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Thyroid Disorders Specialist
Thyroid disorders are medical conditions that affect the function of the thyroid gland, a butterfly-shaped gland located in the front part of the neck.
Are your symptoms affecting your quality of life? Consult our MOH-accredited thyroid specialist for a comprehensive diagnosis of your condition & a personalised treatment plan.
Dr Daphne Lee
MBBS
MRCP(UK)
FAMS
What Is The Thyroid Gland?
The thyroid gland plays a role in the body’s metabolic processes by producing thyroid hormones, primarily thyroxine (T4) and triiodothyronine (T3). These hormones regulate various bodily functions, including heart rate, body temperature, and energy metabolism. When the thyroid gland does not function properly, it can lead to an imbalance in hormone levels, resulting in thyroid disorders.
Types of Thyroid Disorders
The primary types of thyroid disorders include:
Hypothyroidism
This condition occurs when the thyroid gland does not produce enough thyroid hormones. Common causes include Hashimoto’s thyroiditis (an autoimmune disorder), treatment for hyperthyroidism, and certain medications. Symptoms often develop slowly and can include fatigue, weight gain, and sensitivity to cold.
Hyperthyroidism
In contrast, hyperthyroidism is characterised by the overproduction of thyroid hormones. Graves’ disease, an autoimmune disorder, is the most common cause. Symptoms may include weight loss, rapid heart rate, and anxiety.
Other Disorders
- Goitre: This is an enlargement of the thyroid gland and can occur in both hypothyroidism and hyperthyroidism. It may be due to iodine deficiency or other conditions.
- Thyroiditis: This refers to inflammation of the thyroid gland, often caused by an autoimmune response or infection. Types include Hashimoto’s thyroiditis and postpartum thyroiditis.
- Thyroid Nodules: These are lumps in the thyroid gland. While most are benign, a small percentage can be cancerous.
- Thyroid Cancer: Although less common, thyroid cancer can occur, often presenting as a nodule. It is usually treatable when detected early.
Complications
If not managed properly, thyroid disorders can lead to complications. These vary depending on whether the thyroid is underactive or overactive, and how long the condition has been left untreated.
Heart Problems
Both hypothyroidism and hyperthyroidism can affect heart health. Hypothyroidism may increase the risk of heart disease and heart failure, often related to elevated LDL cholesterol levels. Hyperthyroidism can lead to heart palpitations, atrial fibrillation, and an increased risk of stroke.
Mental Health Issues
Hypothyroidism is often associated with depression. Hyperthyroidism can lead to symptoms such as anxiety, irritability, and nervousness, and both conditions can impact cognitive function.
Pregnancy Complications
Thyroid disorders during pregnancy can pose risks to both mother and child, including preterm birth, preeclampsia, and developmental issues in the child.
Goitre
Persistent hormonal imbalance can cause the thyroid gland to enlarge, forming a goitre, which can lead to breathing and swallowing difficulties.
Osteoporosis
In cases of hyperthyroidism, excessive thyroid hormone production can lead to weakened bones, increasing the risk of osteoporosis.
Myxedema
A rare but serious complication of hypothyroidism, myxedema can lead to extreme cold intolerance, drowsiness, profound lethargy, and even coma.
Thyroid Storm
A life-threatening condition that can occur in hyperthyroidism, characterised by high fever, rapid pulse, and delirium.
Symptoms
The symptoms depend on whether the thyroid is underactive (hypothyroidism) or overactive (hyperthyroidism).
Symptoms of Hypothyroidism
- Fatigue and sluggishness
- Increased sensitivity to cold
- Weight gain and difficulty losing weight
- Dry skin and hair
- Muscle weakness and aches
- Constipation
- Depression
- Impaired memory
- Slow heart rate
- Heavy or irregular menstrual periods in women
Symptoms of Hyperthyroidism
- Unexpected weight loss, even when appetite and food intake remain normal or increase
- Rapid heartbeat (tachycardia) or irregular heartbeat (palpitations)
- Nervousness, anxiety, and irritability
- Tremors in hands and fingers
- Increased sensitivity to heat
- Changes in bowel patterns, especially more frequent bowel movements
- Enlarged thyroid gland (goitre)
- Fatigue, muscle weakness
- Difficulty sleeping
- Light or skipped menstrual periods
Diagnosis
Diagnosing thyroid disorders involves a combination of clinical evaluation, symptom review, and specific diagnostic tests. Early and accurate diagnosis allows for effective management of the condition.
- Clinical Evaluation: The process begins with a thorough medical history and physical examination. The doctor will look for signs such as an enlarged thyroid gland, rapid heartbeat, dry skin, or swelling.
- Thyroid-Stimulating Hormone (TSH) Test: A blood test evaluating thyroid function. Elevated TSH levels typically indicate hypothyroidism, while low levels suggest hyperthyroidism.
- T4 (Thyroxine) Test: This test measures the level of T4 in the blood. Low levels are indicative of hypothyroidism, while high levels suggest hyperthyroidism.
- T3 Test: This is sometimes used to diagnose hyperthyroidism if T4 levels are within the normal range.
- Imaging Tests: Imaging tests can show the size and shape of the thyroid gland. They can also help identify nodules or other abnormalities. Common imaging tests include ultrasound and radioactive iodine uptake tests.
- Additional Tests: Depending on the symptoms and the results of initial tests, additional tests may be necessary. For example, cholesterol tests can be relevant for suspected hypothyroidism, while calcium and liver function tests can be useful for hyperthyroidism.
Treatment Options
Treatment for thyroid disorders varies based on the type and severity of the disorder. The primary goal is to restore normal levels of thyroid hormones and alleviate symptoms.
Hypothyroidism Treatment
- Thyroid Hormone Replacement Therapy: The main treatment for hypothyroidism is synthetic thyroxine (T4). This oral medication restores adequate hormone levels, reversing the symptoms of hypothyroidism.
- Regular Monitoring: Patients on thyroid hormone replacement will need regular blood tests to ensure the right dosage.
Hyperthyroidism Treatment
- Radioactive Iodine: Used to destroy parts of the thyroid gland, reducing hormone production. It’s a widely used and effective treatment.
- Anti-thyroid Medications: Medications can help to reduce thyroid hormone production.
- Beta Blockers: These drugs are used to manage symptoms like rapid heart rate and tremors.
- Surgery (Thyroidectomy): In some cases, part or all of the thyroid gland may be surgically removed.
Goiter and Nodules Treatment
Treatments vary based on size, symptoms, and whether nodules are benign or malignant. Options include watchful waiting, hormone therapy, or surgery.
Thyroid Cancer Treatment
The primary treatment is usually surgery, often followed by radioactive iodine therapy. Thyroid hormone therapy may be needed post-surgery.
Dr Daphne Lee
MBBS
MRCP(UK)
FAMS
Dr Daphne Lee has special interests in the comprehensive management & treatment of diabetes, adrenal and pituitary conditions.
Qualifications
- MBBS (National University of Singapore, Singapore) 2006
- MRCP (Royal College of Physicians, United Kingdom)
- Fellow, Academy of Medicine, Singapore (FAMS)
- Registered with Specialist Accreditation Board (SAB)
- Registered with Singapore Medical Council (SMC)
Before private practice, Dr Daphne Lee was a consultant endocrinologist at Khoo Teck Puat Hospital. During her time there, she also ran the pituitary and adrenal clinics.
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Mount Elizabeth Novena Specialist Center
38 Irrawaddy Road, #07 - 63,
Singapore 329563
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6 Napier Road, #03 - 10,
Singapore 258499
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Mount Elizabeth Novena Specialist Center
38 Irrawaddy Road, #07 - 63,
Singapore 329563
Gleneagles Medical Centre
6 Napier Road, #03 - 10,
Singapore 258499
Frequently Asked Questions (FAQ)
Can thyroid disorders be cured?
Some thyroid disorders can be effectively managed with treatments, but they are not typically considered curable. Conditions like hypothyroidism require lifelong treatment, while hyperthyroidism may be resolved with radioactive iodine therapy or surgery.
Are thyroid disorders hereditary?
Genetics can play a role in the development of thyroid disorders. Family history increases the risk, particularly for autoimmune thyroid diseases like Hashimoto’s thyroiditis and Graves’ disease.
Can diet affect thyroid health?
Diet plays a role in thyroid health. Iodine is necessary for thyroid hormone production, and deficiency can lead to disorders. Excessive iodine can also be harmful, making a balanced iodine intake necessary.
How do thyroid disorders affect pregnancy?
Thyroid disorders can impact fertility and pregnancy. Hypothyroidism can lead to complications like preeclampsia and premature birth. Thyroid hormone levels should be managed during pregnancy.
How often should I check my thyroid levels?
The frequency of thyroid testing depends on your condition and treatment plan. Generally check-ups are conducted annually, but more frequent testing may be necessary if you are on thyroid medication or have a history of thyroid problems.
Are there lifestyle changes that help manage thyroid disorders?
Lifestyle changes like a balanced diet, regular exercise, and stress management can support overall health and may help in managing thyroid disorders.