Thyroid Disease: Know the Facts

Thyroid Disease is a world-wide reality

Thyroid abnormalities are very common, yet before the founding of the Thyroid Foundation of Canada in 1980, no lay organization existed in North America to promote public education about thyroid disease and to promote public support of thyroid research.

Thyroid disorders for the most part are treatable; however, untreated thyroid disease can produce serious results in other parts of the body. Improved public awareness and understanding of thyroid disorders will enable patients and their families to cope more effectively with the sometimes disturbing course of thyroid illness. In this way individuals will also be better equipped to play a role in alerting their physicians to a suspected thyroid condition that may otherwise be difficult to diagnose in the sometimes slowly developing initial phases.

The thyroid gland

The thyroid gland is a small butterfly-shaped gland at the base of the neck. It weighs only about 20 grams. However, the hormones it secretes are essential to growth and metabolism and regulate body function.

Types of thyroid disease

There are many types of thyroid disease. However, the main conditions present in most thyroid illnesses are hypothyroidism (thyroid under activity) and hyperthyroidism (thyroid over activity).

Thyroid nodules and thyroid cancer

Thyroid nodules are common and often require no treatment but should be investigated since a small proportion of them are cancerous. The majority of thyroid cancers have a favourable prognosis and require a multidisciplinary approach. The team may include endocrinologists, radiologists, surgeons, pathologists, nuclear medicine specialists and sometimes oncologists. In the past years there has been a rise in the number of thyroid cancers being identified, largely due to the incidental discovery of small low risk cancers related to the increased use of neck imaging for other unrelated conditions. There has been no change however, in the mortality rate.

Symptoms of thyroid disease

Signs and symptoms of hypothyroid and hyperthyroid conditions include:

Hypothyroidism

• Slow heart beat
• Muscular weakness
• Sensitivity to cold
• Dry skin
• Slowed mental processes and poor memory
• Constipation
• Increased size of the thyroid

More on Hypothyroidism

Hyperthyroidism

• Rapid and/or forceful heartbeat
• Tremor
• Muscular weakness
• Weight loss in spite of increased appetite
• Restlessness, anxiety and sleeplessness
• Sweating and heat intolerance
• Diarrhea
• Eye changes
• Increased size of the thyroid


More on Hyperthyroidism

Each person’s experience of thyroid illness differs depending on a number of factors; a patient will not necessarily have all (or even any) of the above symptoms and some patients have the symptoms in the absence of thyroid disease, perhaps due to other causes. A physician should be consulted if thyroid illness is suspected.

The emotional aspects of thyroid illness

There may be emotional reactions to thyroid illness. Hyperthyroid patients often feel unusually nervous or irritable. Hypothyroid patients can feel unusual fatigue or depression. It is important for thyroid patients and their families to understand that these reactions are common and if thyroid disease is the cause, then likely to resolve with treatment. It is also important to realize that some thyroid disorders develop very gradually and it can take a while before they disappear after treatment has been initiated. Since symptoms may not be easily recognized at first, subtle reactions in emotions or behaviour may be the only visible signs of thyroid disorder.

Prognosis

Most patients with significant hypothyroidism need life long therapy with thyroid hormone replacement, and life long monitoring to ensure that the dose of thyroid hormone maintains thyroid function tests in the normal range. Occasionally some forms of thyroid dysfunction can resolve, for example viral thyroiditis can resolve in a relatively short period of months. Graves’ (autoimmune) hyperthyroidism can go into remission, but may return. Sometimes mild abnormalities in thyroid blood tests do not require treatment in the absence of symptoms (subclinical thyroid dysfunction), but still requires monitoring.

The purpose of newborn screening

Canada is a world leader in developing screening methods for the detection of the serious disorder of congenital hypothyroidism. As a result, most North American hospitals now screen for this disease. One baby in 4000-5000 is being identified in Canada by screening tests. Thus the serious mental retardation and growth defects that can result from congenital hypothyroidism are being prevented by providing early identification and treatment of this disorder.

The need for further research

Further thyroid research is necessary to continue the progress that has been made in diagnosis and treatment. Although there are effective treatments for most thyroid disorders, the underlying causes and optimal treatment approaches require further investigation. The continued study of the thyroid may yield important knowledge in other areas of medical science. The role of new treatments for thyroid cancer has to be defined and improved. To achieve these goals, public support of thyroid research is vital.

Who Are We?

The Thyroid Foundation of Canada was founded in Kingston by Diana Meltzer Abramsky in 1980. It grew from the concerns and feelings of isolation of thyroid patients and their families. These feelings were largely due to the lack of adequate information available on thyroid disease and lack of support groups for discussion of mutual problems and frustrations.

A growing network of chapters is being developed across Canada. The Foundation has raised funds to support thyroid research and awards have been granted for a variety of projects. Grants from government and corporate sources have been received for the production of educational material in English and French.

What Are Our Aims?

• To awaken public interest in, and awareness of, thyroid disease;
• To lend moral support to thyroid patients and their families;
• To assist in fund raising for thyroid disease research.

What Do We Provide?

• THYROBULLETIN – is the Foundation’s quarterly publication. It presents up-to-date information on thyroid disease and chapter events for members.
• EDUCATIONAL MATERIAL – is available free or at reduced rates for members and interested individuals and organizations.
• PUBLIC EDUCATION MEETINGS – on aspects of thyroid diseases are presented by local chapters, free to members and the public.

What Can You Do?

We need you – as a member, a donor or a volunteer. The success of this organization depends on the efforts of many dedicated individuals who choose to become involved. For more information call the National Office.

Please Join Us!

Your membership and support will help us reach our goals and continue with our programs for the benefit of many concerned with thyroid disease.

Updated in August 2018 by Deric Morrison, MD FRCPC, Div. of Endocrinology, Dept. of Medicine, University of Western Ontario.  Original text written by: Irving B. Rosen, MD, FRCS(C), FACS, Professor of Surgery, University of Toronto, Department of Surgery, Mount Sinai Hospital; Consultant in Surgery, Princess Margaret Hospital, Ontario Cancer Institute, and Paul G. Walfish CM, MD, FRCP(C), FACP, FRSM, Professor of Medicine, Pediatrics and Otolaryngology, University of Toronto; Senior Consultant, Endocrinology and Metabolism and Head and Neck Oncology Program, Mount Sinai Hospital.