Thyroid Functions and Diseases
The thyroid is a small gland in your neck shaped like a butterfly. It is part of your body’s hormone system. The thyroid makes special chemicals called hormones. These hormones travel in your blood and help control how your body works.
The thyroid helps your body use energy and controls how fast things happen inside you, like growing or using food. It also helps control your body weight, temperature, energy, and how your heart and stomach work.
Sometimes, the thyroid doesn’t work right. If it makes too little hormone, it is called hypothyroidism. This is common, especially in women.
Some people can have thyroid problems after certain cancers or cancer treatments. Kids who had cancer treatments are more likely to get thyroid problems.Thyroid problems can start soon after treatment or even years later.
Thyroid function
The thyroid produces hormones that participate in growth and mental development. They also help regulate metabolism, the chemical process that occurs in the body to make and use energy. The thyroid is controlled by the pituitary gland
Thyroid hormones There are type of thyroid hormones:
- Thyroxine (T4) is the main hormone made by the thyroid. T4 doesn’t do much by itself. The body changes T4 into T3, which does most of the work. This change happens in the liver and other parts of the body.
How much T4 turns into T3 depends on what your body needs. - Triiodothyronine (T3) is the hormone that is most active.
T4 and T3 travel in the blood attached to a special protein.
Only a small amount is free in the blood. Only the free hormone can do its job in the body. -
When the free hormone is used by the body, some of the bound hormone is released by the binding protein. To make thyroid hormones, the thyroid needs iodine, an element found in water and food. The thyroid captures iodine and integrates it into its cells for the synthesis of thyroid hormones.
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When thyroid hormones are used, a small portion of their iodine is released and returns to the thyroid, where it is reused to make other thyroid hormones. Interestingly, the thyroid releases slightly fewer hormones if it receives high levels of iodine through the blood.
What are the symptoms of a thyroid problem?
Hyperthyroidism (excessive production of hormones by the thyroid) may cause some or all of the following symptoms:
- Restlessness
- Nervousness
- Emotionality
- Irritability
- Trouble sleeping
- Hyperactivity Hand tremor.
- Weight loss despite increased appetite.
If your thyroid is not working well, you might have some symptoms.
If your thyroid is slow, your nails and hair can get thin and break easily.
You might gain weight, feel tired, have a slow heartbeat, get constipated, and feel cold a lot.
If your thyroid is too fast, you might lose hair and lose weight without trying.
Your heart might beat fast, you could feel nervous or sweaty, and you might need to go to the bathroom more often.
Girls and women might have periods that are not regular.
The doctor checks for thyroid problems by asking about your symptoms and feeling your neck.
They may also do a blood test to check your thyroid hormone levels.
What is thyroid disease?
Hyperthyroidism, or thyrotoxicosis, is a condition in which the thyroid produces too many hormones. Symptoms include hair loss, weight loss, increased heart rate, nervousness, frequent bowel movements, sweating, menstrual irregularities
Blood tests linked to thyroid function
To assess the proper functioning of the thyroid, doctors generally measure hormone levels in the blood. They measure the following rates:
- TSH The TSH level in the blood is generally the best indicator of thyroid function. As the role of this hormone is to stimulate the thyroid, its level in the blood is typically high when the thyroid is working insufficiently (hypothyroidism), and therefore needs to be more stimulated, and decreases when the thyroid is working excessively (hyperthyroidism), and therefore needs to be less stimulated. However, in rare cases where the pituitary gland is not functioning normally, the TSH level does not reliably reflect thyroid function. When a person is examined for a thyroid problem, TSH is always measured, and sometimes other tests are done as well. Additionally, for people with insufficient thyroid function (hypothyroidism) who are treated with thyroid hormones as medication, TSH is usually measured one or more times a year to check whether the medication dose needs to be adjusted.
- T3 or T4 : When doctors measure the levels of thyroid hormones T4 and T3 in the blood, they usually measure the bound and free forms of each hormone (total T4 and total T3). The majority of circulating levels of T4 and T3 are linked to a protein called thyroxine-binding globulin. If the thyroxine-binding globulin level is abnormal, total thyroid hormone levels may be misinterpreted; This is why doctors sometimes measure only the levels of free thyroid hormones in the blood (free T4 and free T3). Levels of thyroxine-binding globulin are lower in people with kidney disease or conditions that reduce protein synthesis by the liver, or in those taking anabolic steroids. The rate is higher in pregnant women, those taking oral contraceptives or other forms of estrogen, and in the early stages of hepatitis.
Thyroid ultrasound: When one or more masses (nodules) are palpated in the thyroid, an ultrasound can be performed. Ultrasound uses sound waves to measure the size of the gland and determine whether the growth is solid or fluid-filled (cystic), what the characteristics of the nodule are, such as the presence or absence of calcium, and the number and the prominence of blood vessels in the thyroid.
Radioactive iodine: In another test (radioactive iodine uptake test, a type of scan), a small amount of a radioactive substance (such as iodine or technetium) is injected into the blood stream. The radioactive substance concentrates in the thyroid and a device (gamma camera) performs another type of examination which detects the radiation and produces an image of the thyroid which will show any physical abnormalities. As the amount of radioactive iodine picked up by the thyroid depends on the functioning of the thyroid, a thyroid scan also helps determine whether the functioning of a part of the thyroid is normal, increased or decreased, compared to the rest of the gland.
Other thyroid tests: If doctors suspect an autoimmune disease, a blood test is done to detect possible antibodies that attack the thyroid. If thyroid cancer is suspected, doctors take a sample of thyroid tissue using a small needle to analyse it (biopsy). Doctors usually perform an ultrasound to identify the biopsy site. If medullary thyroid cancer is suspected, the blood level of calcitonin is measured, because these cancers always secrete calcitonin.
Thyroid disease Video Screening for thyroid disorders. Some specialists recommend screening for thyroid disease by measuring blood TSH levels every year or every few years in people over 70. However, several professional medical societies that have examined this issue recommend against screening asymptomatic adults to avoid over-treating people with minor biological abnormalities. Screening is recommended for all newborns to detect hypothyroidism (congenital hypothyroidism), which can cause major malformations in the developing brain and other organs if left untreated.
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