Diseases of the thyroid gland

In the case of hypothyroidism, no or insufficient amounts of the two thyroid hormones thyroxine (T4) and triiodothyronine (T3) are produced, so that their effect is reduced or absent at the target site. In general, the thyroid hormones have an activating effect on the metabolism, regulate the circulatory function, growth processes and have an influence on the psyche. Consequently, an underfunction has a reducing effect on the metabolism.

An underactive thyroid gland cannot be cured, except in a few exceptional cases. However, a normal life can be led with a permanent drug treatment. In the case of hyperthyroidism, the two thyroid hormones thyroxine (T4) and triiodothyronine (T3) are produced in increased quantities.

This results in an increased hormone effect at the target site, which is reflected in an overall increase in metabolism and a promotion of growth. In addition, T3 and T4 also influence the calcium and phosphate balance as well as the musculature. Usually the causes are to be found in the thyroid gland itself.

Nevertheless, these can be further differentiated, which in turn has an effect on the respective therapy. Graves’ disease is an autoimmune disease, which means that the body’s own immune system is directed against its own cells. In this case it is the production of IgG-type antibodies against the TSH receptors of the thyroid gland.

These autoantibodies have the same effect as natural TSH, but lead to a permanent stimulation of the receptors. This results in a permanent stimulation of growth, which leads to the formation of a goiter, as well as a gesterigerte production and secretion of the thyroid hormones T3 and T4. In addition to the symptoms of hyperthyroidism, a characteristic symptom triad (Merseburg Triad) consisting of goiter, tachycardia and exophthalmos can be observed.

The latter makes the eyes “protrude” and, according to recent findings, is due to an additional disease mechanism. Hashimoto’s thyroiditis is an autoimmune disease in which the immune system recognizes and destroys the body’s own cells and tissue as foreign.This leads to a chronic inflammation of the thyroid gland and is one of the most common forms of hypothyroidism. The exact causes are still not understood, but it is known that women are affected significantly more often than men.

The symptoms seem confusing at first, as the body tries to counter-regulate in the early stages, which tends to cause symptoms of hyperthyroidism. In the long run, however, these symptoms turn into the typical symptomatology of hypothyroidism. The complicated course of the disease and individual characteristics make the diagnosis of Hashimoto’s thyroiditis even more difficult.

Roughly speaking, one can say that thyroid nodules are focal (individual) changes of the normal thyroid gland tissue. The exact causes are still not understood. As a possible starting point, there are mutations in certain genes.

In addition, it is already known that in iodine deficiency areas the development of the nodes is significantly increased. The differentiation between cold and hot nodules can be roughly understood as follows: “less happens” – the affected area produces less thyroid hormones. A hot node, on the other hand, produces more hormones – this area is therefore more active.

Depending on which form is present, it does not necessarily mean that the affected person suffers from hypothyroidism or hyperthyroidism, but the respective clinical picture can develop or be already socialized.

Hot lump in the thyroid gland
Cold knot in the thyroid gland

Thyroid carcinoma is a malignant change in the epithelial cells of the thyroid gland. The first symptoms are usually disturbing nodules in the thyroid gland or an increase in size with the development of struma. You can find more information on our main page about thyroid cancer