Thyroid Disorders

Thyroid Gland

The thyroid gland is situated at the front of the neck, below the voice box or larynx (Adam's apple).

​​The thyroid gland produces thyroid hormones that are important for:

• Development and growth
• Regulation of body temperature
• Energy expenditure & metabolism
• Heart rhythm and regulation of breathing
• Ovulation & development of pregnancy

Pregnancy

Thyroid dysfunction can affect a person at any age and it’s more common among women than men.
​During pregnancy, imbalances in thyroid hormones can cause:

• Miscarriages
• Foetal growth restriction and cognitive impairment
• Maternal high blood pressure
• Premature delivery
• Placental abruption

How are thyroid hormones made and regulated?

Thyroid hormones (T4 and T3) are made by the thyroid gland from iodine rich food.

The amount of thyroid hormones secreted by the thyroid gland is controlled by the pituitary gland, via a hormone called thyroid stimulating hormone (TSH).  

Feedback loop
Although the pituitary gland is the control centre, circulating thyroid hormones are fed back to the pituitary gland to modulate the amount of TSH released, thus keeping the thyroid hormones in the normal range. 

• When circulating levels of T4 or T3 hormones fall, the pituitary gland drives the thyroid to produce more T4 and T3 via up-regulating TSH. When there is enough T4 and T3, TSH levels return to normal.
• ​Conversely if there is excess thyroid hormones in the circulation, the pituitary gland switches off TSH until T4 and T3 are normal. TSH turns on when more thyroid hormone is needed.

Too much or too little is not good for you

Transient and subtle changes in your thyroid gland may go unnoticed. Overt changes rarely does as thyroid hormones control many aspects of your body.

EXCESSIVE thyroid hormone is called Hyperthyroidism. 
​Patients may report:

• Exhaustion, anxiety, insomnia
• Intolerance to heat
• Excessive sweating
• Unexplained weight loss
• Thinning of hair
• Rapid heart rate or palpitations
• Tremor
• Gritty, dry building eyes
• Loose +/- frequent stools
• Infertility and miscarriages​

INADEQUATE thyroid hormone is called Hypothyroidism. 
​Patients may report:

• Lethargy, apathy, depression
• problems with concentration
• Intolerance to cold
• Unexplained weight gain
• Coarse and dry hair
• Slow heart rate
• Constipation 
• Puffy face & fluid retention
• Heavy or irregular periods
• Infertility and miscarriages

​

Investigations and Diagnoses

Thyroid disease can be diagnosed from history, physical examination and careful interpretation of blood tests and thyroid imaging.

Treatment

​Treatment advice depends on the underlying cause, severity of presentation and whether you’re pregnant or planning to fall pregnant.