THYROID DISEASES

INTRODUCTION

• Thyroid diseases are conditions that affect the thyroid

gland
• Thyroid gland is a small butterfly-shaped gland located
in the front of the neck.
• It’s a part of your endocrine system.
• It releases thyroid hormones, like thyroxin
(T4) and triiodothyronine (T3).
• Thyroid hormones controls various bodily functions,
including metabolism, heart rate, body temperature,
and energy levels.
Hypothalamus-Pituitary-Thyroid axis
Hypothalamus T3/T4 binds to thyroid hormone
receptors which regulates the

 TRH  transcription of genes

Anterior Pituitary
Gland 
TSH

Thyroid Gland
T3/T4  Target Organs


 Types of Thyroid Disease

HYPOTHYROIDISM
HYPERTHYROIDISM (Insufficient Thyroid
(Excessive Thyroid Hormone Hormone Production)
Production)

1. Hashimoto’s disease
1. Graves' Disease:
2. Cretenism
2. Toxic Multinodular Goiter
3. Nontoxic Goiter
3. Thyroiditis
4. Thyroiditis
(Myxoedema)
5. Thyroid Nodule
6. Papillary Carcinoma of
thyroid
Hyperthyroidism
• Excessive thyroid hormone production and secretion.
• Also known as Thyrotoxicosis.
• Hyperthyroidism happens when the thyroid gland makes too
much thyroid hormone.
• This condition also is called overactive thyroid.
• Hyperthyroidism speeds up the body's metabolism.
Graves’ Disease
• It is an autoimmune disorder where antibodies stimulate the
thyroid gland to produce excess hormones.
• Pathogenesis:
– Autoantibodies known as thyroid-stimulating immunoglobulins (TSI)
formed.
– TSI bind to TSH(Thyroid Stimulating Hormone)
– Activate the thyroid-stimulating hormone (TSH)
– TSH stimulates the thyroid gland.
– This leads to excessive production and release of thyroid hormones
(T3 and T4).
– Growth and enlargement of Thyroid Gland (Goiter).
Graves’ Disease
DIAGNOSIS:
• TFT (Thyroid Function Test)
• Thyroid-Stimulating Immunoglobulin (TSI) Test
• Thyroid Ultrasound
Sign & Symptoms:
• Bulging Eyes (Opthalmopathy)
• Warm and moist skin(Dermopathy)
• Weight Loss
• Fatigue
• Rapid Heart beat
• Increased Appetite
• Excessive sweating
• Insomnia
• Hair loss
Graves’ Disease
Treatment:
• Beta blockers: Propranolol
• Anti-thyroid medication
• Radioiodine therapy
• Surgery (Thyroidectomy)
Toxic Nodular Goiter
 Also known as TMNG(Toxic Multi Nodular Goiter)
 It is a thyroid disorder characterized by the presence of multiple nodules
(lumps) in the thyroid gland that produce excessive amounts of thyroid
hormones, leading to hyperthyroidism.
Pathogenesis:
1. Thyroid gland develops multiple nodules or lumps within the gland.
2. These nodules produce and releases thyroid hormones (T3 and T4)
independently of thyroid-stimulating hormone (TSH) regulation.
3. these nodules results in elevated levels of thyroid hormones in the
bloodstream.
4. Leading to hyperthyroidism.
Sign & Symptoms

– Weight Loss: Despite increased appetite

– Heat Intolerance: Increased sensitivity to heat
– Tremors: Fine tremors of the hands
– Palpitations: Rapid or irregular heartbeat
– Fatigue: Despite increased activity
– Muscle Weakness: Especially in the upper arms and thighs
• Goiter:
– Enlargement of the thyroid gland due to the presence of multiple
nodules.
• Tachycardia:
– Rapid or irregular heartbeat due to elevated thyroid hormone levels.
Toxic Nodular Goiter
Diagnosis:
• Thyroid Function Tests:
– Elevated levels of thyroid hormones (T3 and T4)
– Low or normal TSH levels
• Thyroid Ultrasound:
– To evaluate the size, number, and characteristics of the thyroid
nodules
• Biopsy: To check Cancerous cells

Treatment:
• Beta blockers: Propranolol
• Anti-thyroid medication
• Radioiodine therapy
• Surgery (Thyroidectomy)
Sign & Symptoms
• Slower-than-usual heart rate.
• Feeling tired (fatigue).
• Unexplained weight gain.
• Feeling sensitive to cold.
• Dry skin and dry and coarse hair.
• Depressed mood
• Heavy menstrual periods (menorrhagia)
Hypothyroidism
• Insufficient production of thyroid hormones by the thyroid
gland
• Slowdown of the body's metabolic rate
• Hyperthyroidism happens when the thyroid gland makes too
much thyroid hormone.
• This condition also is called overactive thyroid.
• Hyperthyroidism speeds up the body's metabolism.
Sign & Symptoms
• General Symptoms:
– Fatigue: Persistent tiredness and lack of energy
– Weight Gain: Despite no change in diet or exercise
– Cold Intolerance: Feeling excessively cold in normal or cool environments
– Constipation: Infrequent bowel movements
– Dry Skin: Skin becomes dry, rough, and pale
– Hair Loss: Thinning hair or loss of hair
– Muscle Weakness: Especially in the arms and legs
• Cardiovascular Symptoms:
– Bradycardia: Slow heart rate
– Hypertension: Elevated blood pressure
– Hypercholesterolemia: Elevated cholesterol levels
• Reproductive Symptoms (in women):
– Menstrual Irregularities: Heavy, prolonged, or irregular menstrual periods
– Infertility: Difficulty getting pregnant
Cretenism:

• Cretinism, is a congenital disorder of thyroid gland.

• It occurs due to the inadequate production of thyroid
hormones by the thyroid gland during fetal development or
shortly after birth.
Hashimoto’s Disease:

• Hashimoto's disease, also known as Hashimoto's thyroiditis

• It is an autoimmune disorder that causes inflammation of the
thyroid gland, leading to hypothyroidism or underactive
thyroid function.
• In this Antibodies are produced against Thyroid Gland and
destroy thyroid gland.
Non-Toxic Goiter:

• Non-toxic goiter refers to an enlargement of the thyroid gland

• It is a benign condition leads to thyroid enlargement.
Myxoedema:

• It is hypothyroidism disorder occurs in Adults.

• Develops due to :
– Autoimmune thyroiditis
– Thyroidectomy (Surgical removal of thyroid Gland)
Thyroid nodule:

• A thyroid nodule is a abnormal nodule(lump) or abnormal

growth within the thyroid gland.
• Thyroid nodules are noncancerous (benign).
• These nodules do not respond to TSH.
Diagnosis
• Thyroid Function Tests:
– Low Levels of Thyroid Hormones: Decreased levels of free T4
(thyroxine) and free T3 (triiodothyronine).
– Elevated TSH Levels: Increased levels of thyroid-stimulating hormone
(TSH) due to feedback mechanism trying to stimulate the thyroid
gland.
• Antithyroid Antibody Tests:
– Positive thyroid peroxidase (TPO) antibodies in autoimmune thyroiditis
(Hashimoto's thyroiditis).
• Thyroid Ultrasound:
– To evaluate the size, structure, and characteristics of the thyroid gland,
especially in cases of goiter or suspected thyroid nodules.
TREATMENT
• Thyroid Hormone Replacement Therapy:
– Levothyroxine (Synthroid, Levoxyl): Synthetic thyroid
hormone medication that replaces the deficient thyroid
hormones.
• Monitoring:
– Regular follow-up visits with a healthcare provider to
monitor thyroid function, adjust medication dosages, and
evaluate for potential complications.
TREATMENT
• Dietary Changes:
– Iodine-Rich Foods:
• iodized salt, seafood, dairy products, and seaweed.
– Balanced Diet:
• Diet rich in fruits, vegetables, lean proteins, whole grains, and healthy fats
to support overall health and metabolism.
– Limit Goitrogenic Foods:
• Foods like cabbage, broccoli, cauliflower, kale, spinach, and soy products,
(especially raw or in large amounts).
• Regular Exercise:
– Physical Activity:
• Engage in regular physical activity such as walking, jogging, cycling,
swimming, or yoga to boost metabolism, improve energy levels, and
manage weight.
– Strength Training:
• Incorporate strength training exercises to build muscle mass, which can
help increase metabolism and improve overall body composition.