Thyroid diseases

We have known for a long time that the function of every organ in the human and animal body affects the entire organism. This is also the case with the thyroid. As soon as it is disturbed in its function, vital processes are adversely affected to a decisive extent, and in some cases completely inhibited. The most modern examination methods even showed that almost every cell in the body is affected by such functional disorders.

How the thyroid works

Infogram on the anatomy and position of the thyroid gland, as well as the symptoms of hyperthyroidism and hypothyroidism. Click image to enlarge.

The thyroid weighs 25 to 30 grams and is therefore the largest glandular organ with internal secretion, which has considerable reserve forces. It is subject to a well-balanced control mechanism that emanates from central points in the diencephalon. Via the pituitary gland (pituitary gland) the thyroid gland is given impulses with the help of a certain hormone, which stimulate the thyroid function. The thyroid gland then produces its own hormones, which then affect the whole organism. The peripheral areas of the organism in turn signal to the central points whether there is too much or too little thyroid hormones. From here the decisive impulses are passed on to the thyroid gland.

It can therefore be seen that the thyroid gland by no means works independently, but adapts to the needs of the organism for thyroid hormones. The reaction of different body cells to this hormone is never constant, even in a healthy person; it is always based on the living conditions, which are different at different times - for example during puberty, during pregnancy or during the so-called menopause. If the thyroid gland is removed from an adult mammal, the signs of deficiency are initially hardly noticeable externally. Even adults can live without a thyroid gland, but severe physical and psychological impairment occurs.

The thyroid is, if you will, not an absolutely vital organ in adulthood. It influences the extent of metabolic processes, but maintenance and basic control can also be taken over by other mechanisms. Quite different during the development of the human and animal organism: Here the thyroid gland is a vital organ. Animals without thyroid gland stop in their development: they do not reach sexual maturity, they are unable to adapt to extreme environmental conditions, such as temperature changes and hunger, and ultimately perish.

Diseases associated with hypothyroidism

The same applies to humans. Children who were born without a thyroid gland will reach puberty at most without medical treatment. If the thyroid gland is present in childhood, but its function is greatly reduced, the clinical picture of cretinism develops, which is associated with mental deficiencies. There is also hearing loss and developmental disorders of the skeleton. In order to compensate for the hormone deficiency, the thyroid gland receives constant work impulses from the pituitary gland. However, since it cannot cope with the production, it reacts with an increase in tissue, that is, it expands its production facility.

Cretinism occurs primarily where there is little iodine in the environment, but especially in drinking water, which the thyroid urgently needs to build up hormones. Furthermore, a higher frequency of goiter was observed, especially in people who live in poor economic and hygienic conditions. However, substances have also been found in various foods, especially in most types of cabbage, carrots and beets, which block hormone production and thereby cause a goiter. These substances are also found in forage; they pass into cow's milk and can in turn be absorbed by humans.

It is therefore necessary to avoid a completely unbalanced diet with the mentioned foods over a long period of time. If the goiter-producing substances encounter an adult organism, the clinical picture of cretinism does not develop from it. However, there is often an enlargement of the thyroid gland and in some cases symptoms of an underactive thyroid gland, which can also have other causes. If you once again visualize the control circuit in which the thyroid is embedded, it becomes clear that any interruption at one point in this circuit - be it in the body periphery, in the diencephalon, in the pituitary gland or in the thyroid gland itself - results in an underproduction of hormones can cause.

Symptoms, ailments & signs

In other words: the hormones produced are not enough to meet the needs of the organism. The main causes of hypothyroidism are, in addition to the acute and chronic thyroid inflammations already mentioned, which cause the destruction of the glandular tissue, as well as conditions after surgical removal of the thyroid gland. The main symptoms of hypofunction are general weakness, apathy, sensitivity to cold, lack of perspiration, dry and rough skin, and weight gain.

The sick person's activity is sometimes so reduced that he cannot even make up his mind to go to the doctor. As the disease progresses, speaking slowly becomes apparent; the tongue is thickened, the language seems lumpy. There may also be swelling of the face, legs or hands. The sick look remarkably pale. However, it must be emphasized that only the combination of several symptoms speaks for the presence of an underactive thyroid, but not the occurrence of individual ones.

As already mentioned, the adaptability of our organism depends on the functioning of the thyroid gland. In certain phases of life we can observe a particularly high level of hormone consumption, which the thyroid gland is not always able to cope with. So it has to increase. There are high requirements - this has already been indicated - during puberty, pregnancy, breastfeeding and menopause; in general, the hormone requirements of women are greater than that of men. For example, the enlargement of the thyroid gland regresses in young men after puberty, while it often persists in girls.

Hyperthyroidism diseases

It is precisely in the life situations mentioned that an overactive thyroid can develop. In chronic hormone deficiency situations, the thyroid gland can enlarge to such an extent that there is a feeling of tension and pressure in the throat. Sometimes it grows down into the chest cavity and causes the trachea and esophagus to be pushed away. The result is swallowing and breathing difficulties. In such cases, the person concerned must see a doctor immediately so that surgery can still be avoided.

A special word should apply to those patients who had to undergo thyroid surgery. The removal of thyroid tissue consequently results in a hormone deficiency. But since there is always a remnant of the thyroid gland, it can enlarge again under the influence of higher-level signals, sometimes even reaching the same size as before the operation. Unfortunately, the doctor can never quite predict which patient will have this second magnification. It is therefore absolutely necessary to follow-up treatment for all patients over a longer period of time in order to cover the thyroid hormone deficiency with medication.

Certainly, some patients find it uncomfortable to take one tablet a day for years. However, this is inevitable if the second diseases are to be avoided, and is ultimately only in the interests of those who have had thyroid surgery. It is a painful fact for doctors that a large part of the comprehensive prophylactic measures fail in the various countries because the majority of patients who have undergone thyroid surgery do not see the need. While there are understandable explanations for the hypofunction and the enlargement of the thyroid gland with normal hormone production, the mechanism of overfunction, also known as hyperthyroidism or Graves' disease, is not yet fully understood.

Thyroid disease can lead to a variety of complications if left untreated. An enlargement of the thyroid gland called goiter often leads to swallowing difficulties, shortness of breath and congestion of the neck vessels due to unhindered growth in size. Malignant degeneration of the proliferating tissue is also possible. If the thyroid is underactive, the risk of premature vascular calcification increases, which can lead to cardiovascular diseases, circulatory disorders and decreased kidney function.

Cardiac arrhythmias and long-term enlargement of the heart muscle can also occur as part of an underactive thyroid. In rare cases, myxedema characterized by tissue swelling can develop into a myxedema coma with breathing problems and slow heartbeat, which must be treated immediately by intensive care.

Acute excess hormone production in the event of an overactive thyroid (thyrotoxic crisis) is associated with nervousness, gastrointestinal disorders, an increase in body temperature and clouded consciousness; in the worst case, cardiovascular failure can result without medical intervention. In the long term, inadequately treated overactive thyroid glands can damage the heart and adrenal glands, and metabolic disorders and osteoporosis are also promoted.

Anti-thyroid drugs used to treat hyperthyroidism sometimes lower the number of white blood cells, which can lead to flu-like symptoms. Blood count changes occasionally occur even after radioiodine therapy. Possible complications of thyroid surgery are injury to the vocal cord nerves or the parathyroid glands and bleeding in the operated area.

Symptoms

We can only say that the interactions between the thyroid and the pituitary gland are completely disrupted in this disease. The thyroid inundates the body with hormones, although there is no need. The result is an increase in metabolism; stimulated by the overproduction of hormones, all organs run at full speed, so to speak; the ingested food components are quickly broken down and burned and the heat dissipation is immense. Of course, the thyroid gland can enlarge under this condition as well. But often, before patients notice an increase in neck circumference, they feel the increase in metabolism. They complain of general restlessness, sweating, palpitations, cannot stand warmth and tire easily. Palpitations and nervous agitation are the most noticeable constant symptoms.

As the disease progresses, weight loss can occur despite cravings and large amounts of food. The purely external characteristic is the well-known protrusion of the eyes. However, this symptom is by no means an expression of the severity of the disease. The greatest difficulty lies in differentiating the hyperthyroidism from the nervousness and exhaustion that often occur today, known as vegetative dystonia.

Here side effects can occur that are very similar to those of hyperthyroidism. We recognize certain distinguishing features, however, from the fact that the palpitations and the nervous restlessness in vegetative dystonia are not so constant. The patients are also hardly sensitive to heat and only occasionally tend to break out in a sweat, especially after excitement.

If there is now an enlargement of the thyroid gland, without the need for excessive hormone production, the similarity to the real hyperthyroidism is amazing, and the correct diagnosis can only be made with the most modern examination methods.

Complications

Lump in the thyroid gland

Finally, a few remarks on the formation of nodules in the thyroid gland, which can have different origins. In our part of the world, it is mostly encapsulated bubbles, known as cysts. Furthermore, any enlargement of the thyroid gland, with or without hyperfunction, can transform itself into nodules. So-called "hot knots", which - similar to a fire-breathing mountain - emit more hormones and cause the clinical picture of hyperfunction, are less common.

If a swelling suddenly appears on the neck, which can also be painful, combined with a general feeling of illness, it is usually an inflammation of the thyroid. Also in thyroid cancer, which fortunately occurs very rarely, isolated nodules form. If it is recognized in time, it can be cured like most other organ cancer forms. Lump formation in the area of the thyroid should therefore always be a reason to consult a doctor. However, it should be emphasized once again that not every nodule formation is to be equated with thyroid cancer.

Outlook & forecast

The prognosis for diseases of the thyroid gland is based on the individual complaints and the existing causes. A large number of patients experience a chronic course of the disease and thus the use of long-term therapy. This enables an alleviation of the health irregularities and leads to an improvement in the quality of life.

If the prescribed medication is discontinued without consulting a doctor, a relapse of the symptoms is to be expected. If there are abnormalities in the thyroid due to naturally occurring processes such as puberty, pregnancy or menopause, recovery is usually documented after this phase has ended. The immune system is changed by the body and causes temporary problems. Treatment does not always have to be initiated, as these are natural processes.

In most cases, surgery is performed if the thyroid is optically enlarged. Since an operation is always associated with risks and side effects, these must be taken into account when making a prognosis. If the planned procedure goes without further complications, the affected person can often be released from the treatment a short time later as cured. Further check-ups are still necessary in order to detect changes at an early stage and to be able to react accordingly. Without medical treatment, an enlarged thyroid gland can be expected to increase the symptoms.

Aftercare

In the case of diseases of the thyroid gland, follow-up care options are available to those affected, although this usually depends very much on the exact disease and the time of its diagnosis. Therefore, no general prediction can be made about these possibilities. In general, thyroid diseases should see a doctor for treatment.

It usually cannot heal itself, so that a doctor should be contacted as soon as the first signs and symptoms appear. In many cases, patients are dependent on the use of different medications. It is important to ensure that the medication is taken regularly and that the dosage is correct in order to permanently alleviate the symptoms.

In the case of diseases of the thyroid gland, a healthy lifestyle with a healthy diet also has a very positive effect on the further course of the disease and can also prevent further complications from occurring. The doctor can also create a nutrition plan for the person concerned. In most cases, diseases of the thyroid gland require regular check-ups and examinations by a doctor in order to permanently monitor the condition of the thyroid gland.

You can do that yourself

Depending on the type of thyroid disease, there are various options for taking measures yourself, in addition to medical treatment and taking certain medications.

If the thyroid is overactive, the person affected can consume sage if they sweat heavily and keep small amounts of iodine in their diet. Wraps with quark or healing earth, which are placed on the neck, can ease the symptoms. It is also important to avoid stress and to focus on sufficient recovery. The sufferer can learn special techniques for relaxation, including calming breathing exercises. Make sure you get enough sleep and rest breaks. In addition to medical treatment for hyperfunction, acupuncture can also be helpful. If the states of nervousness and tension predominate, psychological treatment can also be considered.

In the case of an underactive thyroid, measures such as alternating showers and a warm foot bath to stimulate the circulation can be helpful. Baths with rosemary can provide relaxation. If there is an iodine deficiency, the diet should be changed accordingly to compensate for this deficiency. Foods containing iodine include seafood, freshwater fish and sea salt.

When should you go to the doctor?

Thyroid diseases, especially in the early stages, rarely show themselves through clear symptoms. That is why people with a hereditary predisposition to thyroid diseases should watch out for possible warning signs. The earlier a possible problem with the thyroid gland is recognized, the faster it can be regulated again. The typical diseases of the thyroid gland, underactive and overactive, make themselves felt in everyday life either through unnatural fatigue, listlessness and weight gain or in overactive through a feeling of overstimulation and weight loss.

Although these symptoms are possible signs of many diseases, they can always indicate a malfunction of the thyroid gland and should therefore be clarified by a doctor. It can be helpful to ask your family doctor specifically to check the thyroid values, because the more unspecific the symptoms, the more difficult it is to research the cause. Pain directly on the thyroid gland is rather rare. However, if you repeatedly feel a feeling of pressure in the neck or even feel lumps in the neck area, this can also indicate a disease of the thyroid gland. In the worst case, lumps can hide thyroid ulcers. The earlier this is recognized by a doctor, the more successful the treatment is as a rule.

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