Diseases of the thyroid gland

Thyroid diseases - check for symptoms

The thyroid gland is an endocrine gland at the front of the neck that releases hormones that regulate many important processes in the body. Hormones secreted by the thyroid gland (thyroxine T4 and triiodothyronine T3) affect, among others, on metabolism, water balance, and regulate the functioning of the nervous and reproductive systems. Symptoms associated with abnormal thyroid gland function are often ignored by patients. Sometimes thyroid symptoms are so nonspecific or masked by other conditions that patients are not at all aware that they may have thyroid problems. Meanwhile, thyroid disease can lead to many serious health complications. They are especially dangerous for pregnant women and for the baby developing in the mother's body. In addition, nodules may form within the thyroid parenchyma - some of them may be a sign of a malignant neoplastic process. How to recognize thyroid disease? What symptoms might suggest thyroid problems? We invite you to read the article below.

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Hypothyroidism

Hypothyroidism is a condition in which the thyroid gland produces too little thyroxine and / or triiodothyronine.

The causes of hypothyroidism

The most common cause of hypothyroidism is Hashimoto's disease, in which the immune system attacks its own thyroid gland, gradually destroying the thyroid parenchyma. Hashimoto's thyroiditis is a condition that mainly affects women. This is related to the role of the female hormones, estrogen, which are involved in modulating the inflammatory response at the level of the thyroid gland.
Another cause of damage to the thyroid parenchyma may be radioiodine therapy or radiation therapy to the neck area used in the treatment of cancer. Sometimes it is necessary to have a thyroidectomy (surgical excision of the gland), which completely deprives the body of thyroid hormones.
Iodine is a component of thyroid hormones, therefore iodine deficiency in the diet may result in their decreased synthesis. The production of thyroid hormones is also suppressed in the event of an overdose of iodine compounds.
Hormonal disturbances related to the hypothalamic-pituitary-thyroid axis (e.g. hypopituitarism, hypothalamic tumors) may also result in insufficient thyroxine production by the thyroid gland.

Symptoms of hypothyroidism

Hypothyroidism slows down the metabolic processes and reduces the excitation of the nervous system. In children, this can lead to mental retardation (called cretinism). In adults, the deficiency of thyroid hormones may be responsible for malaise, decreased concentration and psychomotor slowing down. Symptoms of a diseased thyroid are often explained by work, stress and general exhaustion - we rarely think that it may be a sign of a hormonal imbalance. Dry skin and brittle hair are often perceived only as a cosmetic problem, resulting from the wrong choice of cosmetics or insufficient care.
It often happens that the potential symptoms of thyroid disease in adults are analyzed only after the couple has been unsuccessfully trying to conceive for a long time (hypothyroidism negatively affects fertility). Before serious complications related to thyroid disorders occur, it is worth taking an interest in your own health and checking whether our ailments may be the result of thyroid disorders.

What symptoms might indicate an underactive thyroid?

Thyroid symptoms caused by hypothyroidism include:
- chronic fatigue,
- feeling cold in an environment with a neutral temperature,
- fatigue, drowsiness regardless of the number of hours slept,
- lack of concentration, dullness,
- bradycardia (low heart rate),
- swelling,
constipation
- dry skin
- excessive hair loss,
- difficulty in maintaining a healthy body weight, tendency to gain weight,
- irregular menstruation in women.
In some types of hypothyroidism (most often Hashimoto's thyroiditis), goiter is formed. An increase in the circumference of the neck is observed. An enlarged thyroid gland can compress adjacent structures and cause discomfort when swallowing.

How do you finally recognize hypothyroidism?

The symptoms of a diseased thyroid gland may coexist or be very similar to those resulting from other neurological or cardiological conditions.
In the case of hypothyroidism, a blood test of the thyroid gland shows an increased level of the thyroid stimulating hormone TSH secreted by the pituitary gland, as well as a decreased level of thyroxine T4. In advanced and untreated hypothyroidism, there is also a reduction in triiodothyronine levels. Your doctor may also perform an ultrasound to assess the structure and size of the thyroid gland.

Treatment of hypothyroidism

Treatment depends on the type of hypothyroidism. When hypothyroidism is due to damage to the thyroid gland, treatment is by taking orally medications that contain thyroid hormones. When the cause of the insufficient production of thyroid hormones is iodine deficiency, iodine supplementation is recommended.

Overactive thyroid gland

Hyperthyroidism is a condition in which thyroxine and triiodothyronine are produced by the thyroid gland in too large amounts.

The causes of an overactive thyroid gland

The most common causes of hyperthyroidism include:
excessive production of thyroid hormones by autonomic toxic nodules (secretion beyond the control of the pituitary gland),
Graves' disease (an autoimmune disease),
disorders of the hypothalamic-pituitary-thyroid axis,
hormone production by the placenta in pregnant women,
overdosing of orally taken drugs containing thyroid hormones
taking certain medications, e.g. lithium carbonates used in the treatment of mental disorders (relatively rarely).

Symptoms of an overactive thyroid gland

The effect of an overactive thyroid gland is called thyrotoxicosis (poisoning with excess thyroid hormones). The symptoms of thyrotoxicosis include:
nervous hyperactivity,
losing weight for no apparent reason,
excessive sweating
tachycardia (increased heart rate)
chronic diarrhea
more frequent urination, increased thirst,
possible muscle weakness,
menstrual disorders in women,
decreased libido in men.
In the case of Graves' disease, there may also be so-called thyroid ophthalmopathy - a feeling of distraction of the eyeballs, burning eyes, exophthalmia, visual disturbances (e.g. double vision).
Jak potwierdzić stan nadczynności tarczycy?
W badaniach laboratoryjnych (badaniach krwi) poziom TSH jest obniżony przy podwyższonym poziomie hormonów tarczycy (tyroksynie T4 i trójjodotyroninie T3). Następnie wykonywane jest badanie USG pod kątem obecności guzków i/lub stanu zapalnego w obrębie tarczycy. Badanie uzupełniające stanowi scyntygrafia, które polega na ocenie wychwytu jodu przez tarczycę. Guzki najbardziej wychwytujące jod to tzw. guzki gorące – są one odpowiedzialne za nadmierne wydzielanie hormonów tarczycy, niezależnie od stymulacji z poziomu przysadki mózgowej.

Treatment of an overactive thyroid gland

Treatment consists of:
taking medications that inhibit the secretion of thyroid hormones (so-called thyreostatic drugs),
taking beta-blockers,
destroying the nodules with radioactive iodine,
excision of a part of the thyroid gland along with nodules producing excess hormones.

Thyroid cancer

Lumps on the thyroid gland can be benign or malignant (cancer of the thyroid gland). The vast majority of detected nodules (approx. 95%) are benign changes. Some of the lumps can be easily palpated. Smaller nodules are only detectable on ultrasound. An indication for an ultrasound of the thyroid gland, in addition to palpable nodules, should also be an increase in the circumference of the neck. People with autoimmune thyroiditis should undergo regular ultrasound examinations, as chronic inflammation increases the risk of developing a malignant neoplasm.
Ultrasound examination of the thyroid gland allows us to initially distinguish benign lesions from potentially malignant nodules. Thyroid cancer is usually characterized by:
- clear borders of the nodule with an irregular "jagged" shape,
- the presence of calcifications within the nodule,
- heterogeneous structure of the inside of the nodule with no fluid content,
- a nodule with no increased flow, surrounded by an inflamed thyroid parenchyma, with a markedly increased flow.

Treatment of thyroid cancer

Treatment of a malignant thyroid gland may include:
- surgical excision of the nodule with part of the thyroid gland,
- total thyroidectomy,
- radioiodine therapy,
- taking medicines containing thyroid hormones (to prevent the effects of an underactive thyroid gland).

FAQs:
1.What causes thyroid disease?
In most cases, thyroid disorders develop due to autoimmune disorders, e.g. Hashimoto's disease causing hypothyroidism or Graves' disease causing hyperthyroidism. Environmental factors, diet and genetic predisposition play a role in the pathogenesis of thyroid diseases.
2. How to recognize thyroid disease?
Symptoms related to the abnormal secretory function of the thyroid hormones (hypothyroidism or hyperthyroidism) may be related to:
- acceleration or slowing down of the metabolic rate (losing weight or a tendency to gain weight),
- psychomotor disorders (slowness and depressive states or excessive psychomotor agitation),
disturbances in intestinal motility (chronic constipation or diarrhea),
fast or slow heart rate (bradycardia or tachycardia),
- menstrual disorders, infertility,
- cosmetic problems - excessive skin dryness, hair loss.
You should also be concerned about the swelling of the face or pain and bulging eyes. An enlarged neck circumference may indicate a pathological enlargement of the thyroid gland (goiter development). Palpable nodules on the thyroid gland are an indication for an ultrasound examination.
3. What doctor deals with the diagnosis and therapy of thyroid diseases?
The doctor to go to in case of suspected thyroid disease is an endocrinologist. If additional tests or procedures are required, the endocrinologist will refer the patient to a radiologist or general surgeon.