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Thyroid Disease

Univeristy Name
Survey of Thyroid Disease
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Thyroid Disease
Abstract

This report has compiled and provided information relating to Thyroid Disease, common
symptoms, treatment options and prognosis. Thyroid disease can have many causes and
treatment for those who have a genetic disorder may not require medications but may need to be
monitored. For those who have thyroid disease due to environmental factors such as radiation or
certain chemicals will require treatment in the form of medications and monitoring based on
symptoms, blood test results, lifestyle changes such as diet modifications, physical therapy and
exercise for those who are obese.

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Definition.
Thyroid disease is a disorder affecting the production and functions of thyroid hormones. It is
described as being due to a deficiency in or abnormal function of the thyroid gland or as a result
of environmental factors (Daniels and Dayan 2006) .Thyroid disease is responsible for a range of
symptoms from mild abnormalities to profound effects on the body that can be life threatening
(Farling 2000). In addition to thyroid disorders the patient may show signs or have symptoms of
other diseases. An ideal diagnosis will include a thorough history and current manifestations,
along with physical examination findings to support the diagnosis (Farling 2000).
Etiology
There are many causes for thyroid disease which include congenital, genetics, autoimmune
diseases and environmental factors. Thyroid disease can arise from a deficiency in the gland due
to a genetic disorder, defect or damage to the gland itself. It can also be caused by exposure to
certain chemicals or factors that cause inflammation to the gland such as radiation therapy or
certain drugs and medications including those used for HIV treatment. Environmental factors
include the following:
Pathogenesis.
Initially the changes in the thyroid may be subtle starting with glandular hypoplasia and
progressing to glandular hyperplasia. In addition there may be a change in the gland’s
characteristics such as elevated iodine or TSH levels, thyroid enlargement and increased uptake
of contrast studies (Daniels and Dayan 2006). The thyroid can also become calcified and cystic
due to an autoimmune reaction which is a type of auto-immune disease where the body’s
immune system mistakenly attacks its own tissue. Also, the uptake in radioactive iodine is
increased. The thyroid gland can be damaged by exposure to radiation and chemical agents.
Autoimmune reactions play a role in thyroid diseases as the body's immune system mistakenly
attacks the gland.
Manifestation
Thyroid disease can lead to a variety of problems with the major manifestations being weight
gain, fatigue, chronic pain, osteoarthritis and hypothyroidism. Weight gain may result from a
lack of hormones that regulate metabolism or from difficulty losing weight due to hormone
imbalances such as insulin resistance (Daniels and Dayan 2006). Chronic pain may result from
thyroid hormone deficiencies or high levels of cortisol which lowers blood sugar levels resulting
in neuropathy, muscle weakness and pain. Osteoarthritis which is another manifestation of
hypothyroidism can cause joint stiffness, swelling and degeneration. Muscles are not as well
protected from wear and tear and the cartilage may be worn away and bone levels may increase
causing osteoarthritis.

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Laboratory findings
Laboratory findings include the following:
High cholesterol levels, elevated serum glucose levels, low hemoglobin and red cell count,
elevated fibrinogen level, low white cell count, elevated triglyceride level (hyperlipidemia),
elevated liver enzymes and increased liver size. Also increased cortisol levels in the blood along
with high blood pressure which can result in hypertension or hypotension will be found. This is
due to the fact that thyroid hormones influence metabolism, temperature regulation and heart rate
(Vitti and Hegedus, n.d.). Thyroid hormone levels will be low. In addition to the above findings
blood tests will show decreased levels of iron, zinc, vitamin A and B12 along with low
testosterone level in males.
Diagnosis
The differential diagnosis of thyroid disease is quite broad due to three factors: the variety of
environmental agents that may cause thyroid dysfunction, the autoimmune response which can
lead to lifelong immune dysfunction and the spectrum of genetic defects that can cause thyroid
abnormalities from high or low hormone production.
Autoimmune diseases include Hashimoto’s disease, Graves’ disease and Addison’s disease as
well as other types (Vitti and Hegedus, n.d.). The treatment of thyroid disease is based on the
cause and includes surgery, radiation and medications.
The testing may include a thorough history, physical exam, blood tests including radioimmunoassay (RIA), TSH level, thyroid scan or ultrasound, radioactive iodine uptake study,
MRI, CT scan or PET scan. Genetic testing can be be done for those with a family history of
thyroid disease (Vitti and Hegedus, n.d.).
The results of the tests can be recorded and referred to in the report.
In addition, it may be helpful to attach pathology reports from the thyroid scan or ultrasound and
other images of the gland or ultrasound images.
A diagnosis should be made after a thorough history and physical examination with a detailed
differential diagnosis.
To make a good diagnosis, the symptoms must be clearly related to the malfunctioning of the
thyroid gland and not due to other diseases such as grand mal seizures which cause death due to
respiratory failure (Vitti and Hegedus, n.d.). Reports should include all findings that relate to
thyroid dysfunction with emphasis on finding this information in every section as well as finding
all manifestations of hypothyroidism if present as well as any signs of autoimmune disorders.
Treatment

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The treatment of thyroid disease depends on the cause. Those with a genetic disorder may not
require medication but may need to be monitored. However, those with other causes will require
medications and monitoring as well as dietary modifications which should also be included in the
report.
Treatment may include:
Treatment will also include lifestyle changes such as diet modifications, physical therapy and
exercise for those who are obese or have osteoarthritis due to thyroid disease. Along with
monitoring blood levels of TSH, T4 levels, CBC and T3U uptake to determine the effectiveness
of treatment and adjust dosage accordingly (Farling 2000).
Prognosis
The prognosis of thyroid disease depends on the cause, the severity at diagnosis and any
associated conditions such as ...