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Thyroid disease in men and women

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Structure, function and role of the thyroid gland in the body

The thyroid gland is an important part of the endocrine system and provides a synthesis of several hormones that preserve the homeostasis of the organism. The endocrine disorders show themselves with various unpleasant symptoms, but most people do not realize that causes all the trouble can be small (only 4 cm in length), the organ – thyroid gland. While few know where it is, and people who go to the doctor with a lump in the neck, when not to notice the pathology is not strongly trigger the disease.

The thyroid gland is symmetrical paired organ located under the Adam's Apple (Adam's Apple) in front of the trachea. Shaped like a butterfly, consists of left and right side-lobes and the isthmus. The isthmus is adjacent to the trachea and the shares form the "wings" of the butterfly, the upper of which is elongated, in comparison with lower.

The rate of iron has a euthyroid state, while it is soft and almost imperceptible on palpation. However, in the fevered condition, such as in thyroiditis, it can increase in size and swelling to compression of Airways, which can be complicated, the process of breathing and swallowing.

Typical variation in body weight of 20 to 65 g. Size of thyroid gland varies, depending on age and hormonal status. So, in pregnant women, there is a slight enlargement of the thyroid gland, and after giving birth, the body restores its size. In puberty the thyroid becomes more and in old age decreases. In all other cases, if you change the size and weight of the thyroid gland need to consult a doctor.

Topic: thyroid Function

Hormones synthesized in the thyroid gland is iodine thyroxine and triiodothyronine and a peptide hormone calcitonin. The synthesis of thyroxine (T4) and triiodothyronine (T3) does not occur in the absence of molecular iodine. In addition, in the thyroid gland alwaysmust reserve thyroglobulin protein, which is required for synthesis of iodine containing hormones amino acid – tyrosine. The processes of synthesis localized in the apical part of the epithelium of the thyroid gland and are activated only in the presence of the enzyme thyroid peroxidase.

Abbreviated names iodine-containing hormones T3 and T4 indicate how many iodine molecules required for the synthesis of each of them: three for triiodothyronine and four for thyroxine.

Produce calcitonin C-cells of the thyroid and parathyroid glands. Calcitonin regulates the metabolism of calcium, it depends on muscle performance, growth, regeneration of bone and muscle tissue. When there is insufficient amount of this hormone (for example, due to hypothyroidism or autoimmune thyroiditis) impaired absorption of calcium from food, and problems with the musculoskeletal system.

The thyroid hormones regulate vital processes of the body, is necessary for all tissues and organs. Communicating with the sections of the chromosome in the cell nucleus, they stimulate oxidation-reduction reactions, synthesis of new substances. Without thyroid hormones, you cannot work the antioxidant system, cells are unable to protect themselves from the negative effects of free radicals. The thyroid hormones regulate the growth, division and differentiation of cells and their programmed death (apoptosis). They also support the heat balance of the body maintain a constant temperature necessary for the operation of enzymes and hormones. Without thyroid hormones essential for normal functioning of the immune system, the production and activity of T-cell immunity.

The lack of thyroid hormones causes of impaired growth and puberty, diseases of bone and brain pathology in the fetus in dysfunction of the thyroid gland in pregnant women.


The prevalence of thyroid diseases

According to who, thyroid diseases take the second place on prevalence of endocrine disorders, whereas the first is diabetes mellitus. Half a billion people face health problems due to iodine deficiency States, 665 million go to the doctor with endemic goiter. The number of patients is increasing annually by 5% .

According to different regions, from 15 to 40% of Russia's population have thyroid pathology, each year 40 thousand people tolerate surgery on the thyroid gland. In some regions from functional or structural disorders of the thyroid gland affecting up to 95% of the population.

The reasons for thisthe prevalence of disease can be environmental degradation, inadequate diet with low iodine content in food, violation of the absorption of iodine, congenital pathology of the thyroid gland.


Thyroid disease

Thyroid disease divided into three groups depending on the change in its function or structure:

  • Diseases associated with excess secretion of iodinated hormones triiodothyronine and thyroxin –hyperthyroidism;

  • Diseases associated with impaired synthesis and inadequate secretion of thyroid hormones – hypothyroidism or myxedema;

  • Diseases in which the amount of thyroid hormones and normal thyroid function does not suffer, but changing its form and structure, hyperplasia, nodules, goiter.

Hypothyroidism

Hypothyroidism or underactive thyroid is a condition in which the level of thyroid hormones is lowered, the frequency of occurrence of lead women (19 per 1,000 compared with 1 per 1000 in men). Hypothyroidism does not have pronounced symptoms that makes it difficult to diagnose at home. Often hypofunction of the thyroid gland against the backdrop of a number of other concomitant diseases, which from the start are assigned the wrong treatment.

Hypothyroidism is characterized by a slowdown of metabolic processes due to lack of thyroid hormones, a decrease in the formation energy and heat, and a number of other symptoms:

  • Fatigue and weakness, fatigue, memory disorders and depression; 14% of patients diagnosed with depressionactually suffer from hypothyroidism. Depression as a symptom is often observed at the initial stage of hypoplasia of the thyroid gland.

  • Heart disorder, slow heart rate, problems with circulation, because of which the patient is constantly freezing.

  • Violations of metabolism: the slowing of the digestive process, digestive tract problems, constipation, indigestion, difficulty in assimilation of nutrients and vitamins, obesity.

  • Atherosclerosis and high cholesterol level in the blood.

  • Violated the processes of synthesisvitamins, in particular vitamin A, which a person has symptoms of jaundice (the skin is amber-yellow color); the hair becomes brittle and dull, the skin dry, flaky and hypersensitive.

  • Early menopause and disruptions of menstrual cycle in women, polycystic ovaries.

  • Hindered lymph flow, the fluid retained in the tissues, which leads to the formation of edema. Swelling of the tongue and larynx that lower the voice and night snoring.

  • Hearing and twilight vision.
  • Violations of the heat balance, the lowering of body temperature to 30 degrees, which reduces the activity of immune cells and the body becomes more vulnerable to infection.

By themselves, these symptoms do not indicate the hypofunction of the thyroid gland, each of them individually can speak about other diseases. Accurate diagnosis can only ask the endocrinologist after a series of laboratory tests. Not to miss the hypothyroidism and not "heal" a non-existent disease, it is recommended to carry out annual routine thyroid ultrasound.

Learn more: How to treat hypothyroidism thyroid?

The euthyroid

Called the euthyroid state of the thyroid gland, when the level of thyroid hormones (T3 and T4) in the blood normally. By itself, the euthyroid non-hazardous, however, in clinical practice distinguish the concept of euthyroid disease – when the normal level of iodine-containing hormones can occur pathological processes in the tissues of the thyroid gland. Then the euthyroid seen as a temporary state, against which develops autoimmune thyroiditis (autoimmune euthyroid), nodular goiter and other diseases.

Thyroiditis

Called thyroiditis inflammatory thyroid disease, which can have different etymology. The most common form of thyroiditis – acute, subacute and chronic. Pastry thyroiditis has a viral nature, the analyses show the presence in the tissues of mumps virus and adenovirus, as well as an increased level of antibodies in the blood. The reason for the emergence and development of subacute thyroiditis may be the causative agent of lymphoreticulosis.

The first symptoms of inflammation of the thyroid gland usually occur several weeks after illness of an infectious nature href="http://vsebolezni.com/disease/parotit">svinki, kori, grippa. v oblasti zhelezy nabludaetsya otek i vospalenie, iz-za kotorogo bolnomu bolno ot malejshego prikosnoveniya k shee. simptomy obshej intoksikacii – oznob, lomota, slabost i golovokruzhenie.

ostryj tireoidit vyzvan pervichnoj ili vtorichnoj infekciej shitovidnoj zhelezy. pri pervichnoj infekcii vospalitelnyj process srazu ohvatyvaet tkani organa, a vtorichnoj infekcii predshestvuet angina, gripp, brushnoj tif ili drugie infekcionnye zabolevaniya. vospalenie nachinaetsya s levoj ili pravoj doli shitovidnoj zhelezy i postepenno rasprostranyaetsya na ves organ.

hronicheskij tireoidit – eto autoimmunnoe zabolevanie, v hode kotorogo voznikaet fibroz tkanej shitovidnoj zhelezy. po mere razvitiya zabolevaniya, sobstvennye kletki organizma atakuut shitovidnuu zhelezu, razrushaya ee tkani. chem silnee povrezhdaetsya organ, tem yarche vyrazheny simptomy gipotireoza, kotoryj budet progressirovat parallelno s lokalizirovannym autoimmunnym processom. diagnostika na uzi pokazyvaet neodnorodnost tekstury tkani, ee izobrazhenie na ekrane predstavlyaet soboj cheredovanie temnyh i svetlyh pyaten. takaya kartina harakterna i dlya mnogouzlovogo zoba, poetomu autoimmunnyj tireoidit slozhno diagnostirovat srazu. uchastki uplotneniya, kotorye zametny na snimke uzi i pri palpacii zhelezy, na samom dele ne yavlyautsya uzlami, a predstavlyaut soboj ochagi vospaleniya.

v otsutstvii lecheniya zheleza mozhet polnostu atrofirovatsya. oslozhneniyami hronicheskogo tireoidita yavlyautsya gipotireoz i zob.

bessimptomnyj tireoidit chasto nabludaetsya u nedavno rodivshih zhenshin, pri etom, kak i sleduet iz nazvaniya, yarko vyrazhennyh simptomov vospaleniya net. prichinoj zabolevaniya schitautsya autoimmunnye faktory. iz vseh form tireoidita bessimptomnyj schitaetsya samoj legkoj, poskolku posle neskolkih nedel gormonalnoj terapii, funkcionalnost shitovidnoj zhelezy udaetsya vosstanovit. vozmozhny recidivy zabolevaniya, poetomu pacient dolzhen sobludat vse rekomendacii vracha, ne propuskat profilakticheskie osmotry i obrashat vnimanie na malejshie izmeneniya svoego sostoyaniya.

tireoidit imeet takie simptomy:

  • pokrasnenie oblasti shei v meste raspolozheniya shitovidnoj zhelezy, nebolshaya pripuhlost, v oblasti kotoroj mozhet voznikat zhzhenie, zud i boleznennye oshusheniya;

  • povyshenie temperatury tela, slabost, anemiya, bol v oblasti shei, ushej, chelusti;

  • , cardiac arrhythmias, tremor;

  • Irritability and hyperreflexia.

Learn more: Autoimmune thyroiditis – the causes and symptoms

Enlargement of the thyroid gland

Enlarged thyroid gland swelling in the neck may occur during pregnancy, after childbirth goes unnoticed. The increase of mass and size of thyroid may be due to iodine deficiency or, conversely, with its surplus. So, inhabitants of coastal cities that receive a large amount of iodine from food (seafood, algae, fish) and air may have enlarged thyroid gland. If the authority is increased without the formation of knots, this condition is called hyperplasia.

If the mass and volume of the thyroid gland grow unevenly, and be felt under the skin nodular formation, it is diagnosed with nodular goiter of the thyroid gland.

Also causes enlargement of the thyroid gland can be benign or malignancy. Therefore, the condition of that organ must be monitored closely and at the slightest change to go to the doctor.

Find out more: Causes, symptoms, extent and treatment enlarged thyroid gland

Hyperplasia

Hyperplasia – increase in the mass and volume of the thyroid gland without the formation of knots. Hyperplasia may be accompanied as a condition of hypothyroidism (lack of thyroid hormones) and increased their secretion or hyperthyroidism. Developing the disease gradually, structural changes in the tissues of the thyroid gland occur as a compensatory reaction due to the disorders. So, with a deficit of iodine in the body, synthesis of iodine-containing thyroid hormones is reduced, and thyroid tissue begins to grow.

The rate of increase of the body depends on the immune system and General condition of the organism of a healthy person changing the size of the thyroid gland for a long time can be hidden, whereas a person with chronic diseases is rapidly increasing iron and acts as a tumor on the front of the neck.

Reduction of the thyroid gland

Reduction of the thyroid – a dangerous pathology that threatens the life and health of a person. Thyroid hormones are responsible for metabolic processes, growth and differentiation of cells, provide immunity.Reduced thyroid levels could not provide the production necessary number of hormones, which leads to serious health problems.

Reduction of thyroid gland in newborn is called congenital hypoplasia and may be due to hypothyroidism of the mother. Children with congenital hypoplasia sluggish, apathetic, grow and develop more slowly than their healthy peers to suffer from digestive disorders. Hypoplasia can manifest itself with symptoms of hypothyroidism, lack of thyroid hormone impairs the absorption of calcium and minerals in the gut, causing bone and children's teeth become brittle, grow fast enough.

Reduced thyroid gland can be and in adults with autoimmune thyroiditis, the pathologies of the pituitary gland or due to aging.

Hypoplasia

Hypoplasia called congenital pathology of the thyroid gland in which it develops unevenly, and its size is reduced. Hypoplasia may relate to the whole body, and can only be left or right lobe of the thyroid gland. If symptoms of hypothyroidism occur in a newborn from the first days of life, diagnosed as "hypoplasia of the 1st degree", if the deviations from the standards, and hypothyroidism occurs in school age, it is referred to as hypoplasia of 2 degrees.

Causes of congenital hypoplasia associated with pregnancy: if the mother during pregnancy was the hypothyroidism, or in the diet did not contain enough iodine, the newborn may experience underdevelopment of the thyroid gland. Treatment of iodine deficiency States, and hypothyroidism with radioactive iodine can also be the cause of hypoplasia.

Hypoplasia in children has the following symptoms:

  • Lethargy, drowsiness, lack of response to light and sound, stunting;
  • Yellowish tinge to the skin (as opposed to physiological jaundice, not temporary, and lasts a long time);

  • Violations of sleep and appetite, flatulence, constipation;

  • Hoarseness due to swelling of the tongue and larynx.

Thyrotoxicosis

Thyrotoxicosis or hyperthyroidism is characterized by increased secretion of thyroid hormones, which leads to an acceleration of metabolic processes and high heat production. Symptoms of hyperthyroidism include:

  • The increase in body temperature, feeling heat, "tides", women are often confused with the first signs of menopause, sweating.

  • Palpitations, heart rhythm disorders.

  • Irritability and nervousness, insomnia and other sleep disorders.

  • Significant weight loss while preserving of appetite, loss of calories occurs by increasing energy production and heat production.

Zabaykalya is one of the common symptoms in diseases of the thyroid gland. This is a structural change of the tissues due to which endocrine gland is considerably increased in size. If increasing the entire body is called nodular goiter, while increasing the individual parts of the thyroid gland talking about diffuse goitre.

In women, the thyroid gland does not always mean pathology – during pregnancy or after menopause the body may increase in size without breaking functionality. The same happens with women and men during the teenage period.

Learn more: Hyperthyroidism — causes, symptoms and treatment

Causes of thyroid disease

Genetic predisposition is one of the main causes of pathologies of the endocrine system:

But there are several factors contributing to the development of the disease even in a healthy person:

  • These include, primarily, disorders of mineral balance in the body, deficiency of molecular iodine as a consequence of an unbalanced diet and nervous stress, infections and chronic disease, debilitating body.

  • Thyroid pathology can develop due to unfavorable environmental conditions, due to the high radiation (radioactive iodine accumulates in the thyroid gland, causing the occurrence of goiter).
  • Thyroid function may be disturbed after taking some medications.
  • Constant exposure to external stressors wears protective system of the body, where the endocrine organs play a significant role. So, for protection from infection requires a large number of immune cells with increased activity, in the regulation of their generation taking part of thyroid hormones. In chronic diseases of T3 and T4 are produced in large quantities, with the attendant adverse factors can lead to "wear and tear" of the thyroid gland and temporary impairment of its functions or structural disorders. So there are hypothyroidism or hyperthyroidism, hyperplasia, goiter and nodules in the tissuesof the thyroid gland.

Diagnosis of thyroid diseases

Diagnosis of patients with thyroid pathologies is performed in different ways, its purpose is to determine the morphological structure and functional activity of the gland, to find out the cause of the disease for proper treatment. Physical methods allow to detect the heterogeneity of the tissues, nodes or foci of infection before the first symptoms of hypothyroidism or General inflammation of the gland.

Laboratory methods help to determine the concentration of thyroid hormones, which allows to draw conclusions about the functionality of the thyroid gland. The most common of them – immunofermentnyi analysis carried out using standard tests.

You may also need an additional urine sample to determine urinary iodine, from which we can draw conclusions about iodine deficiency condition. A test to determine iodine levels in the body.

Instrumental methods – computed tomography, ultrasound, scintigraphy (patient administered the drug marker and register the gamma radiation) and thermography. Thus it is possible to determine the size of the organ, the structure of the tissue and the nature of accumulation of contrast medium in different parts of the thyroid gland.

Learn more: thyroid ultrasound - training that shows what is the norm?

Rapid diagnosis is done by use of hormone tests T3 and T4, to test for the presence of antibodies to thyroglobulin and thyroid peroxidase.


Treatment of thyroid diseases

Hypothyroidism and hyperthyroidism are often treated with medical drugs – synthetic analogues of natural hormones or drugs that suppress synthesis of thyroid hormones. Thus, with reduced secretion, hypothyroidism prescribe drugs thyroxine and triiodothyronine, and sometimes their reception is combined with additives of inorganic iodine (tireotom, yodtiroksa).

On topic: Drugs and medications used in the treatment of thyroid

Fill the deficit of its own hormones and their synthetic analogues called by hormone replacement therapy and is widely used in Russia to treat hypothyroidism. However, this treatment method has a huge drawback – the synthesis of thyroid hormones is disruptedthe thyroid gland stops producing them in the same quantity, and after drug withdrawal, the patient's condition becomes worse than before treatment. Thus, hormone replacement therapy makes a person dependent on pills for the rest of my life.

Additional hormonal therapy may be contraindicated due to side effects in some patients after taking drugs allergic reactions, disorders of the nervous system and arrhythmias.

Surgical treatment of thyroid (hemithyroidectomy, thyroidectomy, resection) is used only in extreme cases when the increased iron expands so much that interferes with breathing or swallowing during meals. Surgery to remove part of the thyroid gland with tissue pathological structures are held to avoid the risk of a malignant tumor. Surgery can lead to serious complications, up to 10% of disability – loss of voice due to traumatic damage to the nerves, removal of the parathyroid glands. After removing part of the thyroid gland, the function of the body can be broken so that people are forced to depend on pills the rest of my life.

Topic: Operation: indications, analyses, consequences. Is it possible a full life after the surgery?

For overactive thyroid gland (thyrotoxicosis) appoint thyreostatics drugs partially block the synthesis and release into the blood of thyroid hormones. These include tyrosol, merkazolil, and other derivatives tiamazol, propitsil and diyodtirosin.

Among the side effects of this treatment – allergic, impaired function of blood formation and work of the liver, nausea. In the long term, thyreostatics can cause pathology of tissues of the thyroid gland, to disrupt its functional activity, causing the synthesis of thyroid hormones stops completely and there is a need hormone replacement therapy.


Promising drugs for the treatment of thyroid

Because of a number of side effects and undesirable consequences of the use of these agents, there is a need of other means to treat the thyroid gland. Modern preparations made from vegetable raw materials and used as supplements in iodine-deficient condition, the impaired function or structure of the thyroid gland.

Depending on composition, these drugs are divided into three groups:

  • The first group includes preparations containing iodine in organic or inorganic form.
  • The second grouprepresented by a complex of iodine and botanicals.
  • The third group contains only botanicals for normalization of the thyroid gland.

Supplements do not give such serious complications, as the use of thyreostatics or hormone replacement therapy, however, the efficiency of them is low. Quality supplements or iodine-containing complex is difficult to verify, often the manufacturer knowingly commits a fraud, including the composition of the tablets is those parts of the plant where accumulation of biologically active substances does not occur, with the goal of increasing mass and volume of the product and reduce the cost of production. Naturally, the effect of the drug will be hardly noticeable, if at all.

To protect yourself from low-quality dietary SUPPLEMENTS, be sure to ask the manufacturer whether it has the GMP certificate.