The THYROID

GLAND AND
GOITER:
Ating Alamin
Butterfly-shaped
organ
in front of the
neck
What Does Your Thyroid
Gland Do for You?
• Produces Two Hormones Called
• Thyroxine (T4)
• Thyronine (T3)
• Regulates Metabolism so Your
Cells Function Properly
• Affects Every Cell in the Body
 Thyroid Hormone Affects
Many Organs and General Health
Eyes Lungs

Brain Heart

Kidney Liver
Skin GI Tract
Uterus
 Iodine

Thyroid Hormone

•Brain function, memory, concentration

•Muscle movement
•Cholesterol melting
•Normal heart beat
 GOITERS

Any enlargement of the

thyroid gland

“Bosyo”
G O I T E R
 GOITERS

• Structure • Function
- Diffuse - Euthyroid
- Nodular - Hyperthyroid
- Hypothyroid
 When the Thyroid
Doesn’t Work

Hyperthyroidism Hypothyroidism
When the Thyroid Doesn’t
Work

Hyperthyroidism Hypothyroidism
• Too Much Thyroid • Too Little Thyroid
Hormone Hormone
• Metabolism Speeds • Metabolism Slows
Up Down
 Two Common Types of
Thyroid Disease

• Hyperthyroidism • Hypothyroidism
 Signs and Symptoms of
Hyperthyroidism
Hoarseness or
Nervousness Deepening of Voice
Persistent
Irritability
Sore or Dry Throat
Difficulty Sleeping Difficulty Swallowing
Rapid or Irregular Heartbeat
Bulging Eyes/Unblinking Stare

Swelling (Goiter) Infertility

Menstrual Irregularities or Weight Loss
Heat Intolerance
Light Period
Frequent Bowel Movements Increased Sweating

Warm, Moist Palms First-Trimester Miscarriage

Family History of

Excessive Vomiting in Pregnancy Thyroid Disease

or Diabetes
 Signs and Symptoms of
Hypothyroidism

Tiredness Puffy Eyes

Forgetfulness/Slower Thinking Swelling (Goiter)

Moodiness/ Irritability Hoarseness/

Depression Deepening of Voice

Persistent Dry or Sore Throat
Inability to Concentrate
Difficulty Swallowing
Thinning Hair or Hair Loss
Loss of Body Hair Slower Heartbeat
Menstrual Irregularities/
Dry, Patchy Skin Heavy Period
Weight Gain
Infertility
Cold Intolerance
Constipation
Elevated Cholesterol
Muscle Weakness or Cramps
What causes Thyroid
Diseases ?
The “Hidden” Health Problem
What causes thyroid
diseases ?
• Iodine deficiency disorder
• Surgical
• Radioiodine therapy
• Autoimmune diseases
 Clinical Expression of Iodine
Deficiency
Fetus Neonate
• Miscarriages • Increased infant
• Stillbirths mortality
• Neonatal goiter
• Neurological
• Cretinism
cretinism
• Impaired
• Impaired intellectual
intellectual
function function
• Increased perinatal
mortality
 Clinical Expression of Iodine
Deficiency

Child & adolescent Adult

• Goiter • Goiter
• Hypothyroidism • Hypothyroidism
• Impaired and poor
intellectual intellectual and
function physical
• Retarded physical performance
development
Sources of Dietary Iodine

• Iodine in soil, water and crops

• Seafood
• Dairy Products
• Iodised salt and other fortified
foods
• Medicines/health
foods/supplements
• Other adventitious sources
 Myths and Facts
on Thyroid Diseases
 ON FOODS
Myth Fact
Eating carrots, These foods have
cabbage, root goitrogens.
crops can cause But you have to eat
goiter. a truckload of
these foods in a
short time before
you develop
goiter.
 ON FOODS
Fact
Myth
Drinking cold
drinks is bad
if you have
goiter.

The temperature of the food or drink

has no effect on the thyroid gland
since it is not located in the
alimentary tract
 ON FOODS
Myth Fact
Eating seafoods Seafoods are
can cure goiter. important for
their iodine
content but can
not cure goiter.
Not eating A person with
seafoods can iodine deficiency
cause goiter may develop
goiter.
 ON FOODS
Myth Fact
Herbal medicines Contents of herbal
are effective in medicines are
treating goiter often not
and other thyroid specified; their
problems. efficacy to treat
is still in
question.
 ON FERTILITY
Myth Fact
A person with Simple goiter does
goiter becomes not affect fertility
infertile of both sexes.
It is abnormal
thyroid function
that affects
fertility
 ON FERTILITY
Myth Fact
Radioactive iodine Radioactive iodine
treatment for only
hyperthyroidism concentrates in
will lead to the thyroid gland
infertility. and does not
affect other
organs
 ON PREGNANCY
Myth Fact
Bearing down Iodine deficient
during labor can pregnant women
cause goiter develops goiter
to compensate
for thyroid
hormone
deficiency. It is
noted after
delivery when
increased weight
is resolved
 ON PREGNANCY
Myth Fact
Goiter, if present, Bearing down
indicates during labor
caesarean does not affect
section the size of goiter
 ON PREGNANCY
Myth Fact
Any drug for the If the medication is
treatment of for
thyroid problem hyperthyroidism
should be or replacement
discontinued therapy, the
once the patient patient should be
becomes referred to an
pregnant endocrinologist
for dose
adjustment
 ON PREGNANCY
Fact Fact
There is an Patients with
increased risk for inadequate
replacement
miscarriage if
therapy have
medications are abnormal platelet
discontinued function which
may lead to
prolonged
bleeding during
labor
 ON PREGNANCY
Myth Fact
All mothers with Mothers with
circulating thyroid
thyroid diseases antibodies are more
will deliver likely to have
infants with infants with thyroid
problems
thyroid problems
Antithyroid
medications
traverse the
placenta and may
cause transient
hypothyroidism in
the baby
 ON VARIOUS TREATMENT
MODALITIES
Myth Fact
Radioactive Iodine There has been no
report that it can
Treatment can
cause cancer
cause cancer
There is no
chromosomal
abnormality in
children born to
mothers who
received the
treatment
 ON VARIOUS TREATMENT
MODALITIES
Myth Fact
Radioactive Iodine 131 Iodine
Treatment cannot concentrates
be given to only in the
thyroid gland
individuals in
their Fertility is affected
by the abnormal
reproductive age thyroid
functional status
(hyperthyroidism
or
hypothyroidism)
 ON VARIOUS TREATMENT
MODALITIES
Myth Fact
Radioactive Iodine Even without
Therapy leads to intervention, the
hypothyroidism gland will shrink
in > 10 yrs time,
due to
continuous
inflammation and
fibrosis
eventually
leading to
hypothyroidism
 ON VARIOUS TREATMENT
MODALITIES
Myth Fact
Patients who No isolation is
receive necessary for 131
Iodine uptake and
Radioactive
therapy for
Iodine uptake hyperthyroidism
and therapy Only patients who
should be receive high dose
isolated treatment for cancer
should be isolated
in a leaded room
 SURGERY
Myth Fact
Surgery is the Surgery is
ultimate indicated for
treatment for all thyroid cancer,
thyroid diseases multinodular
goiter, and in big
goiters causing
compression
symptoms
 SURGERY
Myth Fact
Patients who get This is rare if
operated on for thyroidectomy is
goiter lose their done by an
voice experienced
surgeon
Laryngeal nerve
damage is higher
on reoperation
 “Kaya lumalaki ang leeg at nagka-
bosyo ang buntis e dahil hindi ito
marunong umire.”

“Bawal magbuhat ng mabigat habang

buntis dahil magkaka-Goiter sya.”
 When you have
GOITER
• Visit your doctor or an endocrinologist
• Blood tests and other tests like
ultrasound may be requested for
evaluation
• Medications given should be taken
regularly as prescribed
The Philippine College of Physicians wishes to acknowledge
the following for their invaluable efforts in the preparation
of this module

Nemesio Nicodemus, MD
Bien Matawaran, MD
Aimee Andag-Silva, MD
Leilani Mercado-Asis, MD
Gabriel Jasul, MD
Rosa Allyn G. Sy, MD
Committee on Advocacy & Public Relations
Philippine Society of Endocrinology and
Metabolism