The thyroid gland is the most important of the endocrine ...



THYROID DISORDER

The thyroid gland is the one most important of the endocrine glands in the body. It is a butterfly shaped gland situated in the Interior part of the neck below the skin and muscle. It plays an important role in the life of every individual. The hormone secreted by it is required by every single cell in the body. 2% of the people suffer from thyroid disorder. Women suffer from the disorder more than the men

Anatomy of the thyroid gland

The thyroid is a small gland located below the skin and muscles at the front of the neck, with left and right halves (called lobes) that look like a butterfly's wings. It weighs about 30grams..

Fig1: Picture showing Thyroid gland in

the neck region.

Hormones produced by thyroid gland

The Thyroid gland produce two hormones namely

• Thyroxine (also known as T4)

• Triiodotyronine (also known as T3)

The thyroid gland stores these hormones and releases them as they are needed. Iodine is a fundamental requirement for the production of T3 and T4 and is therefore essential to life itself. T3 and T4 are responsible for controlling the basic activity of every cell in the human body.

Functions of thyroid hormones

The function of the thyroid is to secrete hormones which control metabolic pathways and thereby control various physiological functions.

Thyroid hormones are essential to proper development and differentiation of all cells of the human body. These hormones also regulate protein, fat, and carbohydrate metabolism

Fig2: Picture showing secretion of thyroid hormones

Control of thyroid hormone production

A properly functioning thyroid will maintain the right amount of hormones needed to keep the body’s metabolism functioning at a satisfactory rate. As the hormones are used, the thyroid creates replacements.

The quantity of thyroid hormones in the bloodstream is monitored and controlled by the pituitary gland which is located in the center of the skull below the brain, senses either a lack of thyroid hormones or a high level of thyroid hormones, it will adjust its own hormone (TSH) and send it to the thyroid to tell it what to do.

The hypothalamus releases thyrotropin-releasing hormone (TRH), which stimulates the pituitary gland to release thyroid-stimulating hormone (TSH).

Change in thyroid hormone production

There are two types of changes in the thyroid hormone production-one excess production is called HYPERTHYROIDISM and another low production called as HYPOTHYROIDISM.

HYPERTHYROIDISM.

When the thyroid produces too much hormone, the body uses energy faster than it should. This condition is called hyperthyroidism.

Causes of hyperthyroidism

The most common cause of hyperthyroidism is Graves' disease. This occurs when the body's immune system over stimulates the thyroid.

The following conditions also cause hyperthyroidism:

• A single or multiple nodules in the thyroid gland may produce more and more hormones.

• Thyroiditis, a disorder that can be painful or painless, can also release hormones that was stored in the thyroid gland causing hyperthyroidism for a few weeks or months.

Symptoms of hyperthyroidism

The following are symptoms for hyperthyroidism:

• Irritability/nervousness

• Muscle weakness

• Infrequent, scant menstrual periods, infertility

• Weight loss

• Sleep disturbances

• Enlarged thyroid gland

• Vision problems or eye irritation

• Heat sensitivity

Fig3: Picture showing of eyes suffering

from Hyperthyroidism

Diagnosis of hyperthyroidism

Diagnosis of hyperthyroidism is usually done by

• Hormone Studies: Study of T3, T4, TSH, free T3 and free T4.

• Thyroid Scanning

Treatment of hyperthyroidism

Several methods of treatment are available for hyperthyroidism.

• Radioactive iodine scan: Because the thyroid is the only organ in the body that takes up and uses iodine, when a dose of radioactive iodine is given the radiation enters the thyroid and destroys part of it.

• Medications (Neomercazole) can also be used for treatment. These drugs slow down the working of thyroid and restore normal levels.

• Surgical removal of part of the thyroid is occasionally used as a treatment.

HYPOTHYROIDISM

When the thyroid doesn’t produce enough hormone, the body uses energy slower than it should. This condition is called hypothyroidism.

Causes of hypothyroidism

The most common cause of hypothyroidism is Hashimoto's thyroiditis. In this condition, the body's immune system mistakenly attacks the thyroid gland.

There are several different causes of thyroid disease. The following conditions cause hypothyroidism:

• Thyroiditis is an inflammation of the thyroid gland. This can lower the amount of hormones produced.

• Hashimoto’s thyroiditis is a painless disease of the immune system that is hereditary.

• Postpartum thyroiditis occurs in 5 percent to 9 percent of women after giving birth. It is usually a temporary condition.

• Iodine deficiency

Symptoms of hypothyroidism

The following are symptoms for hypothyroidism:

• Fatigue

• Frequent, heavy menstrual periods, infertility

• Forgetfulness

• Weight gain

• Dry, coarse skin and hair

• Hoarse voice

• Intolerance to cold

Hypothyroidism Picture

Diagnosis of hypothyroidism

Diagnosis of hypothyroidism is usually done by

• Hormone Studies: Study of T3, T4, TSH, free T3 and free T4.

Treatment of hypothyroidism

Treatment of hypothyroidism consists of taking thyroid hormone in pill form on a daily basis. Adjustment of the dose of thyroid pills is based upon measurements of serum TSH. Most patients need to take thyroid hormone for life.

.

Diseases of Thyroid

Goiter

Enlargement of thyroid gland is called as Goitre. The enlargement is caused by the deficiency of Iodine.

Thyroid Nodules

Thyroid nodules are lumps which commonly arise within normal thyroid gland. Thyroid nodules are common and treatable but should always be investigated since a small proportion of them are cancerous.

Fig 4. Picture showing person with

Goiter due to Iodine deficiency.

Thyroid cancer

Thyroid cancer is a disease in which cancer (malignant) cells are found in the tissues of the thyroid gland. It is although uncommon, but in the majority of cases it is successfully treated.

Thyroiditis

Thyroiditis is an inflammation of the thyroid gland. This can lower the amount of hormones produced. It is an autoimmune disorder, which is caused by antibodies or immune cells to self antigens.

Prevention

• Use of more iodized salts.

• Avoid radiations which leads to cancer.

• Improved public awareness and understanding of thyroid disorders will enable patients and their families to cope more effectively with sometimes disturbing course of thyroid illness.

Conclusion:

Thyroid hormones are extremely important and have diverse actions. As long as thyroid releases the proper amounts of hormones, body system functions normally. But sometimes thyroid doesn't produce enough hormones, upsetting the balance of chemical reactions in the body. The disease is not life threatening, but those affected could be physically weak for a fairly long time. So proper medications & regular follow up should be done.

* * * * *

Dr. C. SHARATH KUMAR

M.B.B.S., M.S. Ph.D (Infertility)

Director and Chief Fertility Surgeon,

Mediwave I.V.F & Fertility Hospital

City X-ray Complex, Sayyaji Rao Road,

Mysore-570021

Phone: 0821-2444441 / 3265002

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