Thyroid disease

GOITRE

1. Goitre means enlargement of thyroid.

2. Hormone level may be normal ( euthyroid), low or high. Thyroid can become hyperactive ( hyperthyroidism) or less active (hypothyroidism).

Types of Goitre

1. "Toxic goiter" is associated with hyperthyroidism.

2. "Nontoxic goiter" is associated with euthyroidism.

3. "Diffuse goiter" is a goiter that causes diffuse enlargement of all of the thyroid.

Investigations

1. Regular monitoring ( every 6 monthly) of T3, T4, TSH is necessary. This should be done in a standard laboratory preferably experienced in endocrine tests.

2. Lipid profile-

Lipids will be high in hypothyroidism.
Read -
Lipids-Enemy of health

Causes of Goitre

1. Goitrogens are certain substances in food like cassava which can cause goiter

2. Iodine is essential for thyroid hormone ( T3, T4) synthesis. Iodine deficiency in the diet will lead to hypothyroidism

3. Hashimoto's thyroiditis - This is an autoimmune disease

Management

This depends upon thyroid status whether hyperthyroidism or hypothyroidism

Rx of hyperthyroidism

Beta-blockers

Propranolol and metoprolol.
These relieve tremors, tachycardia.

Antithyroid drugs

1. Carbimazole
2. Methimazole
3. Propylthiouracil

Radiation therapy

Radioisotope therapy - Radioactive iodine-131 is used for radioablation of gland. This has to be done meticulously to avoid hypothyroidism.

Rx of hyperthyroidism

Iodine should be supplied through diet. Iodized salt is recommended

1. Consult an endocrinologist

2. Supplementation with thyroid hormones – thyroid replacement therapy

3. Tablet Eltroxin – Dose has to be adjusted very carefully

4. Include foods containing iodine in diet. Animal products like fish, salmon, oyster, Corals, sea, lobster, lettuce, butter

5. Avoid goitrogenic substances like peanuts, soybeans, peaches, cabbage, mustard, cauliflower

Read -

Cretinism-congenital-hypothyroidism

Thyroid disease

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Thyroid disease - Goitre

GOITRE

Types of Goitre

Investigations

Causes of Goitre

Management

Rx of hyperthyroidism

Beta-blockers

Antithyroid drugs

Radiation therapy

Rx of hyperthyroidism

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