Thyroid

The thyroid is an endocrine gland located in the anterior region of the neck, in front of the trachea, whose role is to produce some particular hormones, called thyroid hormones.

These play a leading role in the proper functioning of the body, in particular in the regulation of metabolic functions:to regulate body temperature and lipid metabolism, to contribute to the proper functioning of the cardiovascular system, basal metabolic rate and sleep regularity, and it also promotes body growth and the development of the nervous system of the fetus and child allowing their correct psychophysical development.

Thyroid diseases are frequently found in the population, especially in women. These pathologies often manifest themselves in the absence of symptoms or with non-specific symptoms, so their correct identification is not always easy. Thyroid diseases can be linked to an alteration in its function (hypothyroidism or hyperthyroidism), or to the appearance of formations within the gland that are called nodules.

Hypothyroidism


Hypothyroidism is a thyroid dysfunction characterized by insufficient production of thyroid hormones. This condition causes a slowdown in the body's metabolic processes, which at an early stage does not manifest itself with obvious symptoms but, if left untreated, can have serious health consequences.

In most cases, hypothyroidism is acquired, i.e. it occurs in adulthood as a result of various triggering causes, including: iodine deficiency; autoimmune thyroiditis (such as Hashimoto's thyroiditis); taking certain medications (such as lithium, often used in psychiatry, and amiodarone, prescribed in the presence of cardiac arrhythmias); radioactive iodine therapy; removal of the thyroid gland (thyroidectomy); alterations in the function of the pituitary gland, an endocrine gland located near the brain that uses a hormone called TSH (Thyroid Stimulating Hormone) to regulate thyroid function.

There is also a form of congenital hypothyroidism (i.e. present from birth), which can result from predisposing genetic conditions or from a severe maternal iodine deficiency in pregnancy. Congenital hypothyroidism is a form that must be recognized and treated quickly to avoid serious and irreversible consequences for the newborn, especially for the central nervous system. 

In the first phase, acquired hypothyroidism can be asymptomatic, and then manifest itself with symptoms that can vary depending on the age of onset, severity and duration of the disease.

In general, the most common symptoms include:


Hyperthyroidism


 Hyperthyroidism a thyroid dysfunction associated with an excess of thyroid hormones in the circulation, with inevitable consequences on metabolism. This condition determines, in fact, an improper acceleration of the body's metabolic processes, with potential repercussions on various body districts, including heart function and bone metabolism.

Factors that can lead to hyperthyroidism include:


Symptoms associated with a hyperthyroidism condition include:


Hashimoto's thyroiditis 


It is a form of chronic autoimmune thyroiditis. Being an autoimmune condition, at the base there is a malfunction of the immune system, which sees the thyroid gland as an external threat and attacks it through the production of targeted antibodies. The natural outcome is that the progressive destruction of the thyroid gland induced by antibodies in the long term impairs its function.

Although it is not a genetic condition, there is still a familial predisposition. This condition can occur at any age and, like most thyroid diseases, is more common in women.


This thyroiditis can remain silent for years, but when the progressive destruction of the gland no longer allows the thyroid to function properly, symptoms of hypothyroidism may appear. Sometimes, moreover, the process of destruction is so sudden that it causes a large proportion of thyroid hormones, which were previously stored in the thyroid cells, to be released into the bloodstream. This phenomenon, which is called thyrotoxicosis, can manifest itself with symptoms similar to hyperthyroidism.


Diagnosis and treatment


Diagnosis typically requires a specialist endocrinology examination, during which the doctor collects a thorough medical history of the patient by evaluating their medical history and symptoms, and performs a thorough physical examination to assess any characteristic signs or symptoms. A blood test is usually ordered to evaluate thyroid function (TSH, T3, T4 hormone measurement) and to evaluate the presence of autoimmune disease. In addition, the doctor may prescribe an ultrasound scan and a thyroid scan if necessary.

Treatment for hyperthyroidism is personalized according to the underlying cause and also the characteristics of the patient (age, medical history, severity of symptoms).

The therapy is pharmacological, with the prescription of antithyroid drugs; If the disease recurs or does not respond to treatment, radiometabolic therapy (with radioactive iodine) or surgery (thyroidectomy) may be necessary.