have many of the symptoms on either list, your thyroid function may still be normal. There are other disorders that may give a similar set of health symptoms.
The second commonest presentation for thyroid disorders is a change in morphology, ie a change in size or shape. The gland may enlarge generally; this is termed a diffuse goitre, or it may enlarge locally with a nodule (lump), termed a nodular goitre.
If there are multiple lumps this is termed a multi nodular goitre (MNG).
Often this enlargement has no symptoms and has been present for many years. Sometimes there may be symptoms of pressure in the neck, difficulty swallowing, pain or a change in voice.
In most cases of goitre, thyroid function is normal! This causes a lot of confusion to patients.
In the next series of blogs we will discuss the causes of goitre.
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