Summary
The thyroid can become hypothyroidism or hyperthyroidism (Sindhu et al., 2016). Hypothyroidism (underactive thyroid) produces fewer hormones. Hyperthyroidism (overactive thyroid) produces more hormones. The two distinct conditions of the thyroid have diverse manifestations. The thyroid gland produces two hormones (T3 and T4) that impact health and affect an entire aspect of metabolism, and control vital functions (Palace, 2017). The thyroid gland secretes the calcitonin hormone that assists in calcium regulation in the blood. Thyroxine (T4) and triiodothyronine (T3) influence each cell in the body and maintain the rate at which the body uses carbohydrates and fats; regulate protein production; influence heart rate; control body temperature (Lee et al., 2017).
Manifestation of Hypothyroidism
Persons with underactive thyroid experience high levels of low-density lipoprotein cholesterol that cause heart disease (Sindhu et al., 2016). Hypothyroidism causes slowed mental functioning, and persons suffer depression during the early stages that become more severe over time. Long-term uncontrolled hypothyroidism damages peripheral nerves.
Peripheral neuropathy is characterized by tingling in affected areas, numbness, and pain.
Myxedema is characterized by extreme cold intolerance and lethargy, leading to deep unconsciousness and drowsiness. Low thyroid hormones in the body impair infertility due to interference with ovulation and cause autoimmune disorders (Lee et al., 2017).
Symptoms and Signs of Hypothyroidism
When a patient experiences symptoms that are related to hypothyroidism, they are advised to see a doctor.
Causes of Hypothyroidism
- Radiation therapy.
- Hyperthyroidism treatments.
- Autoimmune disease.
- Thyroid surgery and over-response to hyperthyroidism treatment (Palace, 2017).
- Autoimmune diseases such as Hashimoto’s thyroiditis.
- Occurs when antibodies generated by the immune system attack tissues and involve environmental triggers, genes, and antibodies affecting the ability of the thyroid gland to secrete hormones.
- Medications such as lithium that treat psychiatric disorders contribute to hypothyroidism.
- Other causes include congenital disease, pituitary disorder, pregnancy, and iodine deficiency (Maheshwari et al., 2017).
Manifestations of Hyperthyroidism
Most patients with hyperthyroidism do not experience signs and symptoms at early stages until it is in its advanced stages (Maheshwari et al., 2017). In Grave’s disease, antibodies are generated by the immune system, which causes stimulation of the thyroid that increases the production of T4. Too much T4 is also produced by adenomas which result from hyperfunctioning thyroid nodules. Thyroiditis occurs after pregnancy, whereby the thyroid gland becomes swollen, causing excessive thyroid hormone to outflow into the blood (Palace, 2017). Hyperthyroidism can be treated using anti-thyroid medicines and radioactive iodine (Sindhu et al., 2016). These medications slow secretion of thyroid hormones. Surgery can also be done to remove part of the thyroid gland.
Risk Factors of Hyperthyroidism
If hyperthyroidism is left untreated, it causes osteoporosis due to its interference with the ability of the body to incorporate calcium into bones (Maheshwari et al., 2017). Persons with Grave’s ophthalmopathy have eye problems that entail blurring vision, sensitivity to light, swollen eyes, and bulging, and if these severe problems are left untreated, they cause vision loss. It is not common for a person with Graves’ disease to suffer from Graves’ dermopathy which causes swelling and reddening of the skin; often, when it occurs, it is seen on shins and feet (Sindhu et al., 2016). Complications Associated with Hyperthyroidism include cardiovascular complications, fragile bones, eye problems, skin defects, and thyrotoxic crises.
Symptoms of Hyperthyroidism
Goiter is a condition that is caused by continuous thyroid stimulation, which releases extra hormones and enlarges the gland. A large goiter interferes with breathing and swallowing and makes the patient uncomfortable. Hyperthyroidism affects the heart by causing atrial fibrillation, quick heart rate, and congestive heart failure. Hyperthyroidism puts an individual at risk of thyrotoxic crisis, a rapid escalation of symptoms resulting in fever, quick pulsation, and hallucination.
Continuation of Symptoms of Hyperthyroidism
In older people, signs and symptoms can be absent or subtle such as heat intolerance, rapid heartbeat, and tiredness during ordinary activities (Sindhu et al., 2016). Individuals who smoke and have hyperthyroidism are likely to develop Grave’s ophthalmopathy, which affects their eyes by causing swelling and protruding eyeballs.
Symptoms of Grave’s ophthalmopathy are:
- Protruding eyeballs.
- Light sensitivity and reduced eye movement.
- Blurry vision.
- Excessive tearing and discomfort in eyes.
- Swollen or red eyes and dry eyes.
- Patients who experience swelling at the base of the neck, unusual sweating, rapid heartbeat, unexplained weight loss, and any symptoms related to hyperthyroidism are advised to see a doctor.
References
Lee, H., Hodi, F. S., Giobbie-Hurder, A., Ott, P. A., Buchbinder, E. I., Haq, R.,… & Min, L. (2017). Characterization of thyroid disorders in patients receiving immune checkpoint inhibition therapy. Cancer immunology research, 5(12), 1133-1140.
Maheshwari, P., Mohan, R., & Shanmugarajan, T. S. (2017). KAP study on thyroid disorders (hypothyroidism and hyperthyroidism) in a tertiary care hospital. Research Journal of Pharmacy and Technology, 10(1), 41-43.
Palace, M. R. (2017). Perioperative management of thyroid dysfunction. Health services insights, 10, 1178632916689677.
Sindhu, J. B., Reddy, K. R., Netha, G. N. R., & Vani, D. S. (2016). Study of cutaneous manifestations in thyroid disorders. Journal of Evolution of Medical and Dental Sciences-James, 5(104), 7673-7679.