THE THYROID GLAND AND YOUR HEALTH Your Thyroid is a gland located at the base of your neck, just below your Adam s apple. It is shaped like a butterfly each wing or lobe, of your thyroid lies on either side of your windpipe. The purpose of your thyroid gland is to make, store, and release thyroid hormones (T3 and T4) into your blood. Thyroid hormones affect essentially every cell in your body, and help control your body s function. If have too little thyroid hormones in your blood, your body slows down. This is a condition called hypothyroidism. If you have too much thyroid hormone in your blood, your body speeds up. This is a condition called hyperthyroidism. The amount of thyroid hormone made by your thyroid gland is adjusted by another gland called the pituitary, as well as a part of your brain called the pituitary, as well as a part of your brain called the hypothalamus. The pituitary gland makes hormones that control many other glands in your body. The hypothalamus helps the pituitary control many of your glands, as well as helping to control other body functions, such as thirst, 1
hunger, sleep, and body temperature. The thyroid gland, pituitary gland, and hypothalamus all work together to control the amount of thyroid hormones in your body. With the pituitary controlling most of the action, these structures work in a way that is similar to the way a thermostat controls the temperature in a room. For instance, just as the thermometer in the thermostat senses the temperature of a room, your pituitary constantly senses the amount of thyroid hormones in your blood. If there is not enough thyroid hormone, your pituitary senses the need to turn on the heat. It does this by releasing more Thyroid Stimulating Hormone (TSH), which prepares your thyroid to make more thyroid hormones. Your thyroid gland then makes and releases the hormones directly into your bloodstream and restores the amount of thyroid hormone in your blood to normal. When there is just the right amount of thyroid hormone in your body, that message is sent to your pituitary. With your thyroid hormone levels now restored to normal, your pituitary slows its production of TSH back down to normal. 2
Thyroid Disorders --- What can go wrong 1. HYPOTHYROIDISM If you don t have enough thyroid hormone in your bloodstream even after your pituitary has signaled the thyroid to turn up the heat and produce more- you may have a condition called hypothyroidism. Hypothyroidism is usually caused by: a. Hashimoto s disease, a condition in which the immune system interferes with normal thyroid gland function. b. Can result from being treated for hyperthyroidism. c. Can result from having thyroid surgery ie thyroid removed by surgery. d. Congenital absence of thyroid either one lobe is absent or both lobes of thyroid didn t develop normally in the fetus. If you are Hypothyroid, you also have a high level of TSH (which is your body s signal to turn on the heat or to step up the production and release of thyroid hormone). Having too little thyroid hormone causes your body to slow down. As a result, you may feel tired, may have a slow heart beat, Constipation, difficulty concentrating, dry skin, weight gain or Depression. What is happening is that the lack of thyroid hormone is causing an Overall slowing of your bodies function. If left untreated, this can cause serious health problems, which is why is essential that hypothyroidism is identified and treated quickly. TREATMENT FOR HYPOTHYROIDISM is simple and it is by replacing thyroid hormone with a synthetic or ma-made thyroid hormone called Levothyroxine sodium. In most cases, you will need treatment for life. 2. HYPERTHYROIDISM. If thyroid gland produces too much thyroid hormone, you may have a condition known as Hyperthyroidism. If you are hyperthyroid, you also have a low level of TSH in your blood because your pituitary has decreased its TSH signals to your thyroid. 3
Hyperthyroidism can be caused by several conditions:-- Grave s disease - a condition in which the immune system causes too much thyroid hormone to be made and released into the blood. Thyroid nodules - lumps in the thyroid gland that may sometimes overproduce hormones. Overreplacement of thyroid hormone- patient receiving thyroid hormone replacement therapy for hypothyroidism and being given too high a dose (or too much thyroid hormone) can become hyperthyroid. Having too much thyroid hormone causes your body to speed up, resulting in: ---- Weight loss, diarrhea, excess sweating, nervousness. fast heart beat, sleeping problem and easy irritability. If left untreated, this can cause serious damage to your body, so it is very important that the disorder be identified early and treated properly. There are several alternatives for treating Hyperthyroidism, such as: -- Radioactive iodine therapy. Antithyroid medications Surgery. After treatment for hyperthyroidism, you may become hypothyroid. Therefore, thyroid hormone replacement therapy is often required. 3. GOITER. Means enlargement or swelling of the thyroid gland. Your thyroid gland may be enlarged if it is: a. Not working properly, as in Hypothyroidism and Hyperthyroidism. b. Familial tendencies for enlargement of thyroid gland c. Iodine deficiencies. d. Thyroid cancer rarely as a cause of Goiter. 4
Normal Thyroid Gland Goiter may not be treated if you do not have any thyroid malfunction or cancer. If it is present due to Hypothyroidism or Hyperthyroidism, your doctor will treat you for that disorder.. 5
4. Thyroid Nodule/s. Thyroid nodules are lumps in your thyroid gland, which may also cause a goiter. You may have one nodule, called a solitary nodule, or you can have many, which is a condition called multinodular goiter. Thyroid nodules are common. 6
Thyroid nodules are usually benign (not cancerous). They usually produce too much thyroid hormones and cause Hyperthyroidism, or are benign tumors or cysts. Thyroid nodules may or may not require treatment. If you have thyroid nodules that do require treatment, there are variety of treatment options available. What tests are available? There are a number of tests available to help with the diagnosis and treatment of thyroid disorders. Included are tests that measure thyroid hormone level in your blood, as well as the TSH test, which measures the concentration of thyroid- stimulating hormone (TSH) in your blood. 7
What can the TSH test reveal? TSH is a simple blood test that measures the amount of thyroidstimulating hormone in your blood. This is important because TSH is your pituitary gland s signal to your thyroid gland to make less or more thyroid hormone. If you have a high level of TSH in your blood, it usually means that your pituitary senses that there is not enough thyroid hormone in your blood and it is trying to get the thyroid gland to make and release more hormone in blood. If you have a low level of TSH, it usually means that your pituitary senses that there is too much thyroid hormone in your blood, and it has decreased its TSH signal. Doing your Part Staying alert to changes in your health is most important step in identifying possible problems. Any change in your normal health lasting more than a couple of days can be a sign of a problem. A Final Note. If you believe that you may be suffering from a thyroid disorder, ask your doctor to consider ordering a TSH test. If you are already being treated for a thyroid disorder, your blood TSH level should be checked periodically, at least once a year, to ensure that your treatment continues to be successful. Dr. Fatma Almarashi, MD, FACE. Diplomate, American Board of Endocrinology, Diabetes and Metabolism. Medical Director Dr. Fatma Almarashi Advanced Center For Endocrinology, Diabetes and Metabolism 8