Coughing is a very common symptom that can be due to a multitude of disease processes. Whilst some may be less sinister such as common colds or irritation you might have heard of more worrying conditions that may involve organs such as the thyroid. This article will answer any concerns and questions you might be asking yourself!
Whilst it is a highly unlikely symptom of most thyroid diseases, thyroid enlargement can indeed cause cough symptoms. This is because anything that stimulates your cough receptors will elicit the coughing response, and if something were to compress your trachea or displace it, such as an enlarged thyroid gland, this can trigger your cough.
In this article you will be able to understand more about thyroid disease, how it can lead to cough and common ways you can combat your cough as well as when it might be time to visit your health care provider.
What are the thyroid problems that can cause coughing?
Causes
Before talking about how the thyroid gland causes coughing, we need to understand whatthe thyroid does and where it is located. It is known as an endocrine gland and as such secretes hormones, in particular, 90% is the inactive precursor hormone thyroxine (T4) and 10% is the active hormone triiodothyronine (T3).1
The thyroid gland is located in the anterior (forward part) neck and is close to many important structures such as the vascular (blood) supply of the neck, the recurrent laryngeal nerves and another endocrine organ called the parathyroid gland. Anatomically the thyroid gland looks like a butterfly attached to the trachea (windpipe). It has two lobes, right and left, connected by a structure called the isthmus. It is very close tothe cartilages of the larynx and physically attached to the trachea by what is called Berry’s ligament (connective tissue bridging the two structures).2
Commonly the thyroid gland can either be overstimulated or under-stimulated leading to hyperthyroidism or hypothyroidism respectively. Some common conditions of the thyroid glands involve inflammatory processes such as thyroiditis. Thyroiditis can be caused by autoimmune conditions such as Graves’ disease or infectious causes such as bacterial infections. As a result, you can get either hypo- or hyperthyroidism depending on the process and amount of tissue destruction.3
Some other conditions can be more sinister and involve the development of tumours (cancers). These cancers can include the following: papillary thyroid carcinoma, medullary thyroid carcinoma or follicular carcinomas, depending on what part of the thyroid is affected.
Some ways in which thyroid conditions might cause coughing could be through goitre formation or laryngeal sensory neuropathy (LSN). Moreover, thyroxine has been found to stimulate the respiratory system, which could lead to symptoms such as coughing. This means that patients with hyperthyroidism could have a higher circulating volume of thyroxine, and so could be afflicted with a cough, but this relationship has not been fully evaluated.4
Effects
Looking at the study by Hamdan et al., it is possible to see how LSN and goitre formation could be involved in the development of coughing.5 This study suggested that, due to the close proximity of the laryngeal nerves to the thyroid gland people with a goitre were more likely to develop LSN and neck symptoms, including cough. This was explained as the goitre causing compression of the laryngeal nerves, leading to nerve damage and a whole host of symptoms which are detailed in the next paragraph.5 Moreover, thyroid hypertrophy (or enlargement) can cause tracheal deviation and compression of your upper airway. This would stimulate your cough receptors and lead to you feeling like you need to clear your throat or chest.4
Symptoms
There are various symptoms attributed to thyroid disease. Depending on whether you are hypo- or hyperthyroid, your symptoms will vary. Some generalized changes can include voice changes (known as dysphonia) because of laryngeal involvement, coughing, difficulty breathing and goitre formation. In addition, with hyperthyroidism, you might find yourself getting hungrier than normal and eating more but not gaining weight, whilst the opposite might be true for hypothyroidism.
Diagnostics
How do you know if you have thyroid cancer?
When looking at the thyroid there are multiple tests available. In recent years there has been an increasing number of imaging techniques that can be used to view the thyroid. Such techniques include ultrasounds, x-rays, CTs, and MRIs. Depending on where you go, your healthcare provider will refer you to a specialist that will be able to direct you to an answer. In addition, in order to assess whether the tissue is neoplastic (possibly cancerous) or not your healthcare provider might use a technique called a fine needle aspirate. This is where they put a needle in the chosen location (which they will be able to determine through imaging) and get a sample of cells.
This sample can then be sent to the lab for histology, where they will look for the cell types in the sample and neoplastic biomarkers. Neoplastic biomarkers are proteins presented by the tumour, which give us a higher likelihood as to whether a cancer or other tumour is present or not. When looking at thyroid cancers, HBME-1 and GAL-3 are the most specific and selective biomarkers, giving your healthcare provider a more complete picture.6,7 Of course, each doctor will take a slightly different approach to the matter, the above-mentioned methods are only some of the various ways to diagnose a thyroid mass and to differentiate a cancer from other growths.
How to prevent having cough
Coughs can be annoying and irritating; wouldn’t it be nice to find a way to stop them from happening in the first place? Well, read below to find out more. To prevent having a cough it is important to look after your general health through eating a wide and healthy variety of foods and drinking plenty of liquids. In addition, it is best to keep warm and bundle up in the winter when it is colder. All things considered, sometimes it is impossible to prevent a cough or develop some sort of illness, so it is important to know how you can fight a cough on your own.
Treatment and home remedies
The best treatment for a cough is finding the root cause of it. This can be done by going to your healthcare provider and seeking advice. In the meantime, why not try some home remedies that have been passed down for generations? These include warm milk with honey to soothe your throat as well as plenty of warm liquids. There have been recent debates as to whether cold or warm drinks help but drinking lots of fluids is paramount for a quicker recovery. You can also try some over-the-counter medicines such as soothers and cough syrup.
When to seek medical attention
Like with most health conditions it might be hard to know when it is time to phone the doctors. As a general rule of thumb, if your symptoms are chronic (lasting longer than 3 weeks), it might be because you need a little extra help fighting off your symptoms, or further tests are needed to discover what could be causing them. In addition, if you find your symptoms worsening it might also be time to visit your doctor. Lastly, if you are struggling to breathe or are in severe discomfort do not hesitate to contact the emergency services.
Summary
This article has looked at the thyroid and how it can cause symptoms such as coughing. As a general answer, it can be said that thyroid hypertrophy through the development of goitre can lead to coughing due to the obstruction of your trachea or through laryngeal sensory neuropathy. There might be hormonal or metabolic implications of thyroid disease leading to coughing, but these have not been well-researched. Moreover, there are many things you can try at home to relieve your coughing symptoms but if you find yourself not being able to control them or seem to be getting worse do not hesitate to contact your local healthcare provider or even emergency services.
References
- Armstrong M, Asuka E, Fingeret A. Physiology, thyroid function. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2022 Dec 1]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK537039/
- Allen E, Fingeret A. Anatomy, head and neck, thyroid. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2022 Dec 1]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK470452/
- Fariduddin MM, Singh G. Thyroiditis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2022 Dec 1]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK555975/
- LENCU C, ALEXESCU T, PETRULEA M, LENCU M. Respiratory manifestations in endocrine diseases. Clujul Med [Internet]. 2016 [cited 2022 Dec 1];89(4):459–63. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5111483/
- Hamdan AL, Jabour J, Azar ST. Goiter and laryngeal sensory neuropathy. Int J Otolaryngol [Internet]. 2013 [cited 2022 Dec 1];2013:765265. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3681260/
- Sethi K, Sarkar S, Das S, Mohanty B, Mandal M. Biomarkers for the diagnosis of thyroid cancer. J Exp Ther Oncol. 2010;8(4):341–52. Available from: https://pubmed.ncbi.nlm.nih.gov/21222366/
- Ramkumar S, Sivanandham S, Ramkumar S, Kumari S. The Combined Utility of HBME-1 and Galectin-3 Immunohistochemistry and BRAF V600E Mutations in the Diagnosis of Papillary Thyroid Carcinoma. Cureus [Internet]. 2021 [cited 2023 May 11]; 13(12). Available from: https://www.cureus.com/articles/77638-the-combined-utility-of-hbme-1-and-galectin-3-immunohistochemistry-and-braf-v600e-mutations-in-the-diagnosis-of-papillary-thyroid-carcinoma.