Transcript Slide 1
The THYROID GLAND AND GOITER: Ating Alamin Butterfly-shaped organ in front of the neck What Does Your Thyroid Gland Do for You? • Produces Two Hormones Called • Thyroxine (T4) • Thyronine (T3) • Regulates Metabolism so Your Cells Function Properly • Affects Every Cell in the Body Thyroid Hormone Affects Many Organs and General Health Eyes Lungs Brain Heart Kidney Liver Skin GI Tract Uterus Iodine Thyroid Hormone •Brain function, memory, concentration •Muscle movement •Cholesterol melting •Normal heart beat GOITERS Any enlargement of the thyroid gland “Bosyo” G O I T E R GOITERS • Structure - Diffuse - Nodular • Function - Euthyroid - Hyperthyroid - Hypothyroid When the Thyroid Doesn’t Work Hyperthyroidism Hypothyroidism When the Thyroid Doesn’t Work Hyperthyroidism Hypothyroidism • Too Much Thyroid • Too Little Thyroid Hormone • Metabolism Speeds Up Hormone • Metabolism Slows Down Two Common Types of Thyroid Disease • Hyperthyroidism • Hypothyroidism Signs and Symptoms of Hyperthyroidism Nervousness Irritability Difficulty Sleeping Bulging Eyes/Unblinking Stare Swelling (Goiter) Menstrual Irregularities or Light Period Frequent Bowel Movements Warm, Moist Palms Excessive Vomiting in Pregnancy Hoarseness or Deepening of Voice Persistent Sore or Dry Throat Difficulty Swallowing Rapid or Irregular Heartbeat Infertility Weight Loss Heat Intolerance Increased Sweating First-Trimester Miscarriage Family History of Thyroid Disease or Diabetes Signs and Symptoms of Hypothyroidism Tiredness Forgetfulness/Slower Thinking Moodiness/ Irritability Depression Puffy Eyes Swelling (Goiter) Hoarseness/ Deepening of Voice Persistent Dry or Sore Throat Inability to Concentrate Thinning Hair or Hair Loss Loss of Body Hair Dry, Patchy Skin Weight Gain Cold Intolerance Elevated Cholesterol Difficulty Swallowing Slower Heartbeat Menstrual Irregularities/ Heavy Period Infertility Constipation Muscle Weakness or Cramps What causes Thyroid Diseases ? The “Hidden” Health Problem What causes thyroid diseases ? • • • • Iodine deficiency disorder Surgical Radioiodine therapy Autoimmune diseases Clinical Expression of Iodine Deficiency Fetus • • Miscarriages • Stillbirths • • Neurological • cretinism • • Impaired intellectual function • Increased perinatal mortality Neonate Increased infant mortality Neonatal goiter Cretinism Impaired intellectual function Clinical Expression of Iodine Deficiency Child & adolescent Adult • Goiter • Goiter • Hypothyroidism • Hypothyroidism and poor • Impaired intellectual and intellectual physical function performance • Retarded physical development Sources of Dietary Iodine • • • • Iodine in soil, water and crops Seafood Dairy Products Iodised salt and other fortified foods • Medicines/health foods/supplements • Other adventitious sources Myths and Facts on Thyroid Diseases ON FOODS Myth Eating carrots, cabbage, root crops can cause goiter. Fact These foods have goitrogens. But you have to eat a truckload of these foods in a short time before you develop goiter. ON FOODS Fact Myth Drinking cold drinks is bad if you have goiter. The temperature of the food or drink has no effect on the thyroid gland since it is not located in the alimentary tract ON FOODS Myth Eating seafoods can cure goiter. Not eating seafoods can cause goiter Fact Seafoods are important for their iodine content but can not cure goiter. A person with iodine deficiency may develop goiter. ON FOODS Myth Herbal medicines are effective in treating goiter and other thyroid problems. Fact Contents of herbal medicines are often not specified; their efficacy to treat is still in question. ON FERTILITY Myth A person with goiter becomes infertile Fact Simple goiter does not affect fertility of both sexes. It is abnormal thyroid function that affects fertility ON FERTILITY Myth Radioactive iodine treatment for hyperthyroidism will lead to infertility. Fact Radioactive iodine only concentrates in the thyroid gland and does not affect other organs ON PREGNANCY Myth Bearing down during labor can cause goiter Fact Iodine deficient pregnant women develops goiter to compensate for thyroid hormone deficiency. It is noted after delivery when increased weight is resolved ON PREGNANCY Myth Goiter, if present, indicates caesarean section Fact Bearing down during labor does not affect the size of goiter ON PREGNANCY Myth Any drug for the treatment of thyroid problem should be discontinued once the patient becomes pregnant Fact If the medication is for hyperthyroidism or replacement therapy, the patient should be referred to an endocrinologist for dose adjustment ON PREGNANCY Fact Fact Patients with There is an inadequate increased risk for replacement miscarriage if therapy have medications are abnormal platelet discontinued function which may lead to prolonged bleeding during labor ON PREGNANCY Myth All mothers with thyroid diseases will deliver infants with thyroid problems Fact Mothers with circulating thyroid antibodies are more likely to have infants with thyroid problems Antithyroid medications traverse the placenta and may cause transient hypothyroidism in the baby ON VARIOUS TREATMENT MODALITIES Myth Radioactive Iodine Treatment can cause cancer Fact There has been no report that it can cause cancer There is no chromosomal abnormality in children born to mothers who received the treatment ON VARIOUS TREATMENT MODALITIES Fact Myth Radioactive Iodine 131 Iodine concentrates Treatment cannot only in the be given to thyroid gland individuals in Fertility is affected their by the abnormal reproductive age thyroid functional status (hyperthyroidism or hypothyroidism) ON VARIOUS TREATMENT MODALITIES Myth Radioactive Iodine Therapy leads to hypothyroidism Fact Even without intervention, the gland will shrink in > 10 yrs time, due to continuous inflammation and fibrosis eventually leading to hypothyroidism ON VARIOUS TREATMENT MODALITIES Myth Patients who receive Radioactive Iodine uptake and therapy should be isolated Fact No isolation is necessary for 131 Iodine uptake and therapy for hyperthyroidism Only patients who receive high dose treatment for cancer should be isolated in a leaded room SURGERY Myth Surgery is the ultimate treatment for all thyroid diseases Fact Surgery is indicated for thyroid cancer, multinodular goiter, and in big goiters causing compression symptoms SURGERY Myth Patients who get operated on for goiter lose their voice Fact This is rare if thyroidectomy is done by an experienced surgeon Laryngeal nerve damage is higher on reoperation “Kaya lumalaki ang leeg at nagkabosyo ang buntis e dahil hindi ito marunong umire.” “Bawal magbuhat ng mabigat habang buntis dahil magkakaGoiter sya.” When you have GOITER • Visit your doctor or an endocrinologist • Blood tests and other tests like ultrasound may be requested for evaluation • Medications given should be taken regularly as prescribed The Philippine College of Physicians wishes to acknowledge the following for their invaluable efforts in the preparation of this module Nemesio Nicodemus, MD Bien Matawaran, MD Aimee Andag-Silva, MD Leilani Mercado-Asis, MD Gabriel Jasul, MD Rosa Allyn G. Sy, MD Committee on Advocacy & Public Relations Philippine Society of Endocrinology and Metabolism