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Why should we take care of the thyroid?

It is a butterfly-shaped gland, it is located in the center of the neck and above the collarbone, its function is to secrete hormones that circulate through the blood system and help regulate metabolism, the speed with which they are burned calories and heart rate, among other functions.

By controlling metabolism, which is the rate at which every part of the body works, thyroid hormones help keep the brain, heart, muscles, and other organs working properly. A balanced metabolism also ensures a temperature, heart rate and energy level; they also play a fundamental role in the growth of children.

What type of hormones does the thyroid gland secrete?

The hormones produced are mainly thyroxine or T4 and T3 or triiodothyronine. Thyroid stimulating hormone or TSH is synthesized in the pituitary gland (located at the base of the skull), it controls and stimulates the thyroid to produce T4 and T3.

The first test to study thyroid diseases is TSH levels. In patients on thyroid hormone replacement, free T4 levels measure the concentration of levothyroxine in the blood, i.e. whether the dose of the medication is optimal.

Symptoms that something is wrong with the thyroid

The initial changes that can occur are very subtle, depending on whether the level of hormones produced by this organ is low or high; however, most patients are asymptomatic and never develop symptoms during the course of their disease.

When hormone levels are low, you may experience:

  • Slowing down of mental functions

  • Fatigue or tiredness

  • Feeling cold

  • Dry skin and hair

  • Changes in bowel habits (constipation)

  • Alterations in the sleep cycle

When they are high it could be presented:

  • Weight loss

  • Cardiac changes (chest pain or palpitations)

  • Stomach pains or hyperdefecation (increase in the number of bowel movements)

  • Sweating and excessive heat

  • tremors

  • jaundice

  • Dyspnea (fatigue, shortness of breath)

The traditionally described symptoms can be present in many people who do not have thyroid disease, so they cannot be considered as diagnostic tools, the only way to diagnose it is through laboratory tests.

Thyroid diseases

The diseases that are most frequently diagnosed in the consultation related to the thyroid gland are:

  • Hypothyroidism: it is when the production of thyroid hormones is lower than those necessary for the proper functioning of the body. This type of disease is the most common.

  • Hyperthyroidism: unlike the previous one, this is due to the excessive production of hormones.

  • Goal: better known as “vedat” is an enlargement of the size of the gland.

  • Thyroid nodules: is the development of small lumps in the gland, they are quite common being found in 2 out of 10 people who have a thyroid ultrasound, they are almost always benign but must be evaluated by an expert to make individual decisions.

  • Thyroiditis: inflammation of the gland, this can generate a transient increase in the secretion of hormones, or favor a gradual reduction in thyroid function in the long term as a result of the inflammatory reaction.

  • Thyroid cancer

Effects of thyroid hormones on the heart

One of the most important effects is that they influence the heart rate, if there is an increase in thyroid hormone levels, tachycardia, palpitations, risk of developing arrhythmias such as atrial fibrillation, increase in the work of the heart, risk of congestive heart failure.

Patients with hypothyroidism, on the other hand, can reduce the heart rate, modify the blood pressure figures and increase the amount of antihypertensives. Other effects increase the risk of heart attack, thrombosis or changes in kidney function.

What risk factors are latent for having thyroid disease?

  • The majority are women who develop hormonal problems the most.

  • Age over 60 years

  • First degree family member with hypothyroidism

  • Suffering from any other autoimmune endocrine or immune system disease

  • Use certain drugs such as lithium or amiodarone

When are thyroid hormones most important?

Populations that should have thyroid function testing would be:

  • Babies babies

  • Adolescents, especially girls entering puberty

  • Women who want to have children or are pregnant (first and last trimester)

  • People with coronary artery disease, arrhythmias and high cardiovascular risk

  • Seniors at 50 years old

How to diagnose and treat this type of disease?

The initial thing is to consult the doctor if you are in the risk characteristics described above. The evaluation begins through a physical examination, where the doctor can identify if there are changes in the gland, and then through blood studies the TSH levels are verified. Additional testing will be decided upon based on the findings of the physical examination and initial studies.

The only way to treat hypothyroidism is with medication, thyroid hormone replacement is done with free T4 or thyroxine, and you need to follow a routine to have the desired effects:

  • Try taking the same brand of medicine.

  • It must be taken on an empty stomach and only with water.

  • Do not combine with other medications (especially omeprazole).

  • After taking the medicine, wait at least 30 minutes before eating.

  • For no reason forget to take the medicine, and if you do it could be taken 3 hours after the last meal.

Patients with hypothyroidism need pharmacological treatments with antithyroid drugs to slow down the production of hormones from the thyroid gland, by reducing the amount of hormones in the blood they improve the cardiovascular effects that affect the patient.

Treatment times for hypothyroidism are variable, but usually between 12 and 18 months. A good number of patients respond to drug treatment, some patients who do not improve with this treatment may need other options such as I-131 radioactive iodine therapy or surgery.

Surgical treatments are less common and are done in specific conditions, according to the characteristics of the findings of the thyroid ultrasound or other complementary images, plus a biopsy of the affected tissues.

Can thyroid problems be cured?

It is important to clarify that most patients with hypothyroidism need treatment indefinitely, some patients may require it transiently in the context of thyroiditis.

In patients with hyperthyroidism such as Greus’ disease or multinodular goiter the treatment times are 12 and 18 months, as previously mentioned other treatment options may be required.

At Clínica Shaio we have the option of treating patients with these pathologies, as we have a group of specialists to carry out ultrasound procedures, biopsies, radioactive iodine therapy and surgeries.

This article was advised by Dr. Oscar Leonardo Medina Espitia, an endocrinologist at the Shaio Clinic.

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