The Differences between Thyroiditis, Hyperthyroidism, and Thyroid Cancer

Written by Zhang Li

Endocrinology

Updated on September 19, 2024

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Thyroiditis, hyperthyroidism, and thyroid cancer are clinically distinct conditions. Thyroiditis refers to inflammatory changes in the thyroid, either autoimmunity-related, suppurative or due to inflammation. Hyperthyroidism broadly refers to a functional change, which can result from various thyroid changes caused by diseases, including external damage and inflammation, leading to symptoms of hyperthyroidism. However, these manifestations should not be confused with each other, with the latter more closely related to autoimmune thyroiditis. Thyroid cancer, on the other hand, is a malignant alteration that also occurs in the thyroid gland but is not closely related to thyroiditis or hyperthyroidism. Generally, thyroid cancer is malignant, while thyroiditis and hyperthyroidism are benign, chronic conditions.

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How is thyroid cancer diagnosed?

The first point is the diagnostic process for differentiated thyroid cancer. Initially, most patients may not have symptoms, while a minority might show symptoms due to invasion of surrounding organs. Ultrasound examination is the preferred method for diagnosing thyroid nodules. Ultrasound can clarify the number, nature, and location of thyroid nodules, as well as provide information on whether there are abnormally enlarged lymph nodes in the neck. It has a relatively high accuracy in identifying the nature of thyroid nodules. Currently, the most accurate test for determining the nature of thyroid nodules remains the fine needle aspiration cytology, which has a diagnostic sensitivity of 83-92% and specificity of 80-92%, but it is not 100% conclusive. The second point is about the diagnosis of medullary thyroid cancer. Besides the tests common for thyroid cancers, additional tests for medullary thyroid cancer can include fine needle aspiration, ultrasound, and some serological tests, such as calcitonin and carcinoembryonic antigen tests.

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Early symptoms of thyroid cancer

Early symptoms of thyroid cancer: First, differentiated thyroid cancer often exhibits no symptoms in its early stages, only accidentally discovered nodules that vary in size and texture on the front of the neck. Some patients are only diagnosed during routine physical exams or through imaging studies, with clinical symptoms being relatively rare. However, more symptoms and signs may appear in the later stages. Second, medullary thyroid cancer presents some unique symptoms, such as persistent diarrhea, typically watery, and a syndrome involving the endocrine system. Patients may exhibit facial flushing, elevated blood pressure, and decreased blood calcium levels, accompanied by other conditions, such as parathyroid adenomas, multiple mucosal neuromas, and pheochromocytomas, which also manifest specific symptoms.

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What are the early symptoms of thyroid cancer?

Thyroid cancer is a common malignant tumor in the head and neck area. The early symptoms of thyroid cancer are highly atypical, and many patients do not present clear early symptoms. Often, patients discover painless nodules in the thyroid incidentally during physical examinations; these nodules can move up and down with swallowing motions. In a minority of cases, when the nodules of early-stage thyroid cancer are large, they can cause hoarseness or coughing and choking when drinking water. Some patients might experience intermittent, hidden pain in the thyroid area during the early stages, which often resolves on its own without treatment. Besides these, in its early stages, thyroid cancer may not present other obvious symptoms. As the condition progresses, significant clinical symptoms appear only when the tumor invades surrounding structures or metastasizes to distant sites.

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Causes of Thyroid Cancer

Regarding the causes of thyroid cancer, they are similar to most malignant tumors. The etiology of thyroid cancer is currently unclear, but some factors have been found to be associated with the onset of thyroid cancer. The first factor is neck radiation; the thyroid is an endocrine organ that is sensitive to radiation, so radiation exposure may cause carcinogenic changes in thyroid cancer cells. The second factor is genetics; some thyroid cancers have a clear genetic predisposition, the most typical being medullary thyroid cancer, with about 25% of patients showing familial clustering, known as familial medullary thyroid cancer. The third factor is that the rapid increase in the incidence of thyroid cancer also has some reasons, with one recognized reason being advancements in early diagnostic methods, allowing for the easy detection of numerous early lesions. The fourth is iodine intake, which has been shown to be related to some benign diseases of the thyroid, but its relationship with thyroid cancer itself needs further study.

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Is there an abnormality in the routine blood test for thyroid cancer?

If you have thyroid cancer, it is advised that patients promptly visit a formal hospital for examination. If one undergoes a routine blood test, generally there will be no abnormalities. This test can reveal the number of platelets, the presence of anemia, or the state of white blood cells, which are not related to the thyroid. Therefore, if thyroid cancer patients undergo routine blood tests, typically no abnormalities will be found. In daily life, patients should ensure they rest sufficiently, engage in less physically demanding exercise, maintain a cheerful mood, plan their three meals a day wisely, and pay attention to nutritious diet planning.