The thyroid is a gland located in the anterior part of the neck, which has an extremely important role in helping to regulate the metabolism and balance of the body, being related to the proper functioning of the heart, brain, liver and kidneys. In addition, the thyroid also influences growth, menstrual cycle, fertility, weight and emotional state.
These effects are possible because the thyroid releases the hormones T3 and T4 into the bloodstream, being able to spread throughout the body. The thyroid is controlled by the pituitary gland, another gland located in the brain which, in turn, is controlled by a region of the brain called the hypothalamus. Therefore, changes in any of these regions can cause thyroid-related problems and symptoms.
The malfunction of the thyroid can happen due to several problems, and only the evaluation of the doctor can differentiate them and confirm them, however, we mention here some of the most common:
1. Hyperthyroidism or Hypothyroidism
Hypo and hyperthyroidism are diseases caused by changes in thyroid-secreted hormone levels, and may have congenital, autoimmune, inflammatory, or other disease-related causes or side effects of treatments, for example.
In general, in hyperthyroidism there is an increase in the production of T3 and T4 hormones and a decrease in TSH, while in hypothyroidism there is a decrease in T3 and T4 with increased TSH, however, there may be variations depending on the cause.
|Signs and symptoms of Hyperthyroidism||Signs and Symptoms of Hypothyroidism|
|Increased heart rate or palpitations||Tiredness, weakness and indisposition|
|Nervousness, agitation, restlessness||Slowness physically and mentally|
|Insomnia or trouble sleeping||Difficulty concentrating and poor memory|
|Slimming||Body swelling, overweight|
|Increased feeling of warmth, reddish skin, rosy face||Dry and rough skin|
|Warm, moist skin||Sexual impotence|
|Tremor in the body||Feeling cold|
2. Thyroiditis – Inflammation of the thyroid
Thyroiditis is inflammation of the thyroid, which can happen for several causes that include viral infections such as coxsackievirus, adenovirus and mumps and measles viruses, autoimmunity, or poisonings by certain remedies such as amiodarone, for example.
Thyroiditis may manifest acutely, subacutely or chronically, and symptoms range from asymptomatic, to more intense conditions that cause thyroid pain, difficulty swallowing, fever, or chills, for example, depending on the cause.
3. Hashimoto’s thyroiditis
Hashimoto’s thyroiditis is a form of chronic autoimmune thyroiditis that causes inflammation, cell damage, and then damage to thyroid function, which may not secrete enough hormones to blood circulation.
In this disease the thyroid usually increases in size, causing goiter, and symptoms of hypothyroidism may be present or alternate between periods of hyperand hypothyroidism. It is an autoimmune disease that generates antibodies such as anti-thyroperoxidase (anti-TPO), anti-thyroglobulin (anti-Tg), TSH anti-receptor (anti-TSHr).
4. Postpartum thyroiditis
Postpartum thyroiditis is one of the forms of autoimmune thyroiditis, which affect women up to 12 months after the baby’s birth, being more common in patients with type 1 diabetes or other autoimmune diseases.
During pregnancy, the woman is exposed to the baby’s tissues, and to prevent rejection, the immune system undergoes several changes, which may increase the chances of developing autoimmune diseases. This change usually manifests with symptoms of hypothyroidism, but does not always need treatment because thyroid function can return to normal in 6 to 12 months.
Goiter is the increase in thyroid size. May have divcauses, which include lack of iod, inflammation of the thyroid by autoimmune diseases or the formation of nodules in the thyroid, and can cause symptoms such as tightness in the throat, difficulty swallowing, hoarseness, cough, and, in the most severe cases, even difficulty breathing.
Its treatment varies according to the cause, and may consist of the use of iod, remedies for hyper or hypothyroidism or, in cases of nodules and cysts, until thyroid surgery.
6. Graves’ Disease
Graves’ disease is a form of hyperthyroidism due to autoimmune causes, and in addition to symptoms of hyperthyroidism, may present thyroid enlargement, protruding eyes (eyelid retraction), formation of hardened and reddish plaques under the skin (myxema).
Treatment is done by controlling thyroid hormone levels, with medications such as Propylthiouracil or Metimazole, for example, or with radioactive iodine.
7. Thyroid nodule
Not always the cause of the appearance of a cyst or nodule in the thyroid is discovered. There are several types of nodules in the thyroid, and fortunately most of them are benign, and can present through a lump in the anterior part of the neck, which does not cause pain, but that can be seen when the person swallows food, for example.
It can be identified through palpation, and tests such as ultrasound, tomography and thyroid scintigraphy, and sometimes the doctor can request a biopsy to know its type and whether it is benign or malignant. Generally, only follow-up of the nodule is done, except when the person has symptoms, when there is a risk of cancer in the thyroid or when the nodule changes its appearance or grows more than 1 cm.
8. Thyroid cancer
It is the malignant tumor of the thyroid, and when it is discovered one should perform tests, such as full body scintigraphy, to know if other parts of the body have been affected. Treatment is done with thyroid removal through surgery, and there may be a need for other complementary therapies such as the use of radioactive iodine, for example. In cases of more severe and aggressive tumors, radiotherapy can also be used.
How to identify thyroid problems
The tests that may indicate the presence of thyroid changes are the dosage of T3, T4 and TSH in the blood, in addition to others such as antibody dosage, ultrasound, scintigraphy or biopsy, which can be requested by the endocrinologist to further investigate the reason for the changes.