Small organ, but many diseases: Whether for nodes, over- or underfunction, here you will find the most important answers about the thyroid
Recognize thyroid problems: A goiter can often be felt
It sits in the front of the neck and has the shape of a butterfly: the thyroid. The organ fulfills numerous tasks in our body. Thyroid hormones affect metabolism, circulation, growth and psyche. Diseases of the thyroid can therefore manifest themselves in many different ways.
1. How common are thyroid disorders?
Disorders and goiter-like changes in the thyroid occur relatively frequently. They are often harmless. Treatment is really only necessary in certain cases.
2. How does the thyroid work?
The two important hormones triiodothyronine (T3) and thyroxine (T4) are produced in the thyroid gland and enter the blood from there. The thyroid needs protein and iodine to produce these hormones. Since the human body does not produce its own iodine, it has to be consumed in sufficient quantities through food. If iodine deficiency occurs, the thyroid gland can enlarge and form a goiter (Latin: goiter). The hormone calcitonin, which is also formed in the thyroid gland, plays a role in calcium metabolism.
3. How does an overactive or underactive thyroid appear??
One speaks of an over- or underfunction if the gland produces too many or too few hormones. This affects the body functions controlled by the thyroid gland. The symptoms are varied: an overactive thyroid (hyperthyroidism) can manifest itself, for example, in nervousness, poor concentration, sleep disorders or increased sweating. Symptoms of hypothyroidism (hypothyroidism), on the other hand, can be sensitivity to cold, listlessness or depressive moods.
4. Which thyroid values are normal?
The doctor usually determines the so-called TSH value for orientation. TSH is a hormone that is produced in the pituitary gland. It controls thyroid hormone production. As "normal" a TSH value applies that is in a certain spectrum. "The normal range is a TSH value of 0.4 to 4", explains Dr. Roland Gärtner, professor emeritus at the University Hospital Munich. The values for the thyroid hormones T3 and T4 can vary depending on the life situation: "Young women often have higher hormone levels. In contrast, a slight underactive thyroid is normal in older people."
5. What diseases are there, for example?
Overactive and underactive thyroid gland can be due to various causes and diseases. An underactive thyroid is only congenital in rare cases; it is often the result of damage to the thyroid tissue, such as inflammation. Hashimoto’s thyroiditis is a chronic inflammation of the thyroid gland in which the body’s immune system attacks the thyroid tissue. One therefore speaks of an autoimmune disease.
Over 95 percent of hyperfunction can be attributed either to Graves ‘disease (Graves’ disease) or to autonomy. With functional autonomy, parts of the thyroid gland produce hormones in an uncontrolled manner. Graves’ disease is also an autoimmune disease. The body produces certain antibodies, which lead to an increased release of thyroid hormones.
There is also thyroid cancer (thyroid carcinoma). The causes of this disease are not clearly understood. One risk factor is increased exposure to X-rays or radioactive radiation. Every year around 5000 people in Germany develop thyroid cancer.
Underactive thyroid (hypothyroidism)
Hashimoto’s thyroiditis (autoimmune inflammation of the thyroid)
6. How do I recognize a disease??
A goiter on the neck provides the most visible indication of a possible thyroid disease, but is of course not available for all disorders. Only the doctor can make a reliable diagnosis. The symptoms can, but do not necessarily have to indicate a malfunction. For example, sleep disorders can occur with a variety of problems, chronic fatigue and listlessness can also be signs of depression. "I definitely recommend a medical examination to people who are suspected of having thyroid disease", says Roland Gärtner.
7. What treatment options are there??
Therapy depends on the type of disease. Basically, most thyroid problems can now be treated with a high success rate. For example, patients with hypothyroidism can help tablets with synthetic thyroxine (T4). Hyperthyroidism is usually treated with anti-thyroid drugs. They inhibit the production of thyroid hormones. If this measure is not sufficient, radioiodine therapy or surgery is also an option.
8. Does a preventive medical checkup make sense?
To a certain extent, thyroid disorders are also inherited. If there are numerous cases of malfunctions or goiters in your family, a check-up can be useful even without acute symptoms. It is best to talk to your family doctor about this. "All others should be examined at regular intervals of one to two years from the age of 40", explains Dr. Joachim Feldkamp, chief physician at the Clinic for General Internal Medicine, Endocrinology and Diabetology at the Bielefeld Clinic.
The doctor can palpate the thyroid gland for irregularities. In addition, he can use ultrasound to examine the organ and determine the TSH value. However, these examinations are not part of the normal pension benefits of the statutory health insurance companies. You may therefore have to pay the costs yourself if there is no medical need to carry them out.
The thyroid tissue is divided into lobes of different sizes by connective tissue membranes. A large number of blood vessels run through these connective tissue membranes in order to ensure the strong blood flow to the gland, which is supplied with oxygen-rich blood directly from the carotid artery. The used blood is drained away through the left and right jugular or jugular veins, among other things. The thyroid hormones thyroxine (T4) and triiodothyronine (T3) are formed and stored in small, vesicular follicles.
The isthmus (large narrow access) connects the side lobes with each other. Only about every fifth person has another lobe that pulls up to the thyroid cartilage and is called the pyramid lobe.
The hormone-producing cells lie in the lobules of the thyroid gland. The main part of the thyroid tissue is formed by so-called follicles, irregularly shaped vesicles, which form and store the two iodine-containing thyroid hormones thyroxine and triiodothyronine. The hormone calcitonin, on the other hand, is formed by C cells that are interspersed between the follicles. Together with other hormones, it regulates the body’s calcium balance with the aim of keeping the level of calcium in the tissue constant: if necessary, calcium is increasingly incorporated into the bones and thus the calcium level in the blood is reduced or excreted via the kidney. The counterpart of calcitonin is the parathyroid hormone from the parathyroid glands, which releases calcium from the bones and thereby increases the calcium level in the blood.
9. How can I protect myself??
The most important preventive measure is an adequate supply of iodine. Daily needs depend on various factors – such as age and environmental impact. The recommended iodine intake for an adult is 200 micrograms. In addition to the well-known iodized salt, many others play here Food an important role: "You couldn’t cover your daily iodine needs with the amount you ingest through iodized salt", Feldkamp explains. "For example, bread that contains large amounts of iodine is much more important for saturating the iodine balance." Milk, dairy products, and fish and seafood also help meet daily iodine needs. Refraining from smoking also protects the thyroid gland. "Cigarette smoke contains cyanide, which blocks iodine uptake in the thyroid", so gardener.
10. Too much iodine is harmful?
"It is practically impossible to consume too much iodine simply through daily food intake", explains endocrinologist Roland Gärtner. "However, you should be careful with some medications, some of which contain large amounts of iodine." A healthy thyroid can also cope with short-term oversupply.
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