In patients with increased or decreased activity thyroid gland there are many various symptoms and signs. However, in many cases, these disorders are diagnosed during routine examinations for completely unrelated medical problems.
Symptoms of an overactive thyroid gland
An overactive thyroid gland, also known as thyrotoxicosis, is quite common. It affects approximately 0.5% of the population globe. Thyrotoxicosis occurs three times more often in women than in men.Three main options for increasing thyroid activity:
- Graves' disease (in Russian terminology the concept of Graves' disease is more common);
- isolated toxic node;
- multinodular toxic goiter.
An isolated toxic node is rare form thyrotoxicosis. The nodule is a benign group of cells that produces excess thyroxine and can be detected by scanning using radioisotope tracers.
Multinodular goiter is observed mainly in menopausal women. Characterized by chronic enlargement of the thyroid gland, in which part of the goiter degenerates, degenerating into fibrous and colloidal connective tissue. The nodes produce excess thyroxine, which gives clinical manifestations of thyrotoxicosis, which is why the nodes are called toxic.
For all forms increased activity Overproduction of thyroxine by the thyroid gland can cause feelings of heat, excessive sweating, increased heart rate, tremors, irritability, or mood swings. Sometimes there are changes in the frequency of bowel movements and menstrual irregularities.
Physical symptoms
Patients with Graves' disease (Graves' disease) often experience exophthalmos (bulging eyes) and swelling of the eyelids in addition to the symptoms mentioned above. This can cause double vision and, extremely rarely, blurred vision as a result of increased pressure on the optic nerve. Such changes are characteristic only of Graves' disease.In elderly patients, thyrotoxicosis causes tachycardia and disturbances heart rate, which may be accompanied respiratory failure(consequence of heart failure). Children with this condition may experience accelerated growth or behavioral problems such as hyperactivity.
Diagnosis and treatment of overactive thyroid gland
Diagnosis of an overactive thyroid gland is usually based on the described combination clinical manifestations. It is confirmed by a blood test for thyroid hormone levels. In some cases, ultrasound and/or radioisotope scanning of the thyroid gland may be necessary during the initial examination.There are three treatment options used for gland hyperfunction:
- antithyroid drugs;
- radioactive iodine preparations;
- surgery.
The patient's age and other medical conditions should also be taken into account.
For patients with Graves' disease in the best possible way is treatment with radioactive iodine. It is safe, effective and can quickly correct excess thyroxine production. Previously, it was prescribed only to women who already had the desired number of children, or to men. However, at present, treatment with radioactive iodine can be safely used for younger patients who are planning a pregnancy no earlier than a year after treatment.
Antithyroid drugs include carbimazole and propylthiouracil. Both can cause skin irritation or, less commonly, reversible inhibition of function bone marrow. Treatment is usually carried out for 12 months. In approximately 40% of cases, repeat therapy is required.
TO surgical intervention for Graves' disease, it is now rarely used and only in cases where the gland is too large and disfigures the appearance or causes breathing problems.
In patients with extensive multinodular goiter or isolated toxic nodule, antithyroid drugs are rarely effective. In such cases it is usually recommended radioactive iodine or, in some cases, surgery.
Underactive thyroid gland
Decreased thyroxine production causes the patient to gain weight, feel cold, tired, lethargic and depressed.Lethargy and general fatigue are very common clinical signs many diseases, but in some cases a specific cause of fatigue can be called a decrease in the activity of the thyroid gland. It is also known as hypothyroidism (hypo means decreased or insufficient). The syndrome caused by a lack of thyroid hormones in this pathology is called hypothyroidism. It affects about 2% of women and only 0.1% of men. Globally, the most common cause hypothyroidism is a lack of iodine in food. IN developed countries this condition usually results from previous treatment for thyrotoxicosis or autoimmune diseases. Hypothyroidism most often affects women over 50 years of age.
Women have more young This may be a consequence of autoimmune diseases, in which antibodies are present in the blood that attack the thyroid gland, which suppresses the normal production of thyroxine.
Treatment
Drug treatment of patients with hypothyroidism involves lifelong administration of synthetic thyroxine. The use of this hormone helps return metabolism to its normal level. normal state. The patient has an annual blood test to monitor his condition and determine the need for dose changes. In elderly people with heart disease, the dose of thyroxine is increased gradually to avoid heart problems.Symptoms and diagnosis
Typical symptoms of an underactive thyroid include:- weight gain;
- tissue swelling - water retention in tissues, most noticeable on the skin of the eyelids and hands;
- hair loss;
- change in voice, which becomes hoarse, slow and monotonous;
- eyebrow loss;
- muscle weakness;
- lethargy;
- hypertension - high blood pressure;
- cold intolerance;
- constipation
The concentration of both thyroid hormones and thyrotropin, a hormone secreted by the pituitary gland in response to a decrease in thyroxine concentration, is measured. If the thyroid gland is underactive, the concentration of thyroid hormones will be low, while the concentration of thyrotropin will be high.
The human body. Outside and inside. №16 2008
Hypothyroidism is a disease caused by decreased production of thyroid hormones compared to normal. The thyroid gland itself is called “sluggish” or underactive. A lack of thyroid hormones leads to a slowdown in metabolism in the body.
Thyroid function– convert iodine obtained from food into the two main thyroid hormones.
Symptoms of an underactive thyroid gland
Hypothyroidism is also called the “silent disease” because it occurs gradually. Most people fail to recognize this disease. However, this is not their fault, because its symptoms are subtle and, what makes things worse, are similar to the signs of aging. The severity of symptoms is determined by the degree of thyroid hormone deficiency. Low thyroid hormone levels affect different parts of the body differently. Since thyroid hormones are responsible for regulating metabolism in the body, their lack leads to a slowdown in all metabolic processes. Below is a list of symptoms of hypothyroidism.
Skin
| Muscular system
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Gastrointestinal system
| Respiratory system
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The cardiovascular system
| Reproductive system
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Nervous system
| Excretory system
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Both men and women can develop hypothyroidism, but women are eight times more likely to suffer from the disease. It affects people of all ages. Severe cases hypothyroidism in adults is called myxedema,and in children - cretinism.
One of the main causes of an underactive thyroid gland is Hashimoto's thyroiditis, or inflammation of the thyroid gland. This autoimmune disease, in which the body does not perceive the thyroid gland as a native organ and attacks it with antibodies as if it were foreign body. This not only harms the thyroid gland's ability to produce hormones, but also leads to the destruction of the thyroid gland itself. Some other causes of an underactive thyroid are a diet that does not provide the body with enough iodine, problems with the pituitary gland or hypothalamus, thyroid infections, radiation treatment for hyperthyroidism, and birth defects.
Anatomical location of the thyroid gland
Low thyroid hormone levels
When levels of the hormones T4 and T3 in the blood fall, the hypothalamus releases “thyrotropin-releasing hormone” (TRH) into the bloodstream. As the level of TVH in the blood increases, the pituitary gland receives a signal from the hypothalamus to release " thyroid-stimulating hormone"(TTG). And TSH, in turn, stimulates the production and release of thyroid hormones into the blood. If the level of thyroid hormones in the blood is high, the hypothalamus stops releasing thyroid hormone. The pituitary gland senses the low level of TG and stops releasing TSH, thus regulating the level of thyroid hormones in the blood. Such a connection exists between the hypothalamus, pituitary gland and thyroid gland - all these structures work in cooperation with each other.
The normal level of TSH in the blood ranges from 0.4 to 4.0 mIU/L. Determination of thyroid hormone levels occurs through a blood test and determination of the index free thyroxine(IST). If your thyroid hormone levels are abnormal for any reason, it is a cause for concern. High levels of thyroid hormones in the blood are defined as hyperthyroidism, while low levels of thyroid hormones are called hypothyroidism. Hypothyroidism is a more common disease than hyperthyroidism.
The thyroid gland is a butterfly-shaped organ that lies just below the larynx (voice box) or Adam's apple and is an important part of endocrine system. It consists of two lobes located on both sides of the trachea and united by thyroid tissue called the bridge.
Thyroid function– convert iodine obtained from food into the two main thyroid hormones: thyroxine (T4) and triiodothyronine (T3). T4 is the main hormone produced by the thyroid gland, but it is inactive and must be converted to T3. Thyroid hormones are vital for regulating the body's metabolism, controlling body temperature, maintaining calcium balance and overall growth and development of the body.
The thyroid gland is controlled endocrine organ the size of a pea in the brain called the pituitary gland, which in turn is regulated by the hypothalamus (a part of the brain).
Man with reduced levels thyroid hormone levels may not experience all of the above symptoms. Since the symptoms of an underactive thyroid gland are also similar to the symptoms of other ailments, the only way To accurately determine the level of thyroid hormones is to conduct a blood test. Self-diagnosis is not recommended - it is always better to consult a medical practitioner. Treatment of decreased activity of the thyroid gland is carried out using simple and effective means.
Disclaimer: This article is for informational purposes only and should not be used as a substitute for advice from a medical professional.
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It’s not so simple because the symptoms of her disease are similar to the symptoms of other diseases. But there are some signs, the manifestation of which should alert you and prompt you to go to the hospital for examination. What changes in the body's functioning should you pay attention to?
Signs of an overactive thyroid gland
Pathology of the thyroid gland, in which increased levels of hormones are produced, is called thyrotoxicosis. You can suspect changes in the thyroid gland based on the following signs:
- sharp, sudden increase in blood pressure;
- irregular heartbeat, rapid pulse;
- feeling of heat, sweating;
- trembling in the fingers.
In women with increased secretion of hormones thyroid gland violated mental condition, manifested in irritability, short temper, rapid mood swings, sudden tears, and a feeling of anxiety. Emotional swings can happen for no apparent reason, after which a feeling of weakness and lethargy appears.
In some cases, the disease is accompanied by tremors in the body. At first it is not very noticeable and only affects the fingertips. Over time, as the disease progresses, the trembling spreads throughout the body and cannot be controlled.
Sometimes, with diffuse toxic goiter The organs of vision may be affected. Due to changes in the fatty tissue of the orbit of the eyes, the appearance of bulging eyes is created, tearing appears, and a sensation of a foreign body appears under the eyelids.
As a result accelerated exchange substances, the body releases an increased amount of heat. The patient constantly wants to reduce the ambient temperature; he is comfortable in a room with a lower air temperature, but in a normal environment, comfortable for other people, it can be hot and stuffy.
The patient appears very a good appetite, but despite this, a person begins to quickly lose weight, but the opposite reaction also happens - body weight increases. This course of the disease is very rare, has its own name - “fat Graves”, and is an exception to the rule.
If thyrotoxicosis is observed in a pregnant woman, the fetus suffers from hypoxia, which is why there is Great chance disorders of intrauterine development of a child. If you are planning to have children, you need to pay close attention to symptoms indicating changes in the functioning of the thyroid gland.
Signs of an underactive thyroid gland
Insufficiency of hormonal activity of the thyroid gland leads to exactly the opposite consequences, and is called hypothyroidism. Hyperthyroidism manifests itself in the following symptoms:
- , drowsiness;
- decrease in pressure;
- fast fatiguability;
- heart rhythm disturbance, its decrease;
- memory impairment;
- changes in the structure of nails and hair, they become dull, dry, dandruff appears;
- decrease in body temperature, constant chilliness in warm weather.
The mood with hypothyroidism is almost always depressed, lethargy and apathy are observed. Despite the usual diet, body weight is steadily growing, and this process cannot be regulated.
If you notice some of these signs and it worries you, you need to do an ultrasound of the thyroid gland and get tested for hormones and antibodies. To prevent the disease, you should balance your diet - there should be enough iodine and tyrosine in your food. Iodine enters our body with seafood (this seaweed, fish, squid, shrimp) as well as sunflower oil. Regular salt can be replaced with iodized salt. The intake of tyrosine in the body can be regulated by eating milk, eggs, and legumes.
A large number of conditions in which a person pays attention to the thyroid gland are diseases. But the borderline state also requires due attention so as not to lead to advanced pathology.
The thyroid gland, which is located in the neck and is shaped like a butterfly, can have a dramatic impact on a huge number of body functions, and if you are a woman over 35, you have a high risk of thyroid disease - some estimates say more than 30%. Women have thyroid problems 10 times more often than men.
Thyroid
Located above the Adam's apple, this gland produces a specific hormone - thyroid hormone (TH), which regulates, among other things, your body temperature, metabolism and heart rate.
Problems can start when your the thyroid gland is overactive or, conversely, underactive. If the thyroid gland is weak, then it produces too little TN, but if it is overactive, then it produces too much.
What can cause the thyroid gland to fail? It can be genetic reasons, autoimmune attacks, pregnancy, stress, malnutrition or toxins in environment, however, experts are not very sure about this. Since the body is full of thyroid hormones - from the brain to the intestines - diagnosing the disease can be a difficult task.
Signs that your thyroid is not working well.
1. Your strength is depleted
Feeling tired and lacking energy has many causes, but they all have to do with hypothyroidism - a disease in which insufficient thyroid hormones are produced. If you still feel tired in the morning or throughout the day after a night's sleep, this may indicate that your thyroid may be underactive. If there is too little thyroid hormone circulating in your bloodstream and cells, it means your muscles are not getting the signals to start working. “The first signal I see is fatigue,” says Dr. Miller.
2. You're depressed
Unusual feeling depressed or sad may also be a symptom of hypothyroidism. Why? Because by producing too few hormones, the thyroid gland can affect the level of the neurotransmitter " wellness" - serotonin - in the brain. If the thyroid gland is not active enough, then other systems of the body also “slide”, and therefore it is not surprising that our mood also drops.
3. Nervousness and anxiety
Feelings of anxiety are associated with hyperthyroidism, when the thyroid gland produces too much thyroid hormone. Overflowing with constant signals “all systems - forward!”, your metabolism and entire body may become overstimulated. If you feel as if you can't relax, your thyroid may be overactive.
4. Appetite and taste preferences have changed
An increased appetite may indicate hyperthyroidism when too a large number of hormones produced can cause you to experience hunger constantly. The only difference and, one might say, “plus” of this is that in this case, problems with the thyroid gland due to its hyperactivity compensate for the use of excess calories due to increased appetite, so the person ultimately does not gain weight. On the other side, lack of activity the thyroid gland can create confusion in your perception of tastes and smells.
5. Fuzzy thinking
Of course, unclear thinking can be a consequence of lack of sleep or aging, but cognitive abilities can also take a significant hit as a result of problems with the thyroid gland. Too much thyroid hormone (hyperthyroidism) can make it difficult to concentrate, and too little (hypothyroidism) can lead to to forgetfulness and “foggy thinking.”“When we treat patients for hypothyroidism, they are often surprised at how quickly their brain fog goes away and how much more alert their senses become,” says Dr. Miller. “Many women think it’s something that comes with menopause, when in fact it’s a thyroid problem.”
6. Loss of interest in sex
Weak or lack of interest in sex may be side effect thyroid disease. Low level hormones can cause low libido, but overall impact Other hypothyroid symptoms - lack of energy, body pain - may also play a role in this issue.
7. Everything is shaking before my eyes
This “shaking” may occur due to increased heart rate. You may feel like your heart is fluttering or skipping a beat, or beating too hard or too fast. You can also notice these sensations on your wrist or at the pulse points on your throat or neck. "Trembling" of the heart or palpitations may be a sign that your system is flooded with hormones (hyperthyroidism).
8. Dry skin
Dry skin, if it also itches, may be a sign of hypothyroidism. Changes in texture and appearance Skin inflammation most likely occurs due to a slower metabolism (caused by low hormone levels), which can reduce sweating. Skin without sufficient quantity liquid can quickly become dry and begin to flake. Besides, nails become brittle and voluminous longitudinal stripes appear on them.
9. The intestines began to work unpredictably
People with hypothyroidism sometimes complain of constipation. Insufficient functioning of the thyroid gland causes a slowdown in digestion processes. "There's no movement in your bowels," says Dr. Miller. “This is one of the three main symptoms of hypothyroidism that I see.” On the other hand, too high activity thyroid gland may cause diarrhea or more frequent bowel movements. All of these can be signs of hyperthyroidism.
10. The frequency of menstruation has changed
Longer menstrual periods with heavy discharge and pain can be a sign of hypothyroidism, when insufficient amounts of hormones are produced. The periods between periods may become shorter. In hyperthyroidism, high TH levels cause various kinds Irregularity of menstruation. Periods are shorter or longer, menstruation may take place at all a small amount. “I always ask my patients about their cycles and their regularity,” says Dr. Miller. She discovered a close relationship between irregular cycles and problems with the thyroid gland. And if your periods are very difficult, then she also checks for anemia.
11. Pain in limbs and muscles
Sometimes this pain is explained hard work muscles and limbs. However, if you feel causeless and unexpected tingling, numbness or just pain - in the hands, feet, legs or arms- this may be a sign of hypothyroidism. Over time, insufficient levels of thyroid hormones can destroy the nerves that send signals from your brain and spinal cord all over the body. This is expressed in such “inexplicable” tingling and pain.
12. High blood pressure
Increased blood pressure may be a symptom of thyroid disease. This may be due to either hypothyroidism or hyperthyroidism. According to some estimates, people suffering from hypothyroidism have 2-3 times higher risk of developing hypertension. One theory is that low amounts of thyroid hormone can slow the heartbeat, which can affect the force of blood pumping and the flexibility of blood vessel walls. Both can cause high blood pressure.
13. Temperature at zero
Feeling cold or chills may have roots in hypothyroidism. Inactivity of the body's systems due to low hormone levels means there is less energy in the body to be burned by the cells. Less energy equals less heat. On the other hand, an overactive thyroid gland causes cells to burn too much energy. This is why people with hyperthyroidism sometimes feel fever and sweat profusely.
14. Hoarseness and strange sensations in the neck
Changes in voice or feeling of a “lump in the throat” may be a sign of problems with the thyroid gland. One way to check is to take a good look at your neck for any signs of an enlarged thyroid. You can check your thyroid gland yourself by following these recommendations: Take a mirror in your hand and, looking at your throat, drink water. Your job is to watch for any lumps or protrusions in the thyroid area, which is located below the Adam's apple and above the collarbone. You may have to do this several times to understand where the thyroid gland really is. If you notice any bumps or anything suspicious, consult a doctor.
15. Problems with sleep mode
Do you want to sleep all the time? This may be due to hypothyroidism. An underperforming thyroid gland can slow down body functions so much that sleep (even during sleep) daytime) may seem like a brilliant idea. Can't sleep? This may be due to hyperthyroidism. High level hormones can result in anxiety and increased heart rate, which can make it difficult to go to sleep or even cause waking up in the middle of the night.
16. Weight gain
Plus two clothing sizes - there are so many reasons for this circumstance that it is unlikely that your doctor will consider weight gain as a symptom of a potential thyroid disease. However, weight gain is one of the main signals for the need to check the thyroid gland for Dr. Miller. “Patients report that they are not eating more than usual, but they are still gaining weight,” she says. “They do the exercises, but nothing changes. They can't reset it." Almost always the cause is the thyroid gland, says Miller. On the other hand, unexpected weight loss may signal hyperthyroidism.
17. Hair is thinning or falling out
Dry, brittle hair or even hair loss can be a sign of hypothyroidism. Low hormone levels disrupt the hair growth cycle and put many follicles into “rest” mode, resulting in hair loss.“Sometimes even all over the body, including the eyebrows.” “A lot of patients talk about hair loss,” says Miller. They say, “My hairdresser says I’m losing hair and I need to ask the doctor about the condition of my thyroid." Hair salons are more knowledgeable about thyroid problems than some doctors!“ Excess thyroid hormones can also affect the amount of your hair. Symptoms of hyperthyroidism, which are reflected in the hair, are usually expressed as in thinning hair only on the head.
18. Problems with pregnancy
If you long time If you are trying to get pregnant without success, then perhaps this is due to an excess or deficiency of thyroid hormones. Difficulty conceiving connected with high risk undiagnosed thyroid problems. Both hypothyroidism and hyperthyroidism can interfere with the ovulation process, which affects your ability to conceive. Thyroid diseases also lead to problems that arise during pregnancy.
19. High cholesterol
High levels of low-density lipoprotein (LDL) that are unaffected by diet, exercise, or medications may be related to hypothyroidism. Increased levels of “bad” cholesterol" may be caused by a “malfunction” of the thyroid gland and be a cause of concern. If hypothyroidism is left untreated, it can lead to heart problems, including heart failure.
Who should have their thyroid checked regularly?
Starting from the age of 35, every person should undergo a thyroid examination every 5 years. People with an increased risk of thyroid disease, as well as those who have symptoms of thyroid disease, should be tested more often. Thyroid problems most often occur in women aged 60 years.
Thyroid self-examination
Stand in front of a mirror, take some water into your mouth, throw your head back, and when you take a sip, pay attention to your neck below the Adam's apple and above the collarbone. There should be no bulges or swelling. Repeat this procedure several times if you notice something, you need to see a doctor!
Diagnosis of thyroid diseases
If you have one or more of these symptoms and suspect a thyroid problem, contact your doctor and ask for tests for:
- thyroid stimulating hormone (TSH),
- free triiodothyronine (fT3),
- free thyroxine (fT4),
- do an ultrasound of the thyroid gland
Blood analysis will measure the level of thyroid-stimulating hormone (TSH), which regulates the functioning of the thyroid gland.
If TSH is high, thyroid function is too low (hypothyroidism).
If TSH is low, this means an overactive thyroid gland (hyperthyroidism).
Based on the test results, symptoms and examination, you may be prescribed synthetic hormones. Testing and prescribing treatment for thyroid disease can involve some trial and error, so be prepared to visit your doctor several times to get your treatment. correct dosage. In some cases, the doctor may prescribe and thyroid biopsy.