What are thyroid disorders/thyroid diseases?
First of all, let’s briefly understand the story of thyroid hormones.
You have in the center of your skull a gland called (the pituitary gland) which is considered the main motor of all biological processes.
This pituitary gland secretes a hormone called TSH (Thyroid-stimulating hormone).
TSH stimulates the thyroid gland(a small organ located in the front of the neck) to secrete more of its hormones ( T3 and T4) in a certain ratio.
T3(triiodothyronine) Is the active and most important thyroid hormone which is responsible for lots of your body functions like metabolism. it’s secreted in little amounts.
T4(thyroxine) is considered a storage form of thyroid hormone converted into the active form T3.
There is an inverse relationship between TSH and(t3, t4)..if the TSH level is high then the T3 level is low, and when the TSH level is low T3 is within the normal range.
Thyroid diseases can affect anyone, man, woman, infant, teenager, elderly.
Thyroid disorders may be present at birth mostly hypothyroidism or developed with age.
It is developed often after menopause in women.
Thyroid disease is very common. about 20 million people in the United States have some type of thyroid disorder.
Women are likely to be diagnosed with thyroid disorders about five to eight times more than men.
What do thyroid hormones do all over health? (importance of thyroid hormones).
Thyroid hormones are the main regulators of :
- Basal metabolism
- Adaptive energy expenditure.
- Adaptive thermogenesis
Because thyroid hormones regulate metabolism they act on a lot of body functions:
- Regulating appetite
- Regulate cholesterol and carbohydrate metabolism
- Modulates hepatic insulin sensitivity.
And this led to several new therapeutic targets for metabolic disorders.
Both T3 and T4 play an important role in the development of the brain and bone, particularly for the developing fetus, (more important in the first trimester of pregnancy than other stages).
If there is an increase in thyroid hormone secretion, this case is called hyperthyroidism.
And If there is a decrease in secretions, it is called hypothyroidism. (Both conditions are serious and affect all the body functions, and need to be treated).
It’s defined by elevated levels of T3 and T4 in serum.
Hyperthyroidism may occur due to:
- Thyroxine overdose, by an extensive treatment of hypothyroidism.
- Excess thyroid hormone, production and Release
There is a type of hyperthyroidism defined by low or undetectable TSH with normal levels of T3 and T4, called subclinical hyperthyroidism.
What causes hyperthyroidism?
1. Graves disease: an autoimmune disease in which your immune system attacks your thyroid gland, resulting in the overproduction of thyroid hormones.
2. Toxic multinodular goiter: when there are lumps or nodules in your thyroid, which increase the production of thyroid hormones. It is distinguished by swelling of the neck, hoarse voice, tightness in the throat, cough, difficulty breathing, and swallowing.
3. Thyroiditis: it’s the inflammation of the thyroid gland due to infection or immunity problem, which causes swelling of the gland and leaking of hormones into the bloodstream.
Symptoms of hyperthyroidism:
1. Weight loss.
2. Hair loss.
3. Fast heartbeats.
What is hypothyroidism?
It is defined as thyroid hormone deficiency.
Low thyroid can come from a nutrient deficiency of iodine, which is very low in the typical American diet. or from toxicity from exposure to mercury, chloride, and bromide.
There are two types of hypothyroidism:
1. Overt hypothyroidism: high levels of TSH with low T4
2. Subclinical hypothyroidism: high levels of TSH with normal T4.
Untreated hypothyroidism may cause serious effects on multiple organs, especially for heart patients and pregnant women.
Causes of hypothyroidism:
1. Hashimoto thyroiditis: autoimmune disorder which is the most common cause of hypothyroidism
The immune system produces antibodies that attack the thyroid gland and damage its cells, making it can’t produce enough hormones.
2. Severe iodine deficiency: Iodine is very important for the synthesis of thyroid hormones. Iodine is very low in the American diet, or iodine deficiency due to toxicity from mercury, chloride, or bromide.
Common Symptoms of hypothyroidism:
- Cold intolerance
- Shortness of breath
- Dry skin
- Weight gain
What will happen if hypothyroidism is not treated? ( common manifestations of hypothyroidism).
This may lead to:
- Increased thrombosis risk
- Myalgia and increase serum creatinine kinase
- Metabolic symptoms.
- Fetal growth stops, for pregnant women.
What is the Treatment for Thyroid Disorders?
Traditional treatment of hypothyroidism: is the replacement therapy
levothyroxine® (T4 which converts to the active metaboliteT3).
Traditional treatment of hyperthyroidism:
- Antithyroid drugs (methimazole, carbimazole, propylthiouracil, methylthiouracil)
- Iodine radiotherapy: inhibits the secretion of thyroid hormones
- Surgery: by thyroidectomy and you will take replacement therapy for the rest of your life.
Unfortunately, According to a lot of studies, There is an association between treatment with iodine radiotherapy and long-term risk of death due to solid cancer, like breast cancer.
Untreated thyroid disease can be fatal in severe cases.
Insufficient treatment increases the risk of cardiovascular disease and persistent symptoms.
Overtreatment results in heart disease and osteoporosis, particularly for old patients and pregnant women.
Therefore, the management of thyroid disorders should be monitored closely.