Abstract

A REVIEW ON THYROID DISORDERS AND CLINICAL MANAGEMENT OPTIONS

Abdul Mannan, *Ayesha Osman

Abstract

The thyroid gland is a vital, butterfly-shaped endocrine organ in the neck that regulates the basal metabolic rate (BMR), somatic, and psychic growth, and plays a role in calcium metabolism. It consists of two lobes joined by an isthmus, is richly vascularized, and is covered by true and capsules. Thyroid diseases are broadly classified into functional disorders (hypothyroidism and hyperthyroidism) and structural/ inflammatory disorders (goiter, thyroid nodules, and thyroiditis). Hypothyroidism (thyroid hormone deficiency) is primarily caused by chronic autoimmune thyroiditis (Hashimoto's disease) in iodine-sufficient areas. Treatment is mainly with levothyroxine monotherapy. Hyperthyroidism (excess thyroid hormone production/exposure, or thyrotoxicosis) has multiple etiologies, with Graves' disease, toxic multinodular goiter, and toxic adenoma being common. Definitive treatments include radioactive iodine (RAI) therapy, thionamide drugs (methimazole/propylthiouracil), and surgery (thyroidectomy). Goiter (enlargement of the thyroid) and thyroid nodules (discrete lesions) are common. Management for non-toxic goiter and benign nodules involves monitoring, while suspicious or malignant nodules require fineneedle aspiration (FNA) for diagnosis and potential surgery. Thyroiditis (inflammation) is often autoimmune (like Hashimoto's or Graves' disease) or subacute and is generally managed symptomatically or with anti-thyroid drugs/hormone replacement as needed. Thyroid cancer, primarily differentiated thyroid cancer (papillary and follicular), is treated with surgical resection (lobectomy or total thyroidectomy), followed by RAI ablation and thyroid hormone suppression therapy based on risk stratification. Medullary and anaplastic thyroid cancers have distinct, more complex management strategies.

Keywords: Thyroid gland, Hypothyroidism, Hyperthyroidism, Hashimoto's thyroiditis, Graves' disease, Goiter, Thyroid nodule, Thyroiditis, Thyroid cancer, Levothyroxine, Radioactive iodine, Thionamides, Thyroidectomy, Thyroid-stimulating hormone (TSH).