Thyroid gland is situated in our neck. This butterfly shaped gland produces three major hormones, thyroxine or T4 and triiodothyronine or T3 and calcitonin which regulates how the body uses calcium. T3 and T4 travel the entire body and are responsible for controlling the metabolism of the body and influence almost all other processes in the body. Which means these hormones regulate breathing, heart rate, fertility, brain function, heart health, kidney function, temperature, digestive system, bone development, mood and more.

“Any disorder in thyroid functioning can result in a range of health issues,” says Dr S K Wangnoo, endocrinologist, Indraprastha Apollo Hospitals, New Delhi. These include high/low heart rate, change in muscle, brain and digestive function, and issues with bone maintenance.

Playing a powerful role in overall health and wellbeing, it is very important to maintain the suggested levels of thyroid in the body—which otherwise leads to dry skin, constipation, fatigue, nervousness, depression and more. Indian Journal of Endocrinology and Metabolism Journal says that about 42 million people in India suffer from thyroid diseases. For every 100,000 persons, the incidence of thyroid disorders is about 1 for males and 1.8 for females.

Studies find correlation between the levels of vitamin D in the body and development of thyroid diseases. British Thyroid Foundation says that patients with hypothyroidism or hyperthyroidism may have low levels of vitamin D. It also says that “it is possible that low vitamin D may permit the under-performing immune system to facilitate progression of thyroid disease. While more research needs to be done, there is a growing understanding on the importance of vitamin D for overall health, including for a healthy thyroid function.”

Common thyroid disorders and their symptoms
Hypothyroidism: Also known as an underactive thyroid, the gland does not produce enough thyroxine hormone in this condition. Common symptoms of hypothyroidism include tiredness, fatigue, dry skin, brittle nails, hair loss, weight gain, hoarse voice, menstrual irregularity in females, and decreased libido in males.

Hyperthyroidism: Hyperthyroidism is an overactive thyroid that produces too much of thyroxine. Symptoms include increased appetite but unintentional weight loss, palpitation, irritation, and anxiety.

Thyroiditis: Thyroiditis is a basic transient condition where a person may attain overactive or underactive thyroid for 4-6 weeks. There are two types of thyroiditis:

1. Sub-acute thyroiditis: It is a condition when the thyroiditis resolves itself spontaneously in 4-6 weeks.

2. Autoimmune thyroiditis: In this condition, the patient is prone to develop hypothyroidism in later stages.
Subclinical hypothyroidism/hyperthyroidism: A rare condition occurring in 3-8% of the general population, subclinical hypothyroidism/hyperthyroidism occurs when TSH (thyroid stimulating hormone) levels are mildly elevated.

Effect of thyroid disorders on pregnancy
A woman who is planning to conceive should strictly have thyroid under control, says Dr Wangnoo. A woman who is already pregnant but faces risks of thyroid complication such as in PCOS (PCOS is associated with high incidence of thyroid disorders), should be monitored for her thyroid levels in every 4-6 weeks of pregnancy. An untreated thyroid in pregnancy increases the chances of miscarriages and preterm delivery, explains the doctor. In fact, one of the common causes for recurrent miscarriages could be due to thyroid disorders, adds the doctor.

Risk factors for thyroid disorders
Dr Wangnoo says that you are prone to thyroid if you have:

1. Family history of thyroid

2. Autoimmune disorders such as PCOS or type-1 diabetes.
 

Diagnosis of thyroid disorders in India is done using the following tests

1. T3, T4, TSH: These blood tests help to diagnose the type of thyroid disorder. The results/values of these tests are of primary importance.

2. Thyroid Antibodies Test: This test measures the level of thyroid antibodies in the blood. “This test is not done routinely, but is mostly prescribed when the doctor suspects autoimmune thyroid,” says the doctor.
3. Thyroid ultrasound/Scan: This test helps to evaluate the presence of lumps or nodules in the thyroid gland.

4. Thyroid biopsy: A doctor suggests biopsy under the suspicion of cancer.
Treatment of different thyroid disorders
Hypothyroidism: The patient requires simple substitution of thyroid hormone with tablets. These tablets should be taken early in the morning on an empty stomach. “The medication for hypothyroid should be continued for a lifetime except that the doses of medication may vary from time to time depending on laboratory results,” says Dr Wangnoo.

Hyperthyroidism: This disorder is mainly treated using three different methods:

1. Medication: Anti-thyroid tablets are prescribed to patients and this treatment may last for 2-6 years.
2. Use of radio-active iodine: A single dose of radio-active iodine controls the overactive property of thyroid gland. The disorder transforms itself into hypothyroid in a period of 3-4 months. The treatment is then followed by using tablets to keep thyroid in appropriate range.
3. Surgery: A surgical procedure may be needed to remove some or all parts of the thyroid gland.

Thyroiditis: This kind of thyroid disorder does not require any treatment as it often gets cured spontaneously. “Note that thyroiditis is a self-limiting disorder,” says Dr Wangnoo.

Subclinical hypothyroidism/hyperthyroidism: This does not require any treatment. The patient needs to be observed and followed up regularly.

Tips to keep thyroid gland healthy

1. In general, there is no one-size-fits-all thyroid diet. However, studies show that an increase in dietary fibre, a cut down on harmful fats, and consuming healthy foods like fruits, vegetables, whole-grain foods, and nuts are all beneficial.

2. Have iodine in your diet as per recommended doses because thyroid gland relies on iodine for the production of thyroid hormone. Some good sources of iodine include fish, eggs and seafood.

3. Maintain a healthy BMI score. Studies find the positive effect of regular physical exercise on the thyroid function—in the case of hypothyroid. Do exercise to burn more calories and help maintain healthy weight.

4. For an optimum thyroid diet, ensure having enough of vitamin D, selenium and vitamin B12. These help the thyroid gland to function at its best. Some sources include eggs, milk, mushroom, salmon, tuna and sunflower seeds.