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All About Thyroid

April 28, 2022   Return


Our thyroid gland is a small butterfly shaped organ located at the base of our neck, just below the larynx box or Adam’s apple. This little organ goes a long way in regulating the functions and processes of various systems in our body like digestive system, nervous system, genitourinary system, musculoskeletal system and cardiovascular system. This gland is a very important part of an intricate network of glands (also known as endocrine system) in our body. It makes, stores and releases a hormone that influences every cell, every tissue, every organ and every system in our body.



Let’s assume that our body is a car and the thyroid gland is the engine that sets the pace. Just as the engine produces the required amount of energy for the car to operate at a certain speed, the thyroid gland produces the required amount of thyroid hormone that prompts the body cells to perform a particular function at a certain rate.

Now, a car cannot produce any energy without fuel. Similarly, the thyroid gland requires fuel to produce the thyroid hormone. This fuel is iodine that is absorbed into the bloodstream from our food (like iodized salt, bread, milk, and seafood) to produce two different hormones, namely thyroxine (referred to as T4 due to the presence of 4 atoms of iodine), which is storage or inactive form of thyroid hormone and triiodothyronine (referred to as T3 due to the presence of 3 atoms of iodine), which is the active form of thyroid hormone that increases metabolism. The conversion of T4 to T3 takes place outside the thyroid gland, in certain organs or tissues (like brain, liver, and kidney) where T3 is used the most.

Now moving on, just as we increase the speed of our car by stepping on the accelerator, the thyroid gland gets such messages in the form of thyroid stimulating hormone (TSH) that is released by another gland, known as pituitary gland.

Having a healthy and properly functioning thyroid is key to one’s overall good health and well-being. The thyroid functioning has to be perfect in order to be able to support one’s health, as both hyperactivity and hypoactivity can cause severe health complications.



Facts and Figures

  • Thyroid dysfunction increases with age.
  • Most thyroid disorders are lifelong conditions that can be managed with adequate medical attention.
  • Across the world more than 200 million people have some sort of thyroid disorder, with more than 50% of them being unaware about it.
  • Women are 2% to 10% more likely to develop thyroid problems than men.
  • In Malaysia, the prevalence of thyroid disorders is about 10% for hypothyroidism (lower than normal thyroid hormone levels) and 2% for hyperthyroidism (higher than normal thyroid hormone levels).
  • Hyperthyroidism affects 1-in-500 pregnancies.
  • Hypothyroidism occurs in 3 to 5 of every 1000 pregnancies.
  • Graves’ Disease (an autoimmune disorder that leads to hyperthyroidism) is common in people younger than age 40 and is eight times more common in women than men.
  • The causes of thyroid disorders are largely unknown.
  • Stress can contribute signifcantly to thyroid disorders.
  • Approximately 4% to 10% of women have postpartum thyroiditis.
  • Pregnant women with undiagnosed thyroid disorders are at increased risk of miscarriage, preterm delivery and developmental problems to the fetus.
  • Untreated thyroid disorders can be fatal.


Signs that something may be off with our thyroid

  • Changes in sleep habits or pattern.
  • Sudden anxiety.
  • Sudden and increased sensitivity to cold.
  • Changes in bowel habits.
  • Thinning of hair, especially the eyebrows.
  • Excessive sweating at random times.
  • Fatigue and muscle weakness.
  • Unusual weight gain.
  • Unexplained weight loss.
  • Brittle nails.
  • Diffculty in remembering and inability to concentrate.
  • Too much of energy.
  • Tiredness during the day, craving for a mid-day nap.
  • Changes in menstrual cycle and pattern.
  • Infertility and miscarriage.
  • Developmental delays in children.

Upon noticing these signs and symptoms, it is advisable to seek medical attention from our healthcare provider.


Hyperthyroidism is a condition in which the thyroid gland is overactive and produces excess thyroid hormones.Some of the symptoms of hyperthyroidism are nervousness, tremors or shaking of hands, rapid heartbeats, hot flushes and excessive sweating, fatigue, and unexplained weight loss.

Hypothyroidism is a condition in which the thyroid gland is underactive and produces low levels of thyroid hormone. The symptoms of hypothyroidism are dry skin, constipation, always feeling cold, fatigue, difficulty in concentration and thinking, and prolonged and heavy menstrual bleeding.

Goiter is a swelling of the thyroid gland and may have symptoms of hyperthyroidism, hypothyroidism or euthyroid (normal thyroid function). Some characteristic  symptoms of goiter are difficulty in breathing, difficulty in swallowing, and change of voice tone.

Thyroid nodules refer to growth in the thyroid gland, and it can manifest as one or multiple nodules. If the nodule is too large, it can press nearby structures and cause symptoms such as shortness of breath or hoarseness of voice. The nodules are painless and most of the time (99%) non-cancerous or benign in nature. 


Thyroid cancer is the most common cancer of the endocrine glands. It is most common in people whose thyroid glands were exposed to radiation. Symptoms suggestive of thyroid cancer are lump in the thyroid gland, hoarseness of voice, difficulty in breathing or swallowing, swollen lymph nodes in the neck, persistent cough or sore throat and constant pain in the neck.

Thyroiditis, which means inflammation of the thyroid gland, can be acute with sudden onset (occurring over a few days), sub-acute (occurring over a few weeks) and chronic (occurring over months to years). The acute type is caused by bacteria, and is extremely rare. It has symptoms of high fever and severe pain in the neck area. The sub-acute type is caused by virus, and is extremely rare as well. It has symptoms of high fever and severe pain in the jaw and behind the ears, and neck region.

Chronic thyroiditis also known as Hashimoto’s thyroiditis, is an autoimmune disorder, wherein the thyroid cells are destroyed, and is one of the main causes of hypothyroidism.

Graves’ disease is autoimmune hyperthyroidism, and like Hashimoto’s, is an immune- driven attack against the thyroid. Graves’ is the most common reason for hyperthyroidism, and impacts women seven to eight times more than men. Graves’ disease often needs more medical intervention than Hashimoto’s, and may be treated with antithyroid drugs, radioactive iodine, or even thyroid surgery. However, lifestyle factors that calm autoimmunity can also be effective for people who have Graves’ disease.

Thyroid eye disease is often seen in association with Graves’ disease leading to hyperthyroidism. Its common symptoms are redness, itchiness, excessive tears, watery eyes, blurred vision, swelling of eyelids, double vision, and bulging of eyes. It could lead to blindness in severely affected cases. This condition could affect one or both eyes with its cause being linked to autoimmune disorder.

Postpartum thyroiditis refers to thyroid disorder linked to pregnancy. Any of the mentioned disorders can manifest during pregnancy with a higher frequency than in the general population. In some cases, the thyroid gland may enlarge during normal pregnancy and revert to its normal size after delivery. In others, it may be prolonged and may result in permanent hypothyroidism. Women who have a family history of thyroid disorders, or those who already have thyroid disorders are more prone to developing this condition.



Your doctor will take note of your family history, list of medications consumed and treatment (surgical or radiation) cycles you have undergone. Additional screening tests like radioactive iodine uptake test, thyroid scan, thyroid ultrasound and thyroid fine needle biopsy may help in getting a better understanding of the rate at which the condition is progressing. HT 

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