The thyroid is a butterfly-shaped gland at the front of your neck that produces hormones regulating metabolism, energy, heart rate, temperature, and many other vital functions. Thyroid disorders are common, affecting an estimated 200 million people worldwide according to the World Health Organization.
Types of Thyroid Disorders
Hypothyroidism (Underactive Thyroid)
The thyroid does not produce enough thyroid hormone. This slows down body functions.
Symptoms:
- Fatigue and low energy
- Weight gain or difficulty losing weight
- Feeling cold when others are comfortable
- Dry skin and hair
- Hair loss
- Constipation
- Depression or low mood
- Muscle aches and weakness
- Heavy or irregular periods in women
- Memory problems and difficulty concentrating
Hyperthyroidism (Overactive Thyroid)
The thyroid produces too much thyroid hormone, speeding up body functions.
Symptoms:
- Unexplained weight loss despite normal or increased appetite
- Rapid or irregular heartbeat (palpitations)
- Anxiety, nervousness, and irritability
- Trembling hands
- Excessive sweating
- Heat intolerance
- Difficulty sleeping
- Frequent bowel movements
- Thin skin
- Menstrual changes in women
Other Thyroid Conditions
- Goitre: Enlargement of the thyroid gland
- Thyroid nodules: Lumps in the thyroid (most are benign)
- Thyroiditis: Inflammation of the thyroid (including postpartum thyroiditis)
- Thyroid cancer: Relatively rare but treatable, especially when detected early
Who Is at Risk?
- Women (5–8 times more likely than men)
- People with a family history of thyroid disease
- Those with autoimmune conditions (type 1 diabetes, rheumatoid arthritis, coeliac disease)
- People who have had radiation treatment to the neck or head
- Pregnancy and the postpartum period
- Iodine deficiency (less common in the UAE but relevant in some populations)
Diagnosis
Blood Tests
- TSH (Thyroid-Stimulating Hormone): The primary screening test
- High TSH → suggests hypothyroidism (the pituitary gland is working harder to stimulate the thyroid)
- Low TSH → suggests hyperthyroidism (the pituitary gland is reducing stimulation because the thyroid is overactive)
- Free T4 and Free T3: Measure the actual thyroid hormone levels in the blood
- Thyroid antibodies: Can help identify autoimmune causes (e.g., Hashimoto's thyroiditis, Graves' disease)
Additional Tests
- Ultrasound: To examine thyroid structure and nodules
- Fine needle aspiration (FNA): Biopsy of thyroid nodules to check for cancer
- Radioactive iodine uptake: Measures how the thyroid absorbs iodine
Treatment
Hypothyroidism
- Levothyroxine: A synthetic thyroid hormone taken daily as a tablet
- NICE guideline NG145 recommends levothyroxine as the first-line treatment
- Take on an empty stomach, 30–60 minutes before breakfast
- Regular blood tests (TSH) to monitor and adjust dosage
- Treatment is usually lifelong
Hyperthyroidism
Treatment depends on the cause and severity:
- Antithyroid medications: Carbimazole or propylthiouracil reduce thyroid hormone production
- Radioiodine therapy: Destroys overactive thyroid tissue - may eventually lead to hypothyroidism
- Surgery (thyroidectomy): Removal of part or all of the thyroid (for large goitres, suspected cancer, or when other treatments fail)
- Beta-blockers: May be prescribed short-term to control symptoms like rapid heartbeat and tremor
Thyroid Nodules
- Most thyroid nodules are benign and require monitoring only
- Suspicious nodules may need FNA biopsy
- Surgery is recommended for confirmed or suspicious thyroid cancer
Thyroid Health During Pregnancy
- Untreated hypothyroidism in pregnancy can affect foetal brain development
- NICE recommends thyroid function testing in early pregnancy for women with known thyroid disease or risk factors
- Levothyroxine dose often needs to be increased during pregnancy
- Hyperthyroidism in pregnancy requires specialist management
Living With a Thyroid Condition
- Take your medication as prescribed, consistently
- Attend regular follow-up appointments and blood tests
- Report new symptoms to your doctor promptly
- Maintain a balanced diet with adequate iodine (iodised salt, fish, dairy)
- Know that thyroid conditions are very manageable with proper treatment
This article is for informational purposes only and does not replace professional medical advice. Always consult your doctor for personalised guidance.