Thyroid disorders – FAQs

What is the thyroid gland?

The thyroid is a small butterfly-shaped gland in the front of the neck. It is composed of a left and right lobe joined by a small bridge of tissue, and it sits just below the voice box.

What does it do?

The gland produces thyroid hormones that control the body’s metabolic rate.

How can it go wrong?

Thyroid problems may present in a number of ways:

  • Localised enlargement in one area (a nodule)
  • Overall enlargement causing pressure (a goitre)
  • Over-production of thyroid hormones (hyperthyroidism, Grave’s Disease)
  • Under-production of thyroid hormones (hypothyroidism, Hashimoto’s Disease)

Thyroid nodules, goitre and hyperthyroidism may often require surgery to treat them.

Thyroid nodules and goitre are common and affect up to 20% of the population, fortunately 90-95% are benign (non-cancerous). The best test to confirm a nodule is harmless is fine needle aspiration (FNA) which involves inserting a very small needle into the lump and removing some cells to be looked at under a microscope. This can be performed in the out-patient clinic. The result usually takes 1-2 weeks at the most. Benign thyroid nodules may require surgery if very large or unsightly.

Hyperthyroidism is a common disorder and is usually due to the body’s immune system producing antibodies that bind to the thyroid cells and trick it into producing too much thyroid hormone. This speeds up the body’s metabolism and causes weight loss, a rapid pulse, anxiety and many other symptoms. It is almost always treated with medication in the first instance. Definitive treatment may take the form of radioactive iodine or surgery.

Hypothyroidism is also a common problem. Again the body’s immune system produces antibodies that bind to thyroid cells but instead of stimulating them, the antibodies cause inflammation (thyroiditis) and scarring of the thyroid that ultimately prevents it from producing enough thyroid hormone. In this scenario once daily thyroid hormone tablets are necessary to prevent symptoms such as weight gain and tiredness. Surgery is very seldom necessary.

Thyroid Cancer is fortunately rare (20th most common cancer) with approximately 60 new cases per year in Wales. It is diagnosed either by FNA or following removal of part of the thyroid gland. The vast majority (85%) of patients have an excellent prognosis following surgery (and frequently radioactive iodine therapy). To achieve the best results all patients are managed in a multi-disciplinary setting with access to expert specialist nurses, surgeons, radiologists, oncologists and pathologists.