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Thyroid disease

Further information: Thyroid disease in women
Thyroid disease
An illustration of goiter, a type of thyroid disease
SpecialtyEndocrinology, medical genetics Edit this on Wikidata

Thyroid disease is a medical condition that affects the function of the thyroid gland. The thyroid gland is located at the front of the neck and produces thyroid hormones[1] that travel through the blood to help regulate many other organs, meaning that it is an endocrine organ. These hormones normally act in the body to regulate energy use, infant development, and childhood development.[2]

There are five general types of thyroid disease, each with their own symptoms. A person may have one or several different types at the same time. The five groups are:

  1. Hypothyroidism (low function) caused by not having enough free thyroid hormones[2]
  2. Hyperthyroidism (high function) caused by having too many free thyroid hormones[2]
  3. Structural abnormalities, most commonly a goiter (enlargement of the thyroid gland)[2]
  4. Tumors which can be benign (not cancerous) or cancerous[2]
  5. Abnormal thyroid function tests without any clinical symptoms (subclinical hypothyroidism or subclinical hyperthyroidism).[2]

In the US, hypothyroidism and hyperthyroidism were respectively found in 4.6 and 1.3% of the >12y old population (2002).[3]

In some types, such as subacute thyroiditis or postpartum thyroiditis, symptoms may go away after a few months and laboratory tests may return to normal.[4] However most types of thyroid disease do not resolve on their own. Common hypothyroid symptoms include fatigue, low energy, weight gain, inability to tolerate the cold, slow heart rate, dry skin and constipation.[5] Common hyperthyroid symptoms include irritability, anxiety, weight loss, fast heartbeat, inability to tolerate the heat, diarrhea, and enlargement of the thyroid.[6] Structural abnormalities may not produce symptoms, however some people may have hyperthyroid or hypothyroid symptoms related to the structural abnormality or notice swelling of the neck.[7] Rarely goiters can cause compression of the airway, compression of the vessels in the neck, or difficulty swallowing.[7] Tumors, often called thyroid nodules, can also have many different symptoms ranging from hyperthyroidism to hypothyroidism to swelling in the neck and compression of the structures in the neck.[7]

Diagnosis starts with a history and physical examination. Screening for thyroid disease in patients without symptoms is a debated topic although commonly practiced in the United States.[8] If dysfunction of the thyroid is suspected, laboratory tests can help support or rule out thyroid disease. Initial blood tests often include thyroid-stimulating hormone (TSH) and free thyroxine (T4).[9] Total and free triiodothyronine (T3) levels are less commonly used.[9] If autoimmune disease of the thyroid is suspected, blood tests looking for Anti-thyroid autoantibodies can also be obtained. Procedures such as ultrasound, biopsy and a radioiodine scanning and uptake study may also be used to help with the diagnosis, particularly if a nodule is suspected.[2]


Thyroid diseases are highly prevalent worldwide,[10][11][12] and treatment varies based on the disorder. Levothyroxine is the mainstay of treatment for people with hypothyroidism,[13] while people with hyperthyroidism caused by Graves' disease can be managed with iodine therapy, antithyroid medication, or surgical removal of the thyroid gland.[14] Thyroid surgery may also be performed to remove a thyroid nodule or to reduce the size of a goiter if it obstructs nearby structures or for cosmetic reasons.[14]

  1. ^ Hall JE, Guyton AC. Guyton and Hall textbook of medical physiology. OCLC 434319356.
  2. ^ a b c d e f g Bauer DC (2013). Hammer G, McPhee SJ (eds.). Pathophysiology of Disease: An Introduction to Clinical Medicine (Seventh ed.). New York, NY.: McGraw-Hill – via AccessMedicine.
  3. ^ Hollowell, Joseph G.; Staehling, Norman W.; Flanders, W. Dana; Hannon, W. Harry; Gunter, Elaine W.; Spencer, Carole A.; Braverman, Lewis E. (2002). "Serum TSH, T4, and Thyroid Antibodies in the United States Population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III)". The Journal of Clinical Endocrinology & Metabolism. 87 (2): 489–499. doi:10.1210/jcem.87.2.8182. PMID 11836274. S2CID 10850710.
  4. ^ Papadakis MA, McPhee SJ, Rabow MW, eds. (2018-09-07). "Endocrine Disorders". Current medical diagnosis & treatment 2019. ISBN 978-1260117431. OCLC 1050994785.
  5. ^ "Hypothyroidism (Underactive Thyroid)". www.niddk.nih.gov. Retrieved 2016-12-16.
  6. ^ "Hyperthyroidism". www.niddk.nih.gov. Archived from the original on 2016-12-20. Retrieved 2016-12-16.
  7. ^ a b c Kasper DL, Fauci AS, Hauser SL, Longo DL, Larry Jameson J, Loscalzo J (2018-02-06). "Thyroid Nodular Disease and Thyroid Cancer". Harrison's principles of internal medicine (Twentieth ed.). New York. ISBN 9781259644047. OCLC 990065894.{{cite book}}: CS1 maint: location missing publisher (link)
  8. ^ "Final Recommendation Statement: Thyroid Dysfunction: Screening - US Preventive Services Task Force". www.uspreventiveservicestaskforce.org. Retrieved 2018-11-30.
  9. ^ a b Hammer GD, McPhee SJ (2018-11-26). "Thyroid Disease". Pathophysiology of disease : an introduction to clinical medicine (Eighth ed.). New York. ISBN 9781260026504. OCLC 1056106178.{{cite book}}: CS1 maint: location missing publisher (link)
  10. ^ Turkish Endocrinology and Metabolism Association. (2013). Tiroid hastalıkları tanı ve tedavi kılavuzu [Diagnosis and treatment of thyroid diseases guide] (5th Edition). Ankara, Turkey: Miki Matbaacılık.
  11. ^ Atasayar S, Guler Demir S (June 2019). "Determination of the Problems Experienced by Patients Post-Thyroidectomy". Clinical Nursing Research. 28 (5): 615–635. doi:10.1177/1054773817729074. PMID 28882054. S2CID 8593999.
  12. ^ Müller PE, Jakoby R, Heinert G, Spelsberg F (November 2001). "Surgery for recurrent goitre: its complications and their risk factors". The European Journal of Surgery = Acta Chirurgica. 167 (11): 816–21. doi:10.1080/11024150152717634. PMID 11848234.
  13. ^ Cite error: The named reference :0 was invoked but never defined (see the help page).
  14. ^ a b Cite error: The named reference :4 was invoked but never defined (see the help page).

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