Thyroid Gland and Its Diseases

Dr. Aquib K Shaick, Senior Consultant, Surgical Oncology, SUT Hospital, Pattom

The thyroid gland is located in the lower part of the neck. It produces a hormone called thyroxine, which is essential for the normal functioning of almost all organs in the body. The thyroid can be affected by various diseases, which can be broadly classified into:

1. Malfunction of the gland
2. Tumors in the thyroid

Malfunction of the Thyroid

Thyroid malfunction can be of two types:

1. Hyperthyroidism (Overactive Thyroid)
2. Hypothyroidism (Underactive Thyroid)

Symptoms of Hyperthyroidism

• Weight loss
• Increased appetite
• Tremors (shivering)
• Palpitations

Symptoms of Hypothyroidism

• Fatigue
• Excessive sleep
• Weight gain and obesity

Tumors Affecting the Thyroid

Thyroid tumors can be classified into:

1. Benign nodules
2. Cancerous nodules

Diagnosis of Thyroid Diseases

Three common diagnostic tests are used to detect thyroid-related conditions:

• Ultrasound scan of the neck
• Blood test to assess thyroid function
• Fine Needle Aspiration Cytology (FNAC)

Treatment of Thyroid Disorders

1. Treatment of Hyperthyroidism
   If a patient shows symptoms of hyperthyroidism, a thyroid function test (blood test) and ultrasound of the neck are recommended. Once the diagnosis is confirmed, treatment options include:
   • Antithyroid medications
   • Surgery (Total Thyroidectomy)
   • Radioactive iodine ablation

   The best approach is usually to manage thyroid hormone levels with antithyroid medications before considering surgery.

2. Treatment of Hypothyroidism
   If a blood test confirms low thyroid hormone levels, an ultrasound scan is necessary to check for the presence of tumors in the thyroid gland.If no tumors are found, patients only need thyroxine supplements to regulate hormone levels. If a tumor is detected, an FNAC test is performed to determine if it is abnormal or malignant. Depending on the results, surgery may be required.

Treatment of Thyroid Tumors

For tumors not associated with hypothyroidism, treatment differs based on whether the nodule is benign or cancerous. Thyroid cancer is diagnosed through an FNAC test. The standard treatment is total thyroidectomy (complete removal of the thyroid). If cancer has spread to the lymph nodes, a procedure called neck dissection may also be necessary.

Is Surgery Required for Non-Cancerous Nodules?

In some cases, benign thyroid nodules can exert pressure on nearby organs in the neck, leading to difficulty in swallowing, breathlessness, voice changes etc. If these symptoms are present, total thyroidectomy may be required.

Thorough diagnosis and appropriate treatment are crucial for managing thyroid disorders. Patients should always follow the guidance of a specialist doctor for the best outcomes.