The thyroid is a butterfly-shaped gland situated in the front of the neck. Its main function is to produce two hormones - thyroxine and triiodothyronine - which are crucial to the control of various bodily functions. These include but are not limited to heart rate, skin, bowel activity, and muscle.
Should the thyroid malfunction, either by underactivity or overactivity, it could cause health problems that can affect your quality of life. Thyroid hormone (TH) imbalances are usually related to autoimmune disorders - when healthy cells and tissues in your body are mistakenly attacked by your own immune system.
Too little, too much?
When an underactive gland does not produce enough thyroid hormones to adequately meet the body's needs, the condition is referred to as hypothyroidism. Read more about hypothyroidism here.
Conversely, in hyperthyroidism; an overactive thyroid gland results in the excessive production of thyroid hormones. Hypothyroidism and hyperthyroidism are the two most common thyroid disorders in women between the age of 20 and 50, who are also five times more likely than men to develop thyroid disorders.
The symptoms vary from person to person. Common symptoms include but are not limited to:
There are various known causes associated with hyperthyroidism. Learn more about them below:
Hyperthyroidism is diagnosed with blood tests that measure Thyroxine (T4) and Thyroid Stimulating Hormone (TSH). Readings that show high T4 levels and low TSH are signs of hyperthyroidism. Where required, our doctors may prescribe other tests.
There are 3 main treatments:
The 2 most common types of medication are beta-blockers and anti-thyroid drugs
Medication like propranolol and atenolol block the effect of the thyroid hormone on other parts of your body. While they affect the amount of thyroid hormone produced, they do not cure hyperthyroidism; thus, the condition may resurface after a patient halts the medication.
Please note that individuals who suffer from asthma should avoid beta-blockers
Drugs such as carbimazole, thiamazole, and propylthiouracil (PTU) act directly on the thyroid gland to effectively reduce thyroid hormone production within a few weeks.
While uncommon, rash, itching or joint paint may occur.
In rare cases, patients who take these medications may experience low white blood cell count or liver damage.
This treatment involves the use of radioactivity to destroy thyroid cells slowly over time through small doses of radioactive iodine that is absorbed by the thyroid cells. RAI is orally administered once through a small capsule. It takes about 2-3 months to achieve its full effect but will be naturally removed from the body after a few days.
Most patients only required one dose of RAI. Occasionally, some may need more the one dose to completely treat hyperthyroidism.
Take note that RAI is not a suitable treatment for pregnant women and young children.
As iodine is not taken up significantly by other cells, the only common side effect is underactivity of the thyroid gland (also known as hypothyroidism) where too many thyroid cells are destroyed and the remaining gland does not produce enough hormone.
However, this condition is easily diagnosed and treated through thyroid hormone replacement. The treatment fully replaces the hormone deficiency. Thereafter, patients would only need to undergo check-ups once or twice a year.
On the other hand, patients with Grave's disease whose eyes are significantly affected may observe that their eye health deteriorates after RAI. In these circumstances, your doctor may prescribe steroids to hinder this side effect.
Avoid close contact with pregnant women and young children for a few days by:
One commonly asked question is: "My hormone levels are now controlled on anti-thyroid medication. Why is my doctor recommending RAI?"
In a nutshell, there is a chance that hyperthyroidism may recur once a patient ceases his medication intake. As a matter of a fact, more than 50% of all patients experience this once they stop taking anti-thyroid medication. In fact, if hypothyroidism has already recurred once, there is a 90% chance of subsequent recurrence as TSH receptor antibodies (TRAb) tend to persist in the blood stream and continuously stimulate the thyroid gland to be hyperactive. If unmanaged, this could lead to serious damage to the heart and bones.
Removal of the thyroid gland is particularly recommended for patients that:
The potential risks include:
Speak to our doctors about the ideal treatment to manage hyperthyroidism.
One would need to take anti-thyroid drugs to have normalised hormone levels before undergoing surgery for thyroid gland removal. Consult our doctors about the medical prescription and instructions before the surgery.
Download a flyer in mandarin here:
Hyperthyroidism (Chinese).pdf