Thyroid Disorders

Thyroid disorders occur when the thyroid gland produces too much or too little hormone, or when structural changes such as nodules or goitre develop. Early diagnosis and treatment are important to prevent complications and maintain normal metabolic function.

Hormone Imbalances
Metabolic Changes
Nodules & Goitre
Thyroid Cancer

Below you will find an overview of the most common thyroid disorders, their symptoms, causes, and diagnostic considerations.

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What is the thyroid gland?

The thyroid is a small endocrine gland located at the front of the neck, just below the larynx. It consists of two lobes connected by a thin band of tissue called the isthmus. Despite its small size, the thyroid plays a crucial role by producing hormones (T4 and T3) that regulate metabolism, reproductive health, cardiovascular function, and the nervous system.

Thyroid activity is controlled by the hypothalamic–pituitary axis. The hypothalamus releases TRH, which stimulates the pituitary to produce TSH. TSH then signals the thyroid to release T4 and T3.

Symptoms of thyroid dysfunction may be subtle but can lead to serious health problems if untreated.

Main Thyroid Disorders

Hypothyroidism

Hypothyroidism occurs when the thyroid does not produce enough T4 and T3. The most common cause is autoimmune inflammation (Hashimoto’s thyroiditis). Symptoms include fatigue, weight gain, hair loss, dry skin, low mood, and difficulty concentrating. Treatment involves synthetic thyroid hormone replacement.

Hyperthyroidism

Hyperthyroidism is caused by excessive thyroid hormone production. Graves’ disease is the most frequent cause, followed by overactive nodules. Symptoms include anxiety, sweating, tremors, weight loss, palpitations, and menstrual changes. Treatment may include antithyroid medication, radioiodine, or surgery.

Nodular Goitre

Nodular goitre is an enlarged thyroid containing one or more nodules. It may cause visible neck swelling, pressure, difficulty swallowing, or shortness of breath. Causes include iodine deficiency, nutritional deficiencies, medication effects, and environmental factors.

Thyroid Cancer

Thyroid cancer is the most common endocrine malignancy, diagnosed in around 4,000 people each year in the UK. Warning signs include a neck lump, enlarged lymph nodes, voice changes, or rapid growth of a thyroid nodule. Diagnosis is confirmed by ultrasound and FNAB biopsy.

Detailed Overview of Thyroid Disorders

Symptoms include chronic fatigue, excessive sleepiness, impaired concentration, mental slowing, mood disturbances, and depressive symptoms. In women, symptoms may also include brittle nails, hair loss, dry skin, weight gain, and menstrual irregularities.

Diagnosis is based on elevated TSH and low T4. Treatment consists of oral synthetic thyroid hormones.

Hyperthyroidism commonly results from Graves’ disease or overactive thyroid nodules. Symptoms include nervousness, irritability, sweating, tremors, unexplained weight loss, diarrhoea, palpitations, and muscle weakness.

Diagnosis shows elevated T3/T4 and suppressed TSH. Treatment includes antithyroid medication, radioiodine therapy, or surgery.

Nodular goitre is classified as nodular, parenchymal, or mixed. Causes include deficiencies in iodine, selenium, iron, and vitamin A, as well as medication side effects and exposure to chemicals such as perchlorates and nitrates. Diagnosis includes thyroid ultrasound and FNAB.

Thyroid cancer is more common in women and usually develops in adults over 30. Papillary carcinoma is the most common type. Suspicious signs include a neck lump, enlarged lymph nodes, hoarseness, breathing difficulty, and rapid growth of a known nodule.

Treatment typically involves thyroidectomy with possible lymph node dissection.

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