We have all heard about the thyroid gland, but do we really know its function in our body?
The truth is that this endocrine gland is involved in almost all the basic functions of our body, hence the importance of being alert to any suspicion.
Dr. Sánchez Cámara, endocrinologist specialized in thyroid, warns that the most common pathologies are: the thyroid nodule and functional disorders in the synthesis of thyroid hormone, either hypothyroidism or hyperthyroidism.
In recent years, a certain prevalence of these pathologies has been observed and their diagnosis has increased, either due to the improvement in the diagnostic techniques generated and/or due to external factors that in many cases are still unknown to us, but are caused by genetic mutations, without forgetting genetic inheritance.
Why is the thyroid important in the body?
The importance of the function of thyroid hormones lies in their action at a systemic level. Thus, they can act by controlling heart rate, intestinal rhythm, cognitive and metabolic functions, among many others.
Situations of hyper- or hypofunction can generate a multitude of symptoms at different levels, hence its importance, and the fact that each patient’s needs must be individualized according to his or her age and baseline situation.
For example, mild hypofunction may require treatment in pregnancy or childhood, and not in patients with cardiac pathology or osteoporosis.
What symptoms should we be concerned about?
Thyroid problems are commonly associated with “fattening”, referring to hypothyroidism, and “slimming” as hyperthyroidism, and this is a misconception.
While it is true that untreated hypothyroidism generates a tendency to weight gain and untreated hyperthyroidism generates a tendency to weight loss, this tendency is mild and it is important to emphasize that it occurs when the patient is not treated.
What we see in the clinic are patients with hypothyroidism who present with fatigue, drowsiness, mental sluggishness, hair loss and constipation. In cases of patients with untreated hyperthyroidism it is more common to find nervousness, tremor, palpitations, sweating, diarrhea and insomnia.
As for nodular pathology, there are usually no symptoms except in large nodules (larger than 3 or 4 centimeters) and they manifest with difficulties in swallowing or breathing and a foreign body sensation in the anterior cervical region.
What diagnostic tests can detect them?
A simple blood test is sufficient to assess whether a patient has alterations in thyroid function, although a cervical ultrasound can also be requested to confirm the diagnosis. A family history of thyroid pathology may increase our suspicion.
With thyroid ultrasound we can demonstrate the presence or not of thyroid nodules, without forgetting that this technique depends a lot on the experience of the operator and the quality of the ultrasound machine. With the characteristics of the nodule, we can decide whether to perform FNA (fine needle aspiration puncture) to rule out malignancy or whether, on the contrary, to follow it up.
What treatment is applied for thyroid problems?
With regard to hypothyroidism, each patient must be evaluated, since in mild stages of the disease (known as subclinical hypothyroidism) it is not always necessary to treat it.
If indicated, treatment with levothyroxine is recommended, 1 tablet per day, adjusting the dose according to the patient’s needs, weight and age.
The treatment of hyperthyroidism is more complex. Sometimes drugs that block the actions of thyroid hormones can be administered, but surgery can also be used in cases where large nodules or goiters are detected.
To a lesser extent, treatments that destroy the synthesis of thyroid hormones, such as radioactive iodine, are used.
Is there a cure for thyroid pathologies?
Thyroid cancer is a disease with a high cure rate and generally after surgery most patients can be said to be “cured”. In other cases, we have to rely on radioactive iodine treatment after surgery, but we can say that after appropriate treatment, most cases are cured.