Post-ablative Hypothyroidism - An Underactive Thyroid Condition

Introduction:

When the entire thyroid gland is ablated or removed through high radiofrequency, the thyroid gland cannot make enough thyroid hormones to support the needs of the body. When the thyroid gland fails to produce enough thyroid hormones, external sources of thyroid hormones are given to the patients to compensate for the low thyroid hormones.

What Are Thyroid Gland and Its Functions?

The functions of the thyroid gland are:

• The thyroid gland and thyroid hormones are important for the endocrine system. The thyroid hormone is an anabolic hormone that produces high-energy macromolecules from smaller molecules.

• The thyroid hormones maintain mental maturation, basal metabolic rate, and physical maturation, keeping our tissues sensitive to adrenergic drive. The thyroid gland produces the thyroid hormones.

• Thy thyroid gland is located in the neck just below the larynx and in front of the trachea (windpipe). The thyroid gland secretes three hormones. They are thyroxine (T4), calcitonin, and triiodothyronine (T3).

• The thyroid hormones are important for normal growth and have a marked effect on lipids, carbohydrates, and protein metabolism.

• Thyroid hormones and more cholesterol activate lipolysis, and cholesterol metabolism is converted into bile acids.

• The thyroid hormones maintain the body temperature by increasing the basal metabolic rate. The thyroid hormones increase the heart rate, cardiac contractility, and output. It plays an important role in some bodily functions like metabolism, mood, excitability, heart rate, and digestion.

What Are Thyroid Nodules?

A thyroid nodule is an unusual growth in the thyroid gland. It is a non-cancerous benign condition but usually does not causes any symptoms. Thyroid nodules are classified as multiple (more than one), solitary (single nodule), solid, and cystic (fluid-filled). Mostly they are non-cancerous, but sometimes they can be signs of cancer. It can occur in people with iodine deficiency. The factors that lead to an increased risk of thyroid nodules are:

• Iron-deficiency anemia.

• Obesity.

• Smoking.

• Metabolic syndrome.

• Alcohol consumption.

• Increased levels of insulin-like growth factor-1.

What Causes Thyroid Nodules?

Colloid nodules are the most common type of thyroid gland overgrowth that may grow large and do not spread beyond the thyroid gland. Some of the nodules are non-cancerous cysts and do not spread beyond the thyroid gland. They are partially solid, filled with fluid, and larger than two cm. These nodules develop because of long-term thyroid gland swelling and do not cause any pain. The unusual lump of cells in the thyroid gland is common and is detected in approximately five to eight percent of adults during physical examination. These thyroid nodules are less common in children. The symptoms are trouble swallowing, breathing, hoarseness, voice changes, pain in the front of the neck, and gland enlargement.

The overactive thyroid nodules lead to the overproduction of thyroid hormones. Increased thyroid hormones cause:

• Weight loss.

• Rapid heartbeat.

• Trouble swallowing and breathing.

• Enlargement of the thyroid gland.

• Hoarseness of voice.

• Difficulty sleeping.

• Enlarged thyroid gland.

• Missed menstrual periods.

• Diarrhea (frequent bowel movements).

• Increased appetite.

What Is Ablation of the Thyroid?

Thyroid ablation is a technique that uses radioactive iodine (RAI).Thyroid nodules are benign, large growth in the thyroid gland. Thyroid radiofrequency ablation is a minimally invasive procedure that is used to treat thyroid nodules. Ultrasound-guided imaging is used to treat the targeted nodular area. Using the radiofrequency generator, a controlled amount of energy flows through an electrode into the tissues to ablate the nodule. With sustained radiofrequency ablation thermal heat, the nodule is destroyed or degenerated. The butterfly-shaped thyroid gland secretes hormones to regulate blood pressure, heart rate, metabolism, and temperature. The majority of the nodules are life-threatening and benign. They cause problems, including difficulty, discomfort, pain, and swallowing.

Thyroid RFA (thyroid radiofrequency ablation) is a non-invasive, non-surgical treatment for thyroid nodules. The benefits of thyroid RFA are:

• Preserves healthy thyroid tissues.

• Minimally invasive procedure.

• It is performed under local anesthesia.

• No scarring.

• Shorter recovery time.

• Low complication rate and good quality of life.

How Does Thyroid Ablation Cause Hypothyroidism?

The overactive thyroid gland is usually treated with radioactive iodine (RAI). The thyroid gland makes hormones that control the metabolism that provides energy. Hyperthyroidism and overactive thyroid require thyroid ablation as treatment. The other conditions that require thyroid ablation include thyroid nodules and thyroid cancer. In this procedure, the thyroid gland degenerates, which causes low secretion of thyroid hormones. The radioactive iodine treatment is done for an overactive thyroid, which is generally a well-tolerated, safe, and reliable treatment that targets the thyroid cells so that there is little exposure to the rest of the body.

Idoine is essential for producing thyroid hormones, so the thyroid gland needs iodine. The therapy destroys the thyroid cells through radiation. It is taken in capsule form. Most common thyroid cancers and thyroid nodules are treated using large doses of radioactive iodine. The therapy is usually done after removing the thyroid gland that destroys the remaining thyroid tissues.

Permanent hypothyroidism is a risk factor and expected side effect after the RAI therapy. The other temporary side effects of this therapy are:

• Nausea.

• Tenderness and swelling.

• Swollen salivary glands.

• Dry eyes.

• Dry mouth.

• Excessive tears.

• Loss of taste.

What Is the Treatment for Hypothyroidism Due to Ablation?

Hypothyroidism is underactive thyroid where the thyroid does not produce enough hormones. Taking thyroid hormone medications is the treatment for underactive thyroid. The thyroid medications include Levothyroxine (synthetic T4). It is taken orally, and the hormone levels return to normal. Thyroid hormone therapy is generally prescribed when the thyroid is not making enough thyroid hormone naturally to control the growth of the enlarged thyroid gland. Hormonal therapy is given to cancer patients whose thyroid gland has been removed surgically.

To find the right dose of Levothyroxine, the levels of TSH are checked for six to eight weeks. The optimal dose of Levothyroxine is given to prevent too many doses that may cause side effects. Too much dose of Levothyroxine can cause sleep problems, tiredness, sleep problems, and shakiness.

Conclusion:

Hypothyroidism is treated by hormonal replacement therapy by providing synthetic thyroid hormones because the thyroid can no longer make them. The patient is given Levothyroxine, a thyroid hormone medicine identical to natural thyroid hormones produced in the body. Usually, it is prescribed in pill form. The hormone is also available as a liquid and as a soft gel capsule. The newer formulas of thyroid hormones help people with digestive problems to absorb the thyroid hormone.