The thyroid gland’s main function is to secrete the thyroid hormone, whose role is to ensure equilibrium in the metabolism, growth and development. Decreased function of this gland can cause mild to moderate weight gain or inability to lose weight, in addition, it can also cause fatigue, hair loss, menstrual irregularities, constipation, cold intolerance, coarse hair and dry skin.
The most common cause of its decreased function is the condition called Hashimoto thyroiditis, where the immune system produces antibodies that attack the thyroid cells and block them from producing the hormones. Other causes of decreased thyroid function is viral infection and intake of multiple medications, particularly amiodarone (cordarone) which is used to treat heart disease, in addition to contrast material which is given during radiological investigation (such as CT scan).
As such it is important to identify the problem through prescribed tests. Treatment of decreased thyroid function is the replacement of the missing hormones by giving it as tablets (levothyroxine), and omitting, if possible, the causative agent, if present.
When the thyroid gland has increased functioning, the excess thyroid hormones in the body can cause excessive and unexplained weight loss. This again can happen because of viral infection, Grave’s disease, a condition where the immune system produces antibodies that attack thyroid cells and cause them to produce thyroid hormone continuously or toxic adenoma, a condition where a small part of the gland becomes autonomous and starts secreting excessive hormones.
In this case, the treatment entails intake of medicines such as: methimazole or carbimazole, or in other cases radioactive iodine treatment to ablate the gland, or even surgery.
Ultrasound is needed whenever an abnormality is detected during physical examination and fine needle aspiration will follow if the physician judges the thyroid nodule has suspicious characteristics on ultrasound (such as size, blood vessels...). Surgery is recommended when fine needle aspiration yields malignant (cancerous) results, or in cases of hyperthyroidism for radical treatment, or whenever other decided treatment causes side effects.
The author is a specialist in Endocrinology Internal Medicine at Bareen International Hospital
