What is the thyroid gland?
The thyroid gland is located in the neck, under the cartilage called Adam's apple. It produces two hormones called triodothyronine (T3) and thyroxine (T4), which are associated with the body's use and storage of energy
. This body's process of using and storing energy can also be called 'metabolism'
.
What is goiter?
Goiter is the name given to the enlargement of the thyroid gland. Regional growths inside the thyroid gland are called nodules
. Enlargement of the thyroid gland does not always lead to dysfunction.
Functional disorders of the thyroid gland may not be accompanied by goiter.
Hypothyroidism (underactivity or bankruptcy of the thyroid gland)
What is hypothyroidism?
Hypothyroidism means you have too little thyroid hormone. Hypothyroidism is the most common thyroid disease. It is more common in women, its incidence increases with age, and there is familial transmission.
Symptoms:
Fatigue
Mental slowdown
Inactivity
Cold sensation
Weight gain (only
Drying of skin and hair
Constipation
Menstrual irregularity
These symptoms are not specific to hypothyroidism. Many people with hypothyroidism may not have all of these symptoms
The severity varies. A simple blood test provides early diagnosis of the disease.
What is the cause of hypothyroidism? ?
The most common cause of hypothyroidism in adults is Hashimoto's thyroiditis. In this disease, your immune system
attacks your thyroid gland and damages it, preventing it from producing enough hormones. Hypothyroidism also
mainly It may develop as a result of radioactive iodine
treatment and surgery, which are methods used in the treatment of other thyroid diseases. Hypothyroidism also prevents the thyroid gland from developing.
It can also be seen from birth.
Why is hypothyroidism important?
In adults, there is a decrease in mental and physical performance due to hypothyroidism. It can also cause heart disease by causing high cholesterol. Additionally, without serious treatment
myxedema coma, a life-threatening condition due to hypothyroidism, may develop. Diagnosis of hypothyroidism
is also important for the health of the baby, especially during pregnancy. Those with hypothyroidism can be detected in routine tests performed on babies at birth. If left untreated, the child will experience mental slowdown or regression or the child's development will not be normal.
How is hypothyroidism diagnosed?
Thyroid-stimulating-hormone (TSH) and thyroid tests are performed through blood tests. hormone (T4) levels can be measured. High TSH
level and low T4 level in the blood indicate hypothyroidism. In the early
stage of hypothyroidism or in cases of mild hypothyroidism, TSH
levels will rise above normal before T4 levels drop below normal. Of these two blood tests, TSH is the more important. Your doctor will pay more attention to TSH when making the diagnosis
When the cause of hypothyroidism is Hashimoto's thyroiditis
autoantibodies that attack your thyroid gland can also be measured in the blood.
How to treat hypothyroidism. How is it done?
Hypothyroidism is treated by giving thyroid hormone medication. The drug used is levothyroxine. This substance is the synthetically produced (under laboratory conditions) version of T4, which is naturally produced by the thyroid gland. Not all
thyroid hormone preparations are the same. If possible, it is recommended that you stick to the same company's medication
. Thyroid hormone replacement should generally be done for a lifetime. If the medicine needs to be changed for any
reason A blood test for RSA and TSH is required. The drug dose will be adjusted according to the TSH test
result. If thyroid hormone medications are taken more than needed
it may cause bone loss, deterioration in heart functions and abnormalities in heart rhythm over time
. Insufficient doses may not improve complaints. It may be necessary to make frequent dose adjustments during pregnancy and some other times. You need to discuss this with your doctor during your routine checkups.
What should you do based on this information?
If you have hypothyroidism, you should get treatment. If you do not receive treatment, it can become a serious health problem.
If you have one or more of the symptoms of hypothyroidism or if you have a family member with thyroid disease, you should talk to your doctor about a blood test. If the test comes back positive, you should tell your first-degree relatives about your situation. They also need to have a blood test for thyroid disease
.
It is recommended that thyroid
functions be checked during pregnancy and in all women over the age of 60, whether they have complaints or not.
Hyperthyroidism (excess of thyroid hormones)
Hyperthyroidism
Symptoms:
The cause of the complaints is the effects of excessively secreted thyroid hormones on the heart, muscle and nervous system< Originates from /p>
. The frequency of the following complaints may vary depending on the severity of the disease.
Weakness in your muscles (you cannot easily climb stairs, you cannot carry heavy things)
Trembling in the hands
Heart palpitations
Fatigue
Weight loss despite eating normally or excessively
Diarrhea (increased bowel movements)
Nervousness
Eye problems (eye problems) feeling uncomfortable pain, difficulty in seeing)
Menstrual irregularity
Inability to tolerate heat and increased sweating
Infertility
Causes of hyperthyroidism:
Graves Disease: The most common cause of hyperthyroidism is Graves' disease. The thyroid gland enlarges and begins to produce excess
hormones. This disease occurs due to genes and the immune system.
Antibodies formed against the thyroid gland in the immune system stimulate the thyroid gland, causing it to produce more hormones than normal
. In some patients with Graves' disease, one notable symptom is that the eyes appear to pop out because of swelling behind the eye.
Thyroid nodules
Too much thyroid for other conditions taking hormone medication
Inflammation of the thyroid glands (Subacute thyroiditis)
Lymphocytic thyroiditis or postpartum thyroiditis, which is an inflammatory disease of the thyroid gland
and causes the gland to produce more thyroid hormone than necessary.
Treatment Methods
Radioactive Iodine Treatment:
It is a method used in the treatment of hyperthyroidism. Iodine labeled with radioactivity is retained by the thyroid gland
and destroys the thyroid gland. It is administered as a single pill or liquid. After the application, it is necessary to isolate (stay at home) for 24-48 hours in order to avoid spreading radiation.
Although it is an effective method in the treatment of hyperthyroidism, it may cause destruction of the entire thyroid gland
and may require the use of thyroid hormone supplements.
Surgical:
Surgical removal of the thyroid gland (thyroidectomy) is another procedure. Although it is a permanent solution, it is a less preferred option. This surgery should be performed by a skilled and experienced surgeon
It occurs because the nerves around the larynx or the nerves going to the parathyroid gland, the gland responsible for the body's calcium metabolism, may be damaged. Surgery is generally the preferred method
if the thyroid gland becomes too large and prevents you from breathing, if anti-roid medications do not work,
or if radioactive iodine treatment cannot be given for some reasons.
After radioactive iodine and surgical treatments, thyroid hormone levels in your body need to be checked at regular
intervals. After these treatments, most patients develop hypothyroidism (meaning
they cannot produce enough thyroid hormone) and must take thyroid hormone medication once a day.
Who gets surgery?
When we roughly divide thyroid diseases into two, we encounter two types of diseases: One
is functional diseases of the thyroid, and the other is nodular diseases of the thyroid. When it comes to functional diseases of the thyroid, there are two types of situations: one is the thyroid gland working more than normal
(hyperthyroidism), the other is the thyroid gland working less than normal (hypothyroidism). Treatment of underactive thyroid
is not surgical. What needs to be done in this type of problem is to administer the missing thyroid hormone externally as medication. Overactive thyroid is a condition that can be corrected surgically
. However, surgery is not a mandatory treatment method. In case of widespread overactivity of the entire thyroid gland (diffuse toxic goiter or Graves' disease), the disease is first tried to be treated with medication. If this is not successful
or if the disease recurs after the level of thyroid hormones is returned to normal, the patient should receive two types of further treatment
It is recommended: the first is radioactive iodine ablation (RIA; popularly called atom) treatment, and the other is the surgical removal of all or almost all of the thyroid gland. Another situation that may cause the thyroid gland to become overactive is the overactivity of just one or more nodules (toxic nodular goiter). In this disease
Unlike Graves' disease, the remaining thyroid tissue is normal. Therefore, the treatment of the disease
is primarily to surgically remove the overactive thyroid nodule or nodules. However, IUD treatment can also be applied to patients who have serious comorbidities or who do not accept surgery. Response to IUD treatment may not be sufficient in toxic
nodular goiter. For this reason, surgical treatment is preferred first.
The second type of thyroid diseases can be grouped as nodular diseases. In this group, thyroid
functions are normal, but there is an anatomical structural disorder of the thyroid. In this
group, two important conditions are a priority for surgery: The first and most important of these is that the nodule or nodules have been determined to be thyroid cancer, and the other is that the thyroid and/or nodules
Due to its size, it causes pressure problems on neighboring organs. If the needle biopsy performed on nodules detected in the thyroid clearly indicates a benign disease and radiological / clinical
findings confirm this, there is no necessity for surgery. These patients can be followed up with regular radiological and
clinical control. However, even if benign, the size of the nodules increases over time (more than 50% growth in 1 year) or pressure symptoms may be a reason for surgical
treatment. These Apart from this, surgical treatment is inevitable in cases where a needle biopsy is definitively diagnosed as cancer or if cancer is suspected.
In some cases, despite performing a needle biopsy, sufficient material cannot be obtained for diagnosis
< For this reason, pathologists cannot make a definitive diagnosis. In this case, if imaging methodsand clinical examination strongly support the possibility of the nodule being malignant, surgery is preferred
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