We have known for a long time that the function of any organ in the human and animal body affects the whole organism. This is also the case with the thyroid gland. As soon as its function is disturbed, vital processes are unfavorably affected to a decisive degree, and in some cases completely inhibited. The most modern examination methods even revealed that almost every body cell is affected by such dysfunctions.
Functioning of the thyroid gland
Infographic showing the anatomy and location of the thyroid gland, as well as the symptoms of hyperthyroidism and hypothyroidism. Click image to enlarge. The thyroid gland weighs 25 to 30 grams, making it the largest glandular organ with internal secretions, and it has considerable reserve powers. It is subject to a well-balanced control mechanism emanating from central sites located in the diencephalon. Via the pituitary gland, the thyroid gland receives impulses from a specific hormone that stimulates thyroid function. As a result, the thyroid gland produces its own hormones, which then affect the whole organism. The peripheral areas of the organism in turn signal to the central areas whether there is too much or too little thyroid hormone. From here, the decisive impulses are then transmitted back to the thyroid gland. It is therefore evident that the thyroid gland does not work independently at all, but adapts itself in each case to the organism’s need for thyroid hormones. The reaction of various body cells to this hormone is never constant, even in a healthy person; it always depends on the conditions of life, which vary at different times – for example, during puberty, pregnancy or the so-called menopause. If the thyroid gland is removed from an adult mammal, the symptoms of failure are initially hardly noticeable externally. The adult human being can also live without a thyroid gland, but there is severe physical and psychological impairment. Thus, if you will, the thyroid gland does not necessarily represent a vital organ in adulthood. It influences the extent of metabolic processes, but its maintenance and basic control can be taken over by other mechanisms. The situation is quite different during the development of the human and animal organism: here the thyroid gland is a vital organ. Animals without thyroid glands stop developing: sexual maturity is absent they are unable to adapt to extreme environmental conditions, such as temperature changes and hunger, and eventually perish.
Diseases associated with hypothyroidism
The same is true for humans. Children born without a thyroid gland reach puberty age at most without medical treatment. However, if the thyroid gland is present in childhood but its function, however, is severely reduced, the clinical picture of cretinism develops, which is associated with mental maldevelopment. There is also hearing loss and skeletal developmental disorders. In order to compensate for the hormone deficiency, the thyroid gland constantly receives work impulses from the pituitary gland. However, since it cannot cope with the production, it reacts with tissue proliferation, that is, it expands its production site. Cretinism occurs mainly where there is little iodine in the environment, especially in drinking water, which the thyroid gland urgently needs for hormone production. Furthermore, a higher incidence of goiter has been observed especially in people living in poor economic and hygienic conditions. But also in various foodstuffs, especially in most types of cabbage, carrots and beets, substances have been found that block hormone formation and thus can cause goiter. These substances are also found in cattle feed; they pass into cow’s milk and can in turn be ingested by humans. It is therefore necessary to avoid a completely one-sided diet with the above-mentioned foods for a long time at all costs. If the goitrogenic substances meet an adult organism, the clinical picture of cretinism does not develop at all. However, there is often an enlargement of the thyroid gland and in some cases an underactive thyroid gland, which can also have other causes.If we visualize again the control circuit in which the thyroid gland is embedded, it becomes clear that any interruption at any point in this circuit – whether in the body periphery, in the diencephalon, in the pituitary gland, or in the thyroid gland itself – can cause an underproduction of hormones.
Symptoms, complaints, and signs
In other words, the hormones produced are not enough to meet the body’s needs. Main causes of hypothyroidism, in addition to those already mentioned, are acute and chronic thyroiditis, which causes destruction of glandular tissue, and conditions following surgical removal of the thyroid gland. The main symptoms of hypothyroidism are general weakness, apathy, sensitivity to cold, lack of perspiration, dry and rough skin, and weight gain. The activity of the sufferer is sometimes so reduced that he cannot even decide to go to the doctor. As the disease progresses, slow speech is noticeable; the tongue is thickened and speech appears clotty. Swelling of the face, legs or hands may also occur. The patients look remarkably pale. It must be emphasized, however, that only the coincidence of several symptoms indicates the presence of hypothyroidism, not the occurrence of individual ones. As already mentioned, the adaptability of our organism depends on the functioning of the thyroid gland. In certain phases of life we can observe a particularly high consumption of hormones, which the thyroid gland is not always able to cope with. It must therefore increase in size. High demands exist – this has already been indicated – during puberty, pregnancy, lactation and menopause, in general the hormone demand of female persons is greater than that of male persons. For example, the enlargement of the thyroid gland in young men regresses after puberty, while in girls it often persists.
Diseases associated with hyperthyroidism
It is precisely the aforementioned life situations in which hyperthyroidism can develop. In chronic hormone deficiency situations, the thyroid gland can enlarge to such an extent that feelings of tension and pressure develop in the throat. At times, it grows downward into the chest cavity, causing the trachea and esophagus to be displaced. The result is difficulty swallowing and breathing. In such cases, the person concerned must see a doctor immediately so that surgical intervention can perhaps still be avoided. A special word should go to those patients who have undergone thyroid surgery. The removal of thyroid tissue consequently results in a hormone deficiency. However, since a residual thyroid gland always remains, it can enlarge again under the influence of higher-level signals, sometimes even reaching the same dimensions as before the operation. Unfortunately, the physician can never completely predict in which patients this secondary enlargement will occur. Therefore, it is absolutely necessary to follow up all patients for a longer period of time in order to cover the thyroid hormone deficiency with medication. Certainly, some patients are not comfortable taking one tablet a day for years. However, this is unavoidable if secondary diseases are to be avoided, and is ultimately only in the interest of those undergoing thyroid surgery. It is a painful fact for physicians that a large part of the comprehensive prophylactic measures in the various countries fail because the majority of patients who have undergone thyroid surgery do not realize this necessity. While understandable explanations are available for hypothyroidism and enlargement of the thyroid gland with normal hormone production, hyperthyroidism, also known as hyperthyroidism or Graves’ disease, has not yet been completely clarified in its mechanism of origin. Diseases of the thyroid gland can lead to a variety of complications if left untreated. An enlargement of the thyroid gland known as goiter often leads to swallowing difficulties, shortness of breath and congestion of the neck vessels due to unhindered growth in size alone; malignant degeneration of the proliferating tissue is also possible. In the case of hypothyroidism, the risk of premature vascular calcification increases, which can result in cardiovascular diseases, circulatory disorders and reduced kidney function. Cardiac arrhythmias and long-term enlargement of the heart muscle can also occur in the context of hypothyroidism.In rare cases, myxedema characterized by tissue swelling can develop into a myxedema coma associated with respiratory problems and slowed heartbeat, which requires immediate intensive medical care. Acute excessive hormone production in hyperthyroidism (thyrotoxic crisis) is accompanied by nervousness, gastrointestinal disturbances, an increase in body temperature and clouding of consciousness; without medical intervention, cardiovascular failure is the worst-case scenario. In the long term, insufficiently treated hyperthyroidism can damage the heart and adrenal glands, and also promotes the occurrence of metabolic disorders and osteoporosis. Thyrostatic drugs used to treat hyperthyroidism sometimes lower the white blood cell count, which can lead to flu-like symptoms. Blood count changes also occasionally occur after radioiodine therapy. Possible complications of thyroid surgery include injury to the vocal cord nerves or parathyroid glands and postoperative bleeding in the operated area.
Symptoms
We can only say that the interactions between the thyroid and pituitary glands are completely disturbed in this disease. The thyroid gland floods the organism with hormones, although, there is no need. The result is an increase in metabolism; all organs, stimulated by the overproduction of hormones, run at full speed, so to speak; the ingested food components are rapidly broken down and burned, and the heat release is immense. Of course, the thyroid gland can also increase in size under this condition. But often, before patients notice an increase in neck circumference, they feel the metabolic increase. They complain of general restlessness, sweating, palpitations, cannot tolerate heat, and tire easily. Palpitations and nervous restlessness are the most noticeable constant symptoms. As the disease progresses, weight loss may occur despite ravenous appetite and abundant food intake. The purely external characteristic is the familiar protuberance of the eyes. However, this symptom should by no means be taken as an expression of the severity of the disease. The greatest difficulty lies in distinguishing hyperthyroidism from the nervousness and fatigue that are particularly common nowadays, known as vegetative dystonia. In this case, accompanying symptoms can occur that are very similar to those of hyperthyroidism. However, we can recognize reliable distinguishing features by the fact that the palpitations and nervous restlessness are not so constant in vegetative dystonia. Patients are also hardly sensitive to heat and tend to sweat only occasionally, especially after excitement. If an enlargement of the thyroid gland is now added, without the need for excessive hormone production, the resemblance to true hyperthyroidism is striking, and only by using the most modern examination methods can the correct diagnosis be made.
Complications
Diseases of the thyroid gland can result in a variety of complications if left untreated. An enlargement of the thyroid gland known as goiter often leads to difficulty swallowing, shortness of breath, and congestion of the neck vessels due to unchecked growth in size alone; malignant degeneration of the proliferating tissue is also possible. In the case of hypothyroidism, the risk of premature vascular calcification increases, which can result in cardiovascular diseases, circulatory disorders and reduced kidney function. Cardiac arrhythmias and long-term enlargement of the heart muscle can also occur in the context of hypothyroidism. In rare cases, myxedema characterized by tissue swelling may develop into a myxedema coma associated with respiratory problems and slowed heartbeat, which requires immediate intensive medical care. Acute excessive hormone production in hyperthyroidism (thyrotoxic crisis) is accompanied by nervousness, gastrointestinal disturbances, an increase in body temperature and clouding of consciousness; without medical intervention, cardiovascular failure is the worst-case scenario. In the long term, insufficiently treated hyperthyroidism can damage the heart and adrenal glands, and also promotes the occurrence of metabolic disorders and osteoporosis. Thyrostatic drugs used to treat hyperthyroidism sometimes lower the white blood cell count, which can lead to flu-like symptoms.Blood count changes also occasionally occur after radioiodine therapy. Possible complications of thyroid surgery include injury to the vocal cord nerves or parathyroid glands and postoperative bleeding in the operated area.
Nodules in the thyroid gland
Finally, a few remarks about nodule formations in the thyroid gland, which can be of different origin. Mostly, in our latitudes, they are encapsulated blisters, called cysts. Furthermore, any thyroid enlargement with or without hyperfunction can become nodular. Less common are so-called “hot nodules”, which – similar to a fire-breathing mountain – emit increased amounts of hormones and cause the clinical picture of hyperfunction. If there is a sudden swelling of the neck, which can also be painful, combined with a general feeling of illness, it is usually a case of thyroiditis. Isolated nodules also form in thyroid cancer, which fortunately is very rare. If it is detected in time, it is curable, like most other organ cancers. Nodules in the thyroid gland should therefore always be a reason to see a doctor. However, it should be emphasized again that not every nodule formation is equivalent to thyroid cancer.
Outlook and prognosis
The prognosis for diseases of the thyroid gland is based on the individual symptoms as well as the existing causes. In a large number of patients, there is a chronic course of the disease and thus the use of long-term therapy. This enables alleviation of the health irregularities and leads to an improvement in the quality of life. However, if the prescribed medication is discontinued without consulting the physician, a relapse of the symptoms is to be expected. If there are abnormalities in the thyroid gland due to naturally occurring processes such as puberty, pregnancy or menopause, recovery is normally documented after the end of this phase. The immune system is rearranged by the organism and causes temporary problems. It is not always necessary to initiate treatment, as these are natural processes. In most cases of visual enlargement of the thyroid gland, surgery is performed. Since surgery is always associated with risks and side effects, these must be taken into account when making a prognosis. If the planned operation proceeds without further complications, the affected person can often be discharged from the treatment as cured a short time later. Further control examinations are nevertheless necessary in order to detect changes at an early stage and to be able to react accordingly. Without medical treatment, an increase in symptoms is to be expected with an enlarged thyroid gland.
Follow-up
In the case of diseases of the thyroid gland, the affected person has options for aftercare, although this is usually very dependent on the exact disease and the time of its diagnosis. Therefore, no general prediction can be made about these options. In general, the affected person should see a doctor for treatment of thyroid diseases. In most cases, the disease cannot be cured on its own, so a doctor should be contacted at the first signs and symptoms. In many cases, patients are dependent on taking various medications. It is always important to ensure that the medication is taken regularly and in the correct dosage in order to alleviate the symptoms permanently. Likewise, a healthy lifestyle with a healthy diet has a very positive effect on the further course of the disease and can also prevent the occurrence of further complications. Here, the doctor can also create a diet plan for the affected person. Most often, the diseases of the thyroid gland require regular checks and examinations by a doctor to permanently control the condition of the thyroid gland.
This is what you can do yourself
Depending on the form of the disease of the thyroid gland, there are various ways to take measures yourself, in addition to medical treatment and taking certain medications. In the case of hyperthyroidism, the affected person can take sage for heavy sweating and pay attention to small amounts of iodine in the diet. Wraps with curd or healing clay, which are placed on the neck, can lead to relief of the symptoms.It is also important to avoid stress and emphasize adequate rest. The affected person can learn special techniques for relaxation, which also include calming breathing exercises. Attention should also be paid to sufficient sleep and rest. In addition to medical treatment for hyperactivity, acupuncture may also be helpful. If the states of nervousness and hypertension predominate, psychological treatment may also be considered. For hypothyroidism, measures such as alternating showers and an alternating warm foot bath may be helpful to stimulate circulation. Baths with rosemary can provide rest. If an iodine deficiency occurs, the diet should be changed accordingly to compensate for this deficiency. Foods containing iodine include seafood, freshwater fish and sea salt.
When should you go to the doctor?
Diseases of the thyroid gland are rarely noticeable by clear symptoms, especially in the early stages. Therefore, especially people who are hereditarily predisposed to diseases of the thyroid gland should pay attention to possible warning signs. The earlier a possible problem of the thyroid gland is recognized, the faster this can be regulated. The typical diseases of the thyroid gland, hypothyroidism and hyperthyroidism, are noticeable in everyday life either by unnatural tiredness, listlessness and weight gain or, in the case of hyperthyroidism, by a feeling of overstimulation and weight loss. Although these symptoms are possible signs of very many diseases, they can always indicate thyroid dysfunction and should therefore also be clarified by a doctor. It can be helpful to ask the family doctor specifically for a check of the thyroid values, because the more unspecific the symptoms, the more difficult it often is to find the cause. Pain directly at the thyroid gland is rather rare. However, if you repeatedly experience a feeling of pressure in the neck or feel lumps in the neck area yourself, this can also indicate a disease of the thyroid gland. In the worst case, nodules can hide ulcers of the thyroid gland. The earlier these are detected by a doctor, the more successful the treatment usually is.
