Millions of people around the world are affected by a thyroid disease: for example, an enlarged thyroid gland, also called goiter. Overactive or underactive, or benign or malignant thyroid nodules. Some thyroid diseases can be treated with medication. Others, however, require thyroid surgery. During surgery, a neuromonitoring device can help protect nerves from injury.

Definition of Thyroid

The thyroid is located in the lower front part of the neck, just in front of the windpipe. It has the shape of a butterfly because it consists of two “lobes” that lie on either side of a thin strip of fabric. The nerves that control the vocal cords run just behind the thyroid. Usually, you can neither see nor feel the thyroid gland. However, if it is enlarged, a swelling forms on the neck: the goiter or goiter. With other thyroid diseases, a noticeable goiter does not necessarily have to form.

The thyroid gland produces, among other things, the two important hormones thyroxine (T4) and triiodothyronine (T3). These hormones play an important role in metabolism, i.e. in converting the food ingested into energy for the body. If the thyroid is not working properly, the body uses up energy too slowly or too quickly.

What thyroid diseases are there?

The most common thyroid disease is hypothyroidism. A basic distinction is made between congenital and acquired thyroid disorders. But it is much more important whether the thyroid gland produces too little or too many hormones. According to this, doctors differentiate between an underactive thyroid (too few hormones) and an overactive thyroid (too many hormones).

Several causes disturb the function of the thyroid gland: the organ is not properly developed, inflamed, or maligned. Well-known diseases of the thyroid are, for example:

• Hashimoto’s thyroiditis
• Graves disease
• Thyroid autonomy
• Inflammation of the thyroid gland
• Thyroid cancer

The thyroid sometimes tries to compensate for functional disorders or too little iodine by enlarging into a goiter (goiter). Thyroid nodules may also form.

Causes of Thyroid diseases

Goiter (goitre)

A goiter (goitre) can have many causes, for example:

• Graves’ disease – An autoimmune disease that can cause the thyroid gland to swell and become overactive.
• Thyroiditis (inflammation of the thyroid gland), for example from a viral infection.
• Iodine Deficiency – The thyroid needs iodine to produce hormones. With a diet low in iodine, the thyroid gland enlarges.
• Medicines with active ingredients such as amiodarone, interferon-alpha, and lithium.
• In some people, the tendency to have a large thyroid runs in their families.

Thyroid nodules 

Thyroid nodules (small swellings in the thyroid gland) can be of different types:

• Cyst – a fluid-filled benign tumor
• Adenoma – solid benign tumor
• less often: thyroid carcinoma (malignant tumor)

Possible causes of an overactive thyroid (hyperthyroidism) are, for example, Grave’s disease or thyroid nodules.

The two most common causes of underactive thyroid (hypothyroidism) are autoimmune diseases (when white blood cells destroy the cells of the thyroid gland) and side effects of treating thyroid disease. Genetic factors, complications from viral infections, and the side effects of certain drugs rarely cause hypothyroidism.

Symptoms of Thyroid diseases

Hypothyroidism

In hypothyroidism, the so-called hypothyroidism, the thyroid pours to small amounts of hormones. Symptoms of this condition include weight gain, tiredness, and feeling cold.

Hypothyroidism affects more women than men. The metabolic disorder is discovered usually between the ages of 40 and 60. The number increases with age. But children can also suffer from an underactive thyroid.

Tiredness, exhaustion, a swollen face, dry skin, and rough hair: These are typical symptoms of an underactive thyroid. A change in eating habits or weight gain can also be signs of thyroid disease.

In children, it is often less characteristic; for example, through listlessness, concentration and attention disorders, and obesity. A learning disability is often noticeable at school.

Hypothyroidism often requires taking tablets that contain thyroid hormones. Proper nutrition can also support thyroid function. With the right treatment, you can lose weight despite being underactive.

Hyperthyroidism

In contrast to hypothyroidism, the organ produces too many thyroid hormones when it is overactive.

The most common causes of hyperthyroidism are Graves’ disease and thyroid autonomy. In Graves’ disease, your immune system damages the thyroid. So, it is an autoimmune disease. Graves are more common in women than men and are usually diagnosed after the age of 35.

With thyroid autonomy, the organ, or at least parts of it, independently produces too many hormones. The risk of developing this thyroid disorder increases with age.

Typical symptoms of an overactive thyroid are hair loss, excessive sweating, tremors, racing heart, diarrhea or weight loss. In Graves’ disease, the inflammatory processes sometimes also protrude the eyes.

Special drugs, so-called thyreo statics, help against an overactive thyroid. Normal metabolism is achieved with this. Only then does the doctor plan to treat the actual cause, such as surgery or radioiodine therapy.

What are the symptoms of thyroid disease?

Thyroid hormones affect many processes in the body. If problems arise here, complaints can occur in different parts of the body. A Hashimoto’s thyroiditis is manifested by symptoms of hypothyroidism.

General symptoms of an underactive thyroid:

• fatigue
• Slightly cold
• Weight gain, constipation
• Sadness, depression
• Slow heartbeat (bradycardia)

Graves’ disease can be recognized by the symptoms of an overactive thyroid, but patients with thyroid autonomy also suffer from it.

General symptoms of an  overactive thyroid gland:

• Weight loss, diarrhea
• Sweating, sensitivity to heat
• Difficulty sleeping, poor concentration
• Inner restlessness, tremor
• Palpitations, palpitations

Those affected by Graves’ disease sometimes have protruding eyes (bulging eyes). They arise from an increase in connective tissue behind the eyeball. Doctors speak of endocrine orbitopathy.

Hyperthyroidism complaints, on the other hand, are also often complained by people who are sick with thyroid inflammation. Often, additional symptoms are:

• Fever
• Severe pain, swelling, redness, and overheating in the thyroid area
• Radiating pain in jaw and ear
• Difficulty swallowing (dysphagia)

In a thyroid often symptoms do not occur until later. Common symptoms include:

• Thyroid nodules
• Difficulty swallowing (dysphagia)
• Persistent hoarseness
• Stridor
• Swelling of the lymph nodes

With any thyroid disease, the organ can also enlarge. Doctors then speak of a goiter. Thyroid enlargement is popularly known as goiter. It can occur through too little iodine alone (iodine deficiency goiter).

Risk factors for thyroid disease

Certain factors increase your risk of developing thyroid disease:

• Gender – Women are six to eight times more likely to develop thyroid disease than men.
• Age – From the age of 50, there is an increased risk of thyroid disease.
• Thyroid problems during or after pregnancy, or thyroid disease in a close relative
• Smoking – smokers (including former ones) have an increased risk of autoimmune thyroid disease.
• Iodine deficiency
• The body receives too much iodine from dietary supplements.
• Certain forms of medical treatment and drugs
• Excessive stress or high psychological and physical stress

Diagnosis of thyroid diseases

To diagnose thyroid disease, the doctor not only examines the thyroid gland but also other factors that can make thyroid problems noticeable: for example, skin, nails, hair, heart function, weight, or body temperature.

A blood test provides information about the level of thyroid hormones. An imaging exam, such as an x-ray, may also be needed. If a lump is found in the thyroid gland, the doctor can insert a fine needle into the lump. He takes cells for analysis and can determine whether the lump is benign or malignant.

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