Spokespersons: Dr Wong Mei Wan, Consultant Breast and Endocrine Surgeon at Sunway Medical Centre, Sunway City (SMC)

Thyroid health is a fundamental yet often overlooked aspect of our overall well-being. Nestled in the neck like a butterfly, the thyroid gland plays a pivotal role in regulating body metabolism. The thyroid produces hormones crucial for energy regulation, making it a key player in our overall well-being. Dr Wong Mei Wan, Consultant Breast and Endocrine Surgeon at Sunway Medical Centre, Sunway City (SMC), the largest quaternary private hospital in Malaysia shares some valuable insights into the functions of the thyroid, differences between hyperthyroidism and hypothyroidism, common myths, and misconceptions.

Identifying the difference of Hyperthyroidism and Hypothyroidism

Hyperthyroidism is the second most common endocrine disease after diabetes in Malaysia[i]. Dr. Wong Mei Wan also delves into various thyroid diseases categorised based on functionality. These include hyperthyroidism, hypothyroidism, and cases where the thyroid gland is functioning normally but has nodules. Understanding these distinctions is crucial for comprehending the wide range of thyroid-related conditions that individuals may face.

Hyperthyroidism as Dr. Wong Mei Wan shares is characterised by excess hormone production. This condition manifests through symptoms such as restlessness, weight loss, heat intolerance, and excessive sweating. On the other hand, hypothyroidism, resulting from insufficient hormone production, presents symptoms such as fatigue, weight gain, and persistent lethargy.

The causes of hyperthyroidism vary, ranging from autoimmune diseases like Graves disease to thyroiditis triggered by excessive iodine intake. Conversely, hypothyroidism can occur as a result of surgery due to removal of the thyroid gland. Genetics may contribute to some thyroid issues[ii].

The most worrying about hyperthyroidism symptoms can mimic common issues, so many hyperthyroidism cases are often left untreated. According to recent research, about 50% of people with thyroid disease often go undiagnosed[iii]. Dr Wong adds, “Because the symptoms of both hyperthyroidism and hypothyroidism can be difficult to distinguish if it’s a normal occurrence or its due to imbalances, it is imperative that people seek help If they encounter these symptoms. With hyperthyroidism, this is even more important as it can lead to serious health problems even death.”

Graves’ Disease

Graves’ disease, an autoimmune condition causing hyperthyroidism, goiter, and potentially other organ-affecting symptoms[iv]. Dr. Wong Mei Wan explains, “Treatment for Graves’ disease may typically involve medication, radioactive iodine, or surgery, depending on hormone control. Understanding the nuances of complications like Graves’ disease is crucial for individuals navigating thyroid health.”

Symptoms and Misconceptions

To diagnose thyroid diseases, healthcare professionals commonly conduct thyroid function tests—a blood test that assesses hormone levels. Dr Wong Mei Wan adds, “Thyroid symptoms, whether hyper or hypo, are often nonspecific, leading to misinterpretations. If you have symptoms that are persistent over one month period, see a healthcare professional and get a thyroid function test which a blood test.”

Ultrasound may be recommended if nodules or abnormalities are suspected in your thyroid function. Dr. Wong Mei Wan advises, “Like a lump in the breast, if you suspect that there is an abnormality in your neck due to your thyroid, early detection with regular check-ups and screening is encouraged.”

Dr Wong Mei Wan also shares that some of misconceptions with thyroid nodules is that if you have a nodule, it requires medication or its cancer, she shares that as long as the patients’ thyroid levels are normal, medication is not required even if they have a nodule.

Research also suggests a higher prevalence of thyroid diseases among women[v]. While Dr. Wong Mei Wan acknowledges this trend but highlights the lack of conclusive evidence explaining the reason for the gender disparity.

Treating Thyroid Disease

Treatment varies based on the type and severity of thyroid disorders. Medications are often prescribed to regulate hormone levels. Dr. Wong Mei Wan emphasises the importance of monitoring through regular blood tests, especially for those undergoing treatment, to ensure stability in thyroid function.

Thyroid awareness is a critical component of maintaining overall health. With the complexities of thyroid disorders, it stands to reason that there is a need for regular check-ups, awareness of symptoms, and early intervention that can significantly contribute to optimal thyroid health, ensuring a balanced and vibrant well-being among Malaysians.

[i] CPG_Management-of-Thyroid-Disorders.pdf (mems.my), CLINICAL PRACTICE GUIDELINES MANAGEMENT OF THYROID DISORDERS, MEMS Malaysia

[ii] Schultheiss, U., Teumer, A., Medici, M., Li, Y., Daya, N., Chaker, L., Homuth, G., Uitterlinden, A., Nauck, M., Hofman, A., Selvin, E., Völzke, H., Peeters, R., & Köttgen, A. (2015). A genetic risk score for thyroid peroxidase antibodies associates with clinical thyroid disease in community-based populations. The Journal of clinical endocrinology and metabolism, 100 5, E799-807 . https://doi.org/10.1210/jc.2014-4352.

[iii] Canaris GJ, Tape TG, Wigton RS. Thyroid disease awareness is associated with high rates of identifying subjects with previously undiagnosed thyroid dysfunction. BMC Public Health. 2013;13:351. Published 2013 Apr 16. doi:10.1186/1471-2458-13-351

[iv] Menconi, F., Marcocci, C., & Marinò, M. (2014). Diagnosis and classification of Graves’ disease.. Autoimmunity reviews, 13 4-5, 398-402 . https://doi.org/10.1016/j.autrev.2014.01.013.

[v] Kim, Y., Chang, Y., Cho, I., Kwon, R., Lim, G., Jee, J., Ryu, S., & Kang, M. (2022). Menopausal stages and prevalence of thyroid dysfunction.. Thyroid: official journal of the American Thyroid Association. https://doi.org/10.1089/thy.2021.0544.