The thyroid gland is a small gland weighing 15 grams located in the front part of the neck and produces two hormones T3 (Trijodothyronine) and T4 (Thyroxine).
The role of thyroid hormones is to recognize and act on their receptors in cells to regulate the metabolism of every cell. They also have other functions such as in the process of growth and mental and physical development, help the body in adapting to external temperatures, influence the strengthening of bones, increase the oxygenation of every cell. Without the presence of thyroid hormones, no human being could live, or our body would not be able to perform any physical or mental action.
As an endocrine gland, the thyroid directly releases the substances it produces into the blood. More than 99% of thyroid hormones are bound to proteins and are not active, only their free part is active.
It is a disease that affects 2-3% of the population, more often affecting the female sex with a ratio of 3/1 with males. At the base of this disease lies the decrease in production of thyroid hormones which can be partial, complete. When we have a complete deficiency, the patient is in a comatose state and at great risk for their life.
This disease is usually caused by chronic damage to the thyroid gland, the most common cause is chronic thyroiditis which is autoimmune in nature and called Hashimoto's Thyroiditis. Other causes are damage to the thyroid by viruses, medications such as Amiodarone, Lithium, surgeries often, thyroid gland cancer, and surgery required in such cases leads to non-production of hormones, and radiation with radioactive iodine severely damages the thyroid gland and predisposes it to a decrease in its function.
This disease is more common in ages over 50 years but can also occur in newborn children. The latter is a severe condition that must be diagnosed and treated quickly, within the first year of life because otherwise these children will remain mentally retarded or as otherwise known by the name Cretinism.
The thyroid gland is stimulated to produce its hormones by another hormone called TSH (Thyroid Stimulating Hormone) which comes from the pituitary gland. When this gland does not produce the hormone properly, we are dealing with a lack of thyroid stimulation and secondary hypothyroidism. When the damages are only in the thyroid gland, we are dealing with primary hypothyroidism.
Major complaints include:
There may also be temporary hearing loss, joint pain, hand cramps. In the elderly, memory disorders, emotional disorders, depression, stress, anxiety, etc., are more common. As a general sign, the thyroid of these patients is enlarged with goiter, with and without nodules (swelling), but this disease can also be present in people who do not affect the thyroid gland at all. Nowadays, diagnosis is usually made quickly due to people's awareness and advanced laboratory techniques.
As a rule, the treatment is medication-based, but diet plays an important role. These patients should eat products high in iodine such as seafood, sea fruits, fish, meat, internal organs of livestock, milk, yogurt, cheese, fruits, etc.
Should not consume cabbage, cauliflower, broccoli, beans, peas, etc.
Should regularly consume water and mineral salts at normal doses.
Hormone treatment consists of administering Thyroxine, in medication form. This is the standard treatment that is usually taken in the morning 30-60 minutes before eating, accompanied by a glass of water.
This medication accumulates and stays 7 days in the organism, which corresponds to the peak of its action. The aim of the treatment is to return or reduce the symptoms of hypothyroidism, which is achieved and followed by measuring TSH, the more normalized these values are the closer to the ideal treatment and normal function of the damaged thyroid gland we are.
As a rule, TSH is always high at the beginning of the treatment because we emphasized that when the thyroid is damaged or does not respond to TSH stimuli, it increases a lot to try to normalize the thyroid function.
Measuring T4 and T3 is not routinely recommended because the intake of these hormones from outside changes depending on the diet, timing of intake, etc. Therefore, the evaluation of progress is only done with TSH.
There are cases where both thyroid hormones are given in medication form, or when thyroxine is given together with iodine but in this case, it must be taken into account that the thyroid gland must not be completely damaged otherwise iodine would not be processed and would not have any effect.
Subclinical Hypothyroidism occurs when the thyroid has partially lowered its function and when we have slight increases in TSH or we can say this is called the milder form of hypothyroidism. Today, there is a debate in the world whether or not to start replacement therapy in such cases, and most authors agree that treatment should start in subjects with TSH greater than 10mu/l.
Rarely, T3 is used in the treatment of hypothyroidism because it is eliminated very quickly from the body, needs to be taken several times, and does not reach the physiological peak in serum. Attempts have been made several times to launch products that have both T4 and T3 but have not proven to have an advantage over treatment with T4 alone.
Caution must be taken in the treatment with T4 because if the doses needed are exceeded, it can lead to another disease called hyperthyroidism or overproduction of the thyroid gland which is accompanied by heart rhythm disorders, weakness of bone strength, etc.
The TSH hormone should be checked every 3 months to maintain a good balance of the disease. The use of thyroid extracts taken from animals has not shown good results in practice. However, there are patients who prefer the "supposedly natural" treatment over the synthetic one.
This disease, hypothyroidism, should be regularly followed by a specialist endocrinologist in order to adjust the doses and treatment scheme, depending on the clinical condition, laboratory examinations, etc. The treatment of this disease is difficult and under no circumstances should these patients self-treat or consult non-professionals.