Thyroid disorders: Not all the same

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Thyroid disorders: Not all the same


KATHMANDU: Thyroid is like the new kid in town. We all seem to have heard of it. Women in particular are also getting self-diagnosed, which is impressive as this reflects our society and how our Nepali women are getting more health conscious.

May 25 is marked as ‘World Thyroid Day’ — a day to promote awareness and understanding of thyroid health and advances made in treating thyroid. An estimated 20 million Americans have some form of thyroid disease. Up to 60 per cent of those with thyroid disease are unaware of their condition, and we probably share the same scenario in our society. Women are 8-10 times more likely than men to have thyroid problems. There is a chance that one woman in eight will develop a thyroid disorder during her lifetime.

Undiagnosed thyroid disease may put patients at risk of certain serious conditions such as cardiovascular diseases, osteoporosis and infertility, while pregnant women with undiagnosed or inadequately treated hypothyroidism have an increased risk of miscarriage, pre-term delivery, and severe developmental problems in their children.

However, thyroid diseases can vary from something which is so innocent that does not require treatment to something as grave as cancer. So, it is of utmost importance to know what kind of ‘thyroid’ disease one is suffering from so that one can reasonably sort treatment and deal with the problem.f

Often with thyroid diseases, many compare apples to oranges and then end up confused and frustrated. Not all thyroid diseases are the same. Most commonly, we come across hypothyroidism — ‘hypo’ meaning ‘low’ thyroid hormones. This can lead to weight gain, low moods, excessive tiredness and sleepiness with hair loss and menstrual disturbance. This is also one of the most commonly self-diagnosed problems as women who are overweight and find it hard to lose weight in spite of their best efforts tend to have a self-blood test done.

A little rise in TSH (

Hyperthyroid, meaning that one has high or excessive thyroid hormone, is another disorder of the thyroid gland. This usually leads to loss of weight, increased heart rate, excessive sweating, heat intolerance and menstrual disturbance.

Hyperthyroid is a curable disease and most commonly we see this due to two reasons. Infection or drugs which injures the thyroid gland causing pain and leading to spilling of the stored thyroid hormone from the gland into the blood, which increases the level of the hormone in our body but only temporarily. Hence, with this kind of thyroid disease, one does not need any medication. Usually it takes about six months for the thyroid function to revert to normal. We can take some painkillers to alleviate the pain and symptoms.

The other kind is mostly autoimmune, where the thyroid gland is over-working and making excessive hormones. These auto antibodies can also affect the eye and patients might have one eye or both involved where it looks like they are staring out. Some people may get eye involvement before the actual thyroid disorder starts. This is called Grave’s disease. Usually one needs to continue taking medications even if the thyroid function is normal for at least 18 months to two years so as to avoid relapse and recurrence.

Some pregnant women in their early pregnancy can have slightly high thyroid hormones but are acceptable for the first trimester and mostly do not need treatment.

There are generally a lot of concerns about diet restrictions and whether certain foods affect thyroid function. Most commonly we hear about cabbage, cauliflower and soya being notorious for thyroid disorders. These are particularly true for goiters, but there is no proven scientific evidence for such recommendations in other hyper/hypothyroidism. Goiters, especially iodine deficient goiters, are almost unheard of in our country these days owing to the universal iodinisation of salt.

Diseases of the thyroid are in fact very common and affect tens of millions of people worldwide. The causes are largely unknown. Awareness is golden, however, one should understand that all thyroid diseases are not the same and neither is their treatment and hence need to be managed with good medical attention.

(Dr Shrestha is a Consultant Endocrinologist at the Norvic International Hospital) - See more at: