Thyroid is a butterfly shaped gland situated in, front part of neck below larynx i.e. the voice box. This gland makes thyroxine hormone T3 (Total or Free Tri-iodo Thyronine) & T4 (Tetraiodo Thyronine).
These two hormones are under control of TSH (Thyroid Stimulating hormone) which is secreted from pituitary gland in brain. The above Thyroid hormones control many of the organ’s function.
When Thyroid hormone is increased in blood then it is called thyrotoxicosis (Hyperthyroidism) & when these hormones are low i.e. decreased in blood it is called Hypothyroidism (Myxoedema) & when thyroid hormone is normal in blood it is called Euthyroid.Thyroid gland size may increase than normal then it is called goitre (normal size is 2 cm wide & 2 cm. long).
Thyrotoxicosis is a condition when thyroid hormone T3, T4 concentration increases in blood along with subnormal i.e. suppressed or low TSH is called Thyrotoxicosis.
Causes of it are Hyperthyroidism, Graves disease, Toxic multi-nodular goitre, toxic adenoma, thyroiditis (silent & sub-acute) & iatrogenic thyrotoxicosis, struma ovarii & pregnancy induced thyrotoxicosis ,iodine induced.
The symptoms of thyrotoxicosis are swelling in neck (goitre), weight loss, increased appetite, excessive sweating, palpitation, high blood pressure,,darkening of skiin, sometimes heart may fail or can develop atrial fibrillation (Thyrocardiac disease), swelling of leg, hair fall, vitiligo in skiin, sometime thickening & roughening of the skiin of leg. Eye may becomes more prominent & red sometimes may even protrude out. Sometime patient may get double vision (Diplopia) or rarely reduction of vision (Thyroid Ophthalmopathy). Patient may gets extreme weakness (Tiredness), body pain, dyspnoea (breathlessness on exertion i.e. exercise). Patient may also get recurrent diarrhoea, nervousness insomnia, anxiety, tremors of hand. Sometimes patient gets severe weakness of muscles so that he may feel difficulty in getting up from sitting posture (Thyrotoxic myopathy). Approximately one percent patient develop thyrotoxic periodic paralysis in which patient gets repeated bouts of temporary severe weakness of body so that he may can not stand up for few hours intermittently.
Bone may get weak called osteoporosis, also serum calcium & alkaline phosphatase may increase patient may pass excess of urine, develops anemia. It leads to lack of development of beard & moustache in boys & breast development in boys (Gynecomastia). In females it leads to infertility i.e. difficulty in conceiving & even if conceives leads to abortion.
Thyroiditis is one of the common cause of thyrotoxicosis. This is of three type as follows :
Subacute Thyroiditis: In this condition there occurs inflammation i.e. swelling in thyroid gland due to viral infection. Symptoms are swelling in neck, pain in neck, throat pain, fever, along with symptoms & signs suggestive of Thyrotoxicosis.Tests required for proper diagnosis are throid test, ESR, thyrod antibody test & thyroid scan. With appropriate treatment it is cured permanently in two months.
Silent Thyroiditis : In thyroiditis there occurs leakage of preformed thyroid hormone from thyroid gland in blood due to inflammation (i.e. holes) in thyroid gland. In silent thyroiditis etiology is idiopathic with symptom & signs of thyrotoxicosis but no pain or fever.with proper diagnosis & trweatment it is cured easily
(6)Hashimoto Thyroiditis: In this condition there occurs swelling of thyroid due to deposition of inflammatory cells in the thyroid. Symptoms are thyroid enlargement i.e. goiter & symptoms of thyrotoxicosis.
Thyrotoxicosis (Thyroid) during pregnancy we keep thyroid hormone under tight control by every six weekly thyroid test & dose adjustment accordingly
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