Thyroid Conditions
An overview of the thyroid gland
The thyroid gland is a butterfly shaped organ located just below the Adam’s apple. It wraps around the windpipe. The function of the thyroid gland is to convert dietary iodine into thyroid hormone. Thyroid hormones are involved in numerous metabolic function of the body including regulation of temperature, heart rate and growth.
Benign or non-cancerous thyroid diseases include:
thyroid nodules
goitre
thyrotoxicosis
What are thyroid nodules?
Thyroid nodules are very common and are estimated to occur in up to 70% of patients. Majority (>90%) of these nodules are benign. The presence of these nodules can produce symptoms that can be seen or felt as a lump in the neck or can affect your swallowing or breathing. The investigation of a thyroid nodule includes a thyroid function test, ultrasound imaging and fine needle aspirate (FNA) biopsy. The management of thyroid nodules is highly specialized and Dr Chua listens to your symptoms and seeks to correlate the thyroid ultrasound report with the standardized biopsy report as based on the Bethesda classification. Dr Chua assesses each patient individually and discusses a management plan with you.
What is a goitre?
Goitre refers to an enlarged thyroid gland. It could take the form of a multinodular or diffuse goitre. The causes of goitre include iodine deficiency, goitrogens - substances that induce goitre formation (certain medications i.e. phenytoin, lithium, amiodarone; brassica vegetable family i.e. cabbage, broccoli, cauliflower). Symptomatic goitres can cause pressure symptoms in the neck and affect the windpipe. Other reasons to consider include effects on cosmesis, suspicious nodules, toxicity from overactivity of nodules and enlarging goitre that descends into the neck. If any of the aforementioned consideration factors exists, Dr Chua would recommend considering surgery.
What is thyrotoxicosis or Graves’ Disease?
Thyrotoxicosis or Graves’ Disease is an autoimmune condition of the thyroid gland where there is overactivity due to an immune system error where antibodies bind to receptors on the thyroid gland stimulating the thyroid gland to grow, increase blood supply and increase hormone production. This may have widespread ramification on other organs such as the eyes and bodily function. The initial treatment is by medical therapy. A/Prof Terence Chua recommends consulting an Endocrinologist to assist in management. However, at times the medications can lead to significant side effects making it not tolerable, or after some time they fail to work. In this instance, Terence Chua recommends consideration of surgery.