THE SHIELD OF HEALTH BASE
Thyroid gland hormones influence the growth and maturation, increase protein synthesis, speed the fat razing and have the key role in nervous system development…Human body does not react well neither to decreased nor to the increased activity of this gland
THYROID gland is the biggest gland in human body. It has the shape of a shield or a buterfly, while being situated in the front part of human throat, in front of trachea. Thyroid gland creates and secrets hormons T4 (thyroxin) and T3(thyronin). These hormons regulate methabolism of all other tissues in human body. Parafolicular, io C-cells of the thyroid gland, secrete calcitone hormone that participates in calcium homestasis of human body.
Every cell and tissue in human body depends on thyroid hormones. Thyroid hormones influence the growth and maturation, increase basal oxygen spending and heath creation, increase synthesis of proteins, increase the basal oxygen spending and heath creation, increase per minute volume of the heart, speed up the fats razing and decrease the fats quantities in human body. Thyroid hormones have the key role in development of the nervous system, initiate the state of being awake, increase the sensitivity to various stimuluses, influence the sense of hunger, memory and capability for learning, as well as normal emotional tonus. Moreover, these hormones have an important role in reproduction function both in men and women, as well as the normal pregnancy. The hormones influence the growth and development of brain in foetal period and in the course of first few years. The lack of thyroid hormones in this period may lead to mental retardation.
Goitre means every sort of excessive thyroid gland. This enlargement of the gland may be followed by its decreased, normal or increased function. Thyroid gland may also be enlarged diffusely (completely) or nodous (meaning the creation of one or several nods in thyroid gland).
Most often disorder in this gland function is hypothyroidism, appearing when thyroid gland does not create enough hormones. It may be caused by some disorders within the gland itself, or due to disorders of the supervising mechanisms in higher structures of brain (hypophysis, hypothalamus). Most common cause of the primary hypothyroidism is chronic autoimmune thyroiditis (Hashimoto). It appears as the consequence of thyroid gland cells damages by immunologic mechanisms (when disorder of the immunologic body system causes the attack action against its own tissue). In this case either decrease or increase (atrophy) of thyroid gland may occur. Other causes of hypothyroidism may be surgical gland removing, medical treatment including radioactive iodine, or external radiation treatment of head or neck tumors.
Both higher and lower level of iodine may cause hypothyroidism. Lower level of iodine is the most common cause of hypothyroidism in the world, esspecially in monutain areas.Some medicines may cause hypothyroidism, such as metimazol, propiltiouracil (used in hyperthyroidism), amiodaron, interferon alfa etc. Infiltrative diseases, as fibroses inflammation of thyroid gland, amiloidosis, and sacoidosis may also cause hypothyroidism.
Hypothyroidism in some persons does not bring first symptoms, while in some others the symptoms are very strong. Most often symptoms are fatigue, exhaustion, slow reactions, apathy, emotional misbalances, sleepiness, difficulty with standing cold, difficulty in concentration, depression, weaker appetite and weight gain. The skin is dry, hair loss appears, eyes areas might be swollen and periphery edema might appear. Such patients might have slower pace of heartbeat, mild hypertension and increased values of cholesterol in blood, weaker sense of hearing, constipation and disorders, i.e. irregular menstrual cicluses.
When hypothyroidism signs show, one must perform analyses of the TSH and free thyroxin in blood. TSH is thyroid stimulating hormone secreted by hypophysis and it stimulates the production of thyroid gland hormones. This test is the most sensitive one and when the results show the increased values, it clearly shows hypothyroidism. Patients with chronic hypothyroidism need lifelong treatment with syntetic tyroxine.
PEACE BRINGING HORMONE
Hyperthyroidism, i.e. increased function of thyroid gland may occur in any age, most often between the age of 20 to50, most often in women. Most often cause in 70-80% of patients is the exaggerated function of the complete gland caused by autoimmune process called diffuse toxic goiter, or Graves disease, or Bazed disease. Hyperthyroidism may also appear due to increased secretion of TSH caused by tumors, i.e. adenoma of hypophysis (secondary hyperthyroidism). Tropho-blast tumor, chorio-carcinoma or hidatifomna mola also can cause the increased production of this hormone.
All the symptoms are consequences of this increased creation and action of thyroid gland hormones influencing all human body. Patients suffer from nervousness, anxiety, emotional disorders, insomnia, frequent stools, difficulty in standing worm or heat, faster heart beat pace, hypertension, good appetite followed by weight loss, weakness of proximal musculature, and disorders in menstrual cycles. The skin is warm and wet. Fine fingers trembling and increased reflexes also occur. The eyes contain more tears liquid, rare twinkle and low eyesight sharpness. Hyperthyroidism therapy includes anti-thyroid medicines, i.e. thyroidostatics.
There is a difference between acute and sub-acute thyroiditis. Acute thyroiditis is caused by bacterial or fungus infections or as the consequence from radioactive iodine treatments (radiation thyroiditis). Sub-acute thyroiditis is a hypermethabolic condition which is not the result of increased function of thyroid gland, but caused by tissue damages and consequent leaking of huge quantities of thyroid hormones into blood circulation (virus infection activity). Therapy for these cases includes symptomatic treatment. Occasionaly there may occur the infection of thyroid gland after the baby delivery, and it is called pospartal thyroiditis.
There is a less common disorder when one or several nods in thyroid gland become too active and secret the surplus of the hormones, and then it is the case called toxic adenoma or toxic polinodic goiter. Nods in the thyroid gland are more often benign changes and do not demand compulsory medical treatment. However if solid and hard nods are detected, especially in case it is fixed to the surrounding tissue, or followed by enlarged lymph nods in neck, then there is a suspicion to malign character.
Carcinoma of thyroid gland is the rarest disease of this gland, mostly slow developing and lethal outcome rate is very low, as well as postoperative complications (especially in well-differentiated carcinoma as papillary or follicular). The character of a nod may be detected by ultrasound examination, scintiography and cytological punction. Therapy of a nodous goiter depends on the nature of the nod. Sometimes it is necessary only to follow and control it, while sometimes it is advised to apply radioactive iodine therapy or surgical treatment. Medicament therapy is rarely advised.
dr Slađana Drobnjak, Internal medicine specialist
THYROID DISORDERS MORE OFTEN IN WOMEN
More than 200 million people in the world have some form of thyroid gland disorder. In more developed countries, one out of twenty persons suffers from some form of thyroid disorder or disease and it is 5 to 7 times more often in women than in men. Thyroid disorders and diseases are in most case curable, but in case of neglecting the medical treatment, these may lead to heavy and serious consequences, as well as to lethal outcomes due to severe disorders.
