Everything you need to know about Thyroid

The endocrine system in the human body consists of complex glands and organs, which secrete chemicals that control and coordinate the entire body’s metabolism and functioning. One such gland is the thyroid. It is a butterfly-shaped gland located at the frontal base of the neck. The thyroid is one of the most important endocrine glands, whose hormones regulate various metabolic functions like body weight, menstrual cycle, body temperature, heart rate, and much more. The thyroid is a dual-lobed organ that lies on either side of the windpipe. The isthmus is the thyroid tissue that connects both the lobes together. 

Thyroid Glands and it’s Hormones

The thyroid gland secretes hormones into the bloodstream that reaches the target cells and organs. The hypothalamus and the pituitary gland stimulate the production of thyroid hormones, Triiodothyronine (T3), Thyroxine (T4), and Calcitonin. The hypothalamus releases the Thyroid-releasing hormone (TRH), which signals the pituitary gland to produce T3 and T4 in necessary amounts with the help of Thyroid-stimulating hormone (TSH). TSH is released whenever the thyroid hormones levels are low, and it signals the thyroid gland to produce more hormones. Similarly, if the body contains an ample amount of hormones, less TSH is synthesized to decrease the hormone production in the thyroid. This way, the body maintains the balance of thyroid hormone production. Thyroid-related problems will result if the synthesis of the hormone takes place in abnormal amounts. 

The parafollicular cells (C-cells) of the thyroid gland produce a hormone called calcitonin. It helps regulate the serum calcium and phosphate levels in the body. Calcitonin helps lower the levels of calcium and phosphate when their levels exceed the normal physiological range. Osteoclasts are the cells responsible for breaking down the bone tissue and releasing the calcium into the bloodstream. Calcitonin inhibits the activity of osteoclasts and prevents the reabsorption of calcium in the blood. The hormone is also known to be a tumor marker. A high concentration of calcitonin may also be a sign of medullary thyroid cancer. It is a rare malignant form of cancer that affects the C-cells. 

Thyroid Hormones and Their Vital Functions

What makes these hormones so important? As mentioned before, these hormones carry out some vital body functions. 

• T3 and T4 hormones boost the basal metabolic rate of the body. It can cause an increase in body temperature, stronger heartbeat, and quick digestion. 
• The hormones also promote brain and growth development in children, improved muscle-brain coordination, and faster reflexes. 
• Calcitonin also regulates calcium and bone metabolism.

Thyroid Hormones and Women’s Health

According to the American Thyroid Association, one in eight women will develop thyroid issues during their lifetime. Thyroid hormones have a link to overall women’s health and reproduction. Lower production of T3 and T4 increases the secretion of TSH and Prolactin. Increased Prolactin in the blood suppresses the activity of the Gonadotropin-releasing hormone (GnRH). GnRH triggers the pituitary gland to secrete Luteinizing hormone (LH) and Follicle-stimulating hormone (FSH). LH and FSH maintain the normal functioning of the ovaries and ovulation cycle. Therefore, hypothyroidism affects overall menstruation by causing irregular periods, heavy blood flow, early menopause, and more. Overproduction of hormones can also cause heavy bleeding, irregular menses, or amenorrhea. If both conditions are left untreated, it can prevent the chances of getting pregnant. Thyroid problems in females during pregnancy can harm the unborn baby. The risk of miscarriages, stillbirth, premature delivery, and postpartum hemorrhage increases with thyroid-hormonal issues. 

Thyroid related Disorders and Diseases

Around 60-70% of people are not even aware that they suffer from thyroid problems. Thyroid disorders can range from mild to severe in individuals. 

• Lack of iodine in the diet can cause goiter, swelling of the thyroid gland. 
• Severe problems include cancer, which requires life-long medication and treatment. 
• Insufficient thyroid hormones cause hypothyroidism, and overproduction causes hyperthyroidism in the body. 
• An autoimmune condition called Grave’s disease hyperactivates the thyroid gland and causes hyperthyroidism. 
• The increased hyperthyroidism can also indicate tumor cells in the thyroid.
• Abnormal thyroid hormones also cause hair loss in both men and women.
• Some people may experience fatigue, muscle cramps, mood swings, dry skin, and constipation. 
• Severe hormonal imbalance can also cause the formation of a lump in the thyroid or cause swelling of the gland. A lump or nodule need not be always cancerous. 

Successful treatment of these hormonal imbalances is possible with timely diagnosis and medicines. Under the extreme cancerous situation, humans can survive without the thyroid gland, if they consume thyroid-hormone pills life-long. 

Genetics and Thyroid Disorders

Thyroid problems are unavoidable, and most often the hereditary plays a vital role in passing on thyroid-related disorders to offspring. The instructions to produce thyroid hormones lie in the genes present in the DNA. If these genes are defective, they will directly affect hormone synthesis. The thyroid issues result due to the interaction of various genetic variables (polygenetic) such as mutations. There is no single definite cause for thyroid problems. 

Consultation for Thyroid-Related Problems

If a person experiences any of the fore-mentioned problems, they should consult an expert for better treatment options. A medical practitioner specializing in the diagnosis, prognosis, and treatment of the endocrine system is called an endocrinologist. 

An endocrinologist knows and understands the vital functioning of the endocrine glands such as the thyroid, pituitary, adrenals, pancreas, ovaries, and testes. The problems related to menstruation cycles, muscles, brain development, etc., can be treated by the medical experts of that field. However, if the underlying root cause is the thyroid gland and is not detected timely, it can be problematic further. Certain endocrine disorders require life-long medication and care that is possible and advised correctly only by the expert endocrinologist. Apart from medical treatments, these doctors can also consult and help patients mentally to cope with the limitations due to diabetes, thyroid problems, and other health issues. 

Thyroid Function Tests

If you consult an expert for any of the possible thyroid issues, here are some of the tests prescribed:

Blood Tests

A simple blood test measures the normal range of T3, T4, and TSH in the bloodstream. In cases of pregnancy, the levels of the hormone may vary, for which you must inform the concerned authority beforehand. 

Blood Test Result Interpretation

• Thyroxine test (T4) and TSH test go hand-in-hand. Highly elevated levels of T4 hormone indicate hyperthyroidism or overproduction of thyroid hormone. The physiological range lies between 5.0 to 12.0 μg/dL (micrograms of hormone per deciliter of blood.) 
• The normal range of TSH is between 0.4 to 4.0 mIU/L (milli-international units of hormone per liter of blood.) The TSH reading above 2.0 mIU/L indicates that more TSH secretion is necessary to maintain the hormonal balance. Therefore, the person is at risk of suffering from hypothyroidism.  
• The T3 test monitors the levels of triiodothyronine in blood. The normal range is between 100-200 ng/dL (nanograms of hormone per deciliter of blood.) Elevated levels of T3 show an autoimmune disease called Grave’s disease. 

Thyroid Antibody Tests

In some cases, during a hormonal imbalance, the body’s immune cells produce antibodies against the thyroid cell proteins. This condition is called thyroid auto-immunity. The presence of two common antibodies, thyroid peroxidase and thyroglobulin, confirm the presence of auto-immunity. High levels of thyroglobulin are also a tumor marker in recurring thyroid cancers. 

Non-Blood Tests

• Thyroid ultrasound can detect any thyroid tissue abnormalities through the neck skin.
• Radioactive iodine uptake through the mouth can track how much iodine is taken up by the thyroid gland for its normal hormonal functioning. This way, the doctor can assess whether the gland is healthy or not. 
• In the case of potential cancer, CT scans, MRI scans, or PET scans can help identify the metastasis of cancerous cells and tissues. 
• A thyroid biopsy also confirms the presence and prognosis of thyroid cancer.

Thyroid Treatment Plans

The treatments for thyroid issues can be simple hormonal pills or intense therapy sessions in the case of metastatic cancers. The course of medicines depends on the type of thyroid problem, the severity, age, body weight, and medical history. Thyroid diseases can also be permanent in some individuals.

Thyroid Hormone Replacement Therapy

Thyroid hormone replacement therapy is the most common treatment for hypothyroidism. It aims to replicate the normal-functioning thyroid gland. Surgical removal of non-functioning thyroid demands lifetime hormonal therapy. Pure, synthetic thyroxine (T4) copies the functions of the naturally-produced hormones in the body. The dosage of T4 depends on the person’s age, weight, TSH levels, and other underlying medical conditions (if any). Hormone replacement therapy prevents the formation of lumps and goiter. Without consulting the endocrinologist, stopping the prescribed medicines might cause serious troubles. Periodic check-ups are mandatory to make sure the pills are effective.  

Hyperthyroidism treatment

Possible treatments for overactive thyroid gland include:

Anti-thyroid medicines stop the thyroid from producing excess hormones. The treatment lasts for over several months to years. Some people may develop side effects or allergic reactions to the drugs, in which case they must consult the doctor immediately. 

Beta-blockers reduce the symptoms of hyperthyroidism and can be consumed until the hormone levels reach a normal range. 

Surgical removal of the thyroid is usually the last option when none of the other medicines work. After the thyroid removal, the patient has to depend on hormonal medication for a lifetime. 

Cancer treatment

Thyroid cancer is a disease in which malignant cells take over the tissues of the thyroid gland. The reason could be a mutation in the medullary thyroid region or hereditary. There are different standard treatment plans for cancer patients.

• Surgical removal of the tumor can often lead to the removal of the thyroid gland in cases of metastatic cancers. 
• Radiation therapy helps to kill the cancer cells but can also affect the healthy soft tissues surrounding the thyroid area.
• Chemotherapy makes use of special chemicals that target and kill the tumor cells.
• Targeted therapy uses drugs that recognize and kill specific mutated cells without causing much harm to the healthy cells. 
• Cancer treatment kills the thyroid cells, and it cannot produce enough hormones for the body. In such cases, synthetic hormones are prescribed for ingestion. 
• Immunotherapy is emerging useful in cancer treatment over recent years. The drugs trigger the patient’s immune system to fight the cancer cells. 

Cancer treatment has many side effects. Numerous research tries to find safer and less invasive approaches than the standard treatment plans. The unfortunate fact is, thyroid cancers can recur even after treatment. Follow-up tests are necessary to keep a close eye on the patient during the recovery. 

Managing Thyroid Problems with Lifestyle Changes

Along with synthetic medicines, people nowadays like to try alternative medicine or natural remedies. The thyroid issues need not always be genetic. It can arise due to lifestyle changes like poor, unhealthy diet, increasing stress, and deficiency of vital nutrients. 

• Consume a balanced meal with a proper amount of iodine, whole grains, fruits, and vegetables. Try to avoid canned, frozen, and processed foods. 
• Fat-rich foods such as avocados, nuts, fish, a sufficient amount of meat, coconut oil, and fish oils can help boost immunity and prevent thyroid problems. 
• Avoid sugars and gluten-rich food that interfere with the body’s metabolism.
• Include protein-rich foods in the diet like green vegetables, eggs, meat, and more. 
• Thyroid problems can also affect the levels of B-vitamins. Consume eggs, milk, asparagus, cheese, and fish to maintain a healthy level of B-vitamins. 
• Probiotics such as yogurt, apple cider vinegar, kombucha, kimchi, etc., can aid in digestion and better metabolism, thereby affecting thyroid functioning. They also keep gut microflora in control. 
• Regular physical exercises monitor overall body health. People who exercise regularly have a high metabolism, improved blood circulation, strong immunity, and healthy body weight. Women with Polycystic Ovarian Syndrome (PCOS) and thyroid issues often complain about weight gain. Daily workouts and lifestyle changes will help combat problems related to menstrual health. 
• Avoid continuous consumption of alcohol, caffeine, and smoking. The toxins present in the smoke can irritate the thyroid and risk the chances of gene mutation and cancer.