The thyroid gland is a small, butterfly-shaped structure located at the front of the neck. By secreting important hormones that balance metabolism, the thyroid plays a critical role in the body. The secretion of T3 and T4 hormones by the thyroid, whether in excess or deficiency, plays a decisive role in the slow or rapid functioning of other organs.
- Menstrual irregularity
- High blood pressure
- Irritable mood
- Restlessness
- Weight loss
- Feeling hot and sweating
- Palpitations
- Weakness, breakage, and loss of hair
- Persistent diarrhea
- Insomnia
- Hand tremor
- Eye disorders
- Excessive enlargement of the thyroid gland (goiter).
- Delayed puberty in males,
- Decrease in duration and frequency of menstruation in females,
- Fatigue,
- Depressive mood,
- Body edema,
- Excessive cold sensitivity,
- Hoarseness,
- Constipation,
- Weight gain,
- Difficulties in memory and concentration.
What Are Thyroid Diseases?
Imbalances in the hormones secreted by the thyroid, which plays a crucial role in the body, also cause some diseases. These diseases are analyzed under two headings as benign and malignant diseases. Thyroid diseases may arise from either excessive or insufficient hormone secretion or as a result of structural changes in the thyroid gland. For this reason, thyroid diseases should be considered carefully from both functional and structural perspectives.
Symptoms often develop insidiously and can initially be confused with other illnesses since it is associated with various systems. Symptoms like fatigue, weight changes, menstrual irregularities, and skin and hair problems can be seen in many individuals, causing thyroid dysfunction to be overlooked. Therefore, recognizing the symptoms of thyroid diseases and detecting them early is of utmost importance. Regular screening tests are particularly necessary for individuals with a family history and women.
Benign Thyroid Diseases and Treatment
Benign thyroid diseases arise from shape changes in the thyroid gland or hormone imbalances.
Goiter: Refers to the non-tumorous enlargement of the thyroid gland. Goiter may develop due to iodine deficiency, autoimmune diseases, or the presence of nodules. It manifests with symptoms such as neck fullness, difficulty swallowing, and voice changes. The treatment plan is determined according to the patient's age, size of the goiter, and accompanying complaints. In mild cases, observation and periodic follow-up may be sufficient, whereas surgery or radioactive iodine treatment may be necessary in larger goiters.
Hypothyroidism: Arises due to the inability of the thyroid gland to produce enough hormones. It typically develops as a result of an autoimmune process called Hashimoto's thyroiditis. Symptoms include weight gain, fatigue, cold intolerance, hair loss, and constipation. Diagnosis is confirmed with TSH and free T4 tests. Treatment usually involves synthetic thyroid hormones (levothyroxine) and may be lifelong.
Hyperthyroidism: Occurs when the thyroid gland produces more hormones than needed. The most common cause is Graves' disease. Symptoms include weight loss, palpitations, sweating, nervousness, and insomnia. Treatment includes antithyroid drugs, radioactive iodine, and surgical methods. The treatment plan is made considering the patient's age, thyroid hormone level, and overall health condition.
Regular monitoring with blood tests and thyroid ultrasonography is extremely important in benign thyroid diseases. Consistent adherence to medication and attention to lifestyle changes are necessary for treatment success.
Malignant Thyroid Diseases
Malignant thyroid diseases arise from the cancerization of the cells in the thyroid gland. Although thyroid cancer typically progresses slowly and is responsive to treatment, early diagnosis and appropriate intervention offer a high chance of success. There are four main types of thyroid cancer: papillary, follicular, medullary, and anaplastic.
Papillary thyroid cancer is the most commonly seen and generally good in prognosis. Follicular thyroid cancer may be slightly more aggressive. Medullary thyroid cancer might be genetically inherited and requires different treatment strategies. Anaplastic thyroid cancer is rare but may progress quickly and be resistant to treatment.
Thyroid cancer generally presents no symptoms and is diagnosed with nodules detected during routine check-ups. In some cases, hoarseness, swelling in the neck, difficulty swallowing, or breathing difficulty may occur. Diagnosis is clarified with thyroid ultrasound, fine needle aspiration biopsy, and blood tests.
In cancer types detected at an early stage, part or all of the thyroid gland is surgically removed. Post-surgery, some patients are treated with radioactive iodine to eradicate any remaining cells. During follow-up, TSH suppression therapy, thyroglobulin monitoring, and regular imaging are conducted.
How Is Thyroid Cancer Diagnosed?
Thyroid cancer is typically an asymptomatic cancer type. It is identified during follow-up examinations for goiter and similar diseases. In order to determine if the patient has a thyroid nodule, a thyroid ultrasound can be performed. If a nodule is detected in the patient, a fine needle aspiration biopsy may be conducted if deemed necessary by the physician.
Biopsy is a highly reliable method for evaluating the cellular structure of a nodule. The Bethesda classification is used for diagnosis, and a different treatment plan is devised for each category. Suspicious nodules are closely monitored, and surgical planning is made for malignant or high-risk structures.
Additionally, a thyroid scan is used to determine whether the nodule is hot or cold. Hot nodules are usually benign, but cold nodules need to be evaluated more carefully. The follow-up protocol after diagnosis is determined based on the patient’s age, tumor type, and stage.
What Are the Causes of Thyroid Cancer?
The most common cause of thyroid cancer is radiation exposure. Individuals who receive radiation above a certain level in childhood have a significantly increased risk of developing thyroid cancer as they age. Moreover, genetic predisposition is considered a risk factor for individuals with a family history of thyroid cancer.
Other factors that may contribute to thyroid cancer include iodine deficiency or excess, hormonal imbalances, autoimmune thyroid diseases, and environmental toxins. It is more common in women compared to men, highlighting the effect of hormonal changes.
Although the factors causing thyroid cancer cannot be fully controlled, performing regular check-ups in at-risk individuals is crucial for early diagnosis. It is recommended that individuals who have undergone radiotherapy or been exposed to high-dose radiation in childhood monitor their thyroid functions in later years.
Thyroid Cancer Treatment
Treating thyroid cancer involves the surgical removal of part or all of the thyroid gland. If recommended by the patient’s physician, radioactive iodine therapy may be applied after surgery. Patients are often given thyroid hormone supplements after surgery.
Suppressing TSH levels in the postoperative period is important to reduce the risk of cancer recurrence. Follow-up frequency after treatment may vary depending on the type and stage of thyroid cancer. Papillary and follicular cancers typically have a good long-term prognosis with regular follow-up, whereas more aggressive treatment may be required in medullary and anaplastic types.
Success rates in treating thyroid cancer are quite high. Post-treatment, maintaining a quality of life should be supported with regular check-ups, healthy eating, and stress management. Collaboration between endocrinology, oncology, and general surgery specialists enhances the success of the treatment.
Frequently Asked Questions
What Is Thyroid?
The thyroid is an endocrine gland shaped like a butterfly located at the front of the neck. Its primary function is the production of thyroid hormones, which regulate the body's metabolism rate. T3 (triiodothyronine) and T4 (thyroxine) hormones affect many systems, from heart rate to body temperature, the digestive system, and mood. When the thyroid gland does not function correctly, hormone production either decreases (hypothyroidism) or increases (hyperthyroidism). This leads to various systemic symptoms.
The healthy functioning of the thyroid gland directly affects many vital systems such as growth, development, reproductive health, heart, and brain functions. Therefore, thyroid issues should not be viewed merely as hormone imbalances, but as a comprehensive health problem. Thyroid imbalances can become more pronounced in women, especially during pregnancy and menopause.
What Are Thyroid Symptoms?
Thyroid symptoms vary depending on whether the thyroid gland is underactive or overactive. The two main conditions, hypothyroidism and hyperthyroidism, present with different symptoms.
Symptoms of hypothyroidism: Characterized by fatigue, tiredness, weight gain, sensitivity to cold, constipation, dry skin, hair loss, slowed heart rate, and a depressed mood. Since metabolism slows down, the person feels low energy throughout the day.
Symptoms of hyperthyroidism: Include palpitations, nervousness, increased appetite leading to weight loss, excessive sweating, insomnia, hand tremors, and muscle weakness. Due to the accelerated body system, the person may feel generally tense and uneasy.
If these symptoms persist for a long time, it is necessary to evaluate them for thyroid disease symptoms. Diagnosis is made by checking TSH, free T3, and T4 levels.
What Is Thyroid Disease?
What is thyroid disease? covers disruptions in hormone production or the structure of the thyroid gland. The most common thyroid diseases are: Hypothyroidism (insufficient hormone production), hyperthyroidism (excess hormone production), thyroid nodules, goiter (general gland enlargement), and thyroid cancer. Thyroid diseases can develop due to genetic predisposition, iodine imbalance, autoimmune diseases, stress, and environmental influences.
If not diagnosed early, it can lead to metabolic imbalance, heart rhythm disorders, depression, and weight problems. The diagnostic process is carried out through thyroid tests, ultrasonography, and biopsy if necessary.
What Is the Thyroid Gland?
The question of what is the thyroid gland? is important for understanding the body's hormone system. The thyroid gland is part of the endocrine system where hormones that regulate metabolism are produced. Its healthy functioning is critical for many bodily functions such as energy levels, body temperature, heart rhythm, mood, and weight control.
Thyroid gland health is important from the growth stage onwards. Especially during childhood and adolescence, thyroid hormone imbalances can lead to growth retardation, reduced school performance, and attention deficit. Therefore, if growth retardation is observed in children, thyroid functions should definitely be checked.
Which Department to Consult for Thyroid?
The question of which department to consult for thyroid is one of the most frequently asked by patients. The diagnosis and follow-up of thyroid diseases are managed by the following departments:
- Endocrinology and Metabolism Diseases: Adjusting thyroid hormones, monitoring nodules and goiter are the primary tasks of this branch. Endocrinologists are authorized in long-term monitoring and medication planning.
- Internal Medicine (Internal Diseases): Generally the first point of consultation. Performs basic tests like TSH and, if necessary, refers patients to endocrinology.
- General Surgery: Evaluates and plans surgical operations if there is suspicion of thyroid nodules, masses, or cancer. Especially intervenes when biopsy is necessary for nodules.
Additionally, the monitoring of thyroid diseases may involve other branches such as radiology, nuclear medicine, and pathology if required.
What Is a Thyroid Nodule?
The question of what is a thyroid nodule? is answered as round or oval masses formed in the thyroid gland. Nodules can be solitary or multiple, and while they are often benign, some may produce hormones (toxic nodule) or carry a cancer risk.
Thyroid nodules often present no symptoms. However, in some cases, symptoms such as difficulty swallowing, pressure sensation in the neck, or hoarseness may occur. Such nodules should be monitored with ultrasonography, and suspicious ones should undergo needle biopsy.
Which Thyroid Nodule Is Dangerous?
The question of which thyroid nodule is dangerous? is critically important for patients with detected nodules. Features of suspicious nodules include hardness, irregular borders, growth tendency in a short time, and the presence of microcalcification on ultrasonography.
Moreover, nodules causing symptoms like hoarseness and swallowing difficulties might be pressing on surrounding tissues. Nodules seen in individuals with a family history of thyroid cancer should be evaluated more carefully. In such cases, needle aspiration biopsy (FNA) is conducted for cellular examination.
Early intervention greatly enhances the success rates of treating thyroid cancers. Therefore, individuals with thyroid nodules should remain under regular observation and should not delay scheduled tests.