Thyroid and disease
Thyroid gland: The thyroid gland is a butterfly-shaped inner gland that weighs 20-25 in the lower part of the Adam’s apple in the front part of the neck. It is a small but powerful organ that produces the hormones T3 and T4, which determine the speed at which the metabolism works, thereby balancing our metabolism. Thyroid tests: The first tests to assess thyroid function should be TSH (Thyroid Stimulating Hormone) and T4.
TSH (thyroid stimulating hormone) upper limit by age;
- 4 mI U / L in young people
- 2.5 ml U / L for the first 3 months and 3 ml U / L for pregnant women and women who are planning to get pregnant.
- 6 mI U / L between 70 and 79 years
- Over 80 years, 7.5 mI U / L
Causes of the TSH increase despite the use of thyroid medicine:
- Insufficient drug dose
- Celiac disease
- Taking levothyroxine with cholestyramine, iron, aluminum hydroxide, calcium (if possible, should be taken after 4 hours)
- Measure TSH 6 weeks ago during levothyroxine treatment
- Low thyroid production (hypothyroidism)
It is the condition that the thyroid gland cannot secrete the necessary amount of thyroid hormone for the body.The thyroid hormone level is reduced and a sufficient amount of hormones cannot be released into the tissues. The most common causes of hypothyroidism are: autoimmune thyroiditis (Hashimoto’s thyroiditis), thyroidectomy (thyroid surgery) or radioiodine therapy.
Weakness, sleepiness, weakness, weight gain despite malnutrition, chills, irregularities with menstrual bleeding, dry skin, hair loss, nail breakage, constipation, hoarseness of the voice, slight sweating, tingling in hands and feet, swelling of the face and reduced memory capacity. Psychological changes can also be seen.
Levothyroxine is used as the T4 preparation. The average replacement dose is 1.6 μg / kg. The desired TSH level should be achieved by adjusting the dose in 4-6 week processes.
Levothyroxine should be taken in the morning when you are hungry. At least 30 minutes after the meal and should not be taken with other medications. Because levothyroxine preparations are dissolved in an acidic medium, proton pump inhibitors can be affected by celiac disease and malabsorption. Antacids such as iron, cholestyramine, sucralfate, calcium and aluminum hydroxide can effect levothyroxine absorption. Such drugs should be taken at least 4 hours after levothyroxine administration.
Thyroiditis (inflammation of the thyroid gland)
The thyroid gland is a group of diseases that are similar to inflammation.
- Chronic autoimmune thyroiditis (Hashimoto’s thyroiditis)
- Painful inflammation of the thyroid gland
- Subacute granulomatous thyroiditis
- Infectious thyroiditis
- Radiation thyroiditis
- Traumatic thyroiditis
- Painless inflammation of the thyroid gland
- Subacute lymphoid thyroiditis (silent thyroiditis)
- Postpartum thyroiditis
- Drug-induced thyroiditis (IFN-α, IL-6, amiodarone)
- fibrous thyroiditis (Riedel thyroiditis)
Thyroid cancer accounts for less than 1 percent of all cancers. It is among the top 5 cancers that have occurred after the twenties. The incidence in the community is 4.2 percent. Thyroid nodules are more common in women than in men, but the incidence of cancer in men is higher.
There are 4 common types of thyroid cancer:
- papillary (most common type)
- medullary canal
- Anaplastic thyroid cancer
Papillary and follicular thyroid cancers are well differentiated and have a good prognosis, and these two types of thyroid cancer account for 85% of all thyroid cancers. Anaplastic thyroid cancer is poorly differentiated thyroid cancer and local and distant metastases with poor prognosis. Medullary thyroid cancers occur in paraphollicular cells that secrete calcitonin in the thyroid, and are known to be more aggressive than well-differentiated cancers.