Change of normal operation thyroid gland necessarily affects the state of the whole organism, since the spectrum of action of its hormones is very wide. Hormone-producing tissue is extremely sensitive to the action of a number of factors - from chronic intoxication to unfavorable environmental conditions and hereditary predisposition to endocrine pathologies. Therefore, the nature of the thyroid gland disorder and, accordingly, the accompanying symptoms depend on the cause (etiology) of the disease and the mechanism of its development.
Causes of diseases and prevalence
Thyroid– the largest endocrine organ in the human body. Her main function– production of the hormones thyronine and triiodotyrosine, which are involved in all types of metabolism, promote growth and harmonious development young body, maintaining the normal functioning of almost all organ systems in adulthood.
As a result of numerous studies of the epidemiology (prevalence) of thyroid diseases, a fairly high frequency of their occurrence throughout the world is revealed. The prevalence of pathologies varies from region to region, and also depends on the person’s age, gender and genetic characteristics. than in men, which is now associated with greater susceptibility female body hormonal fluctuations, both physiological ( adolescence, menopause, pregnancy), and pathological.
The most common cause of thyroid diseases is long-term iodine deficiency. Approximately a third of the world's population lives in areas where iodine deficiency is endemic: iodine intake in them is less than 50 mcg, in some - less than 25 mcg (the norm is 140-200 mcg). Thyroid dysfunction in such conditions can occur in up to 80% of the population. In Russia, iodine deficiency is typical for the northern regions and Transbaikalia.
Other causes of the disease may be:
- chronic intoxication (occupational hazards);
- CNS pathology;
- congenital endocrine pathologies;
- autoimmune processes;
- head and neck injuries;
- infection, inflammatory processes.
- hereditary predisposition in combination with other unfavorable factors.
Types of thyroid pathologies
Depending on the nature and intensity etiological factor and at what level certain dysfunctions occurred, several types of pathologies can be distinguished:
- an imbalance of iodine-containing hormones, which leads to hypothyroidism or hyperthyroidism, which provokes systemic disorders in the body and manifests itself in the form of goiter syndrome or thyrotoxicosis;
- autoimmune pathologies associated with a violation of the key link of immunity and the production of specific antibodies;
- pathological foci that change the structure of endocrine tissue and often affect productive function (tumors of various natures, nodes, cysts, calcifications);
- dysfunction of the thyroid gland associated with its injury or planned operations by resection or ectomy.
Pathological formations
Certain things can lead to the emergence of pathological foci. The nature of the formations, their structure and size depend, first of all, on the nature of the pathological processes on the basis of which they arose.
A node in endocrine tissue is most often formed due to a decrease in productive function. In conditions of a lack of thyroxine and triiodothyronine, under the influence of thyroid-stimulating hormone, which is secreted by the hypothalamus in the central nervous system, a compensatory increase in blood flow in the thyroid gland and the growth of its individual structures - follicles - develop. IN normal conditions thyrocyte cells secrete colloid with iodine-containing hormones into the lumen of the follicle, from where they are sent into the bloodstream. With hyperplasia (proliferation) of the follicles, the colloid accumulates and its outflow becomes difficult, resulting in a formation filled with a gel-like substance - a colloid node. Significant growth and appearance of clusters of nodes manifests as goiter varying degrees expressiveness. Goiter large sizes due to noticeable compression of nearby organs, it can lead to decompression syndrome - difficulty swallowing, speech and breathing disorders.
Another formation that may be caused by a malfunction of the thyroid gland is a cyst. It is characterized by the presence of a shell and a cavity filled with liquid contents. A cystic lesion can form in situ inflammatory process, hemorrhages as a result of trauma. The size of cysts can vary from a few millimeters to tens of centimeters. The internal structure can be homogeneous or with inclusions; sometimes calcified or multi-chambered formations are found. Small cysts do not cause any adverse effects and often do not require treatment. The appearance of cysts common symptom disorders (dysfunction) of the thyroid gland in women.
Thyroid tumors
A tumor is a pathological focus of accumulation of cells with changes in their genetic apparatus. Identifying the causes of their occurrence remains actual problem medical research. One of the supposed factors leading to the appearance of such cells in the body is the action of carcinogens of a physical, chemical and biological nature. If signs of a tumor are detected, the endocrinologist must prescribe additional research to clarify its nature.
Benign neoplasms grow, gradually pushing apart neighboring tissues, do not metastasize (do not spread throughout the body) and in most cases do not recur after removal. These include follicular adenoma and Hürthle cell adenoma.
Malignant tumors are capable of rapid growth deep into the tissue (infiltrative growth) and metastasis. Today it is known that in cancerous tumor uncontrolled growth and division of a pool of low differentiation cells occurs. Have high risk reappearance after surgical removal. These include papillary and medullary carcinomas, lymphoma, and anaplastic carcinoma.
Violation of hormone synthesis
The amount of iodine-containing hormones synthesized in healthy body maintained at approximately the same level. The system that regulates productive function consists of the pituitary gland and hypothalamus, located in the brain. When the functioning of these organs changes, the balance of iodine-containing hormones is also disrupted. At congenital pathologies In the central nervous system or after head trauma, insufficient (secondary hypothyroidism) or excessive (secondary hyperthyroidism) biological production may develop. active substances. Inflammatory processes also provoke a persistent disruption of the synthesis of thyroid hormones.
Hypothyroidism
Iodine deficiency, acquired dysfunction of thyrocytes due to intoxication or autoimmune processes lead to hypothyroidism. A lack of tyrosine and triiodothyronine affects the functioning of almost all organ systems. This disruption of the activity of thyrocytes of the thyroid gland leads to the development of the following symptoms:
- fragility and hair loss;
- drowsiness, loss of strength;
- and limbs;
- depressive episodes, in severe cases – dementia;
- weight gain;
- slight persistent decrease in temperature;
- disorder menstrual cycle.
There is also a congenital type of hypothyroidism, when dysfunction of endocrine tissue, manifested in the prenatal period, leads to the development of mental retardation varying degrees of severity. With deep dysfunctions, cretinism develops - severe mental illness, associated with underdevelopment of the cerebral cortex due to a deficiency of iodine-containing hormones. With timely administration of synthetic hormones (the first week of life), partial recovery is possible.
Hyperthyroidism
Another sign of thyroid dysfunction is hyperthyroidism. Clinically this pathology may also manifest as goiter syndrome and lead to thyrotoxicosis - intoxication of the body with excessive amounts of iodine-containing hormones. This condition characterized by the following symptoms:
- Persistent increase in temperature;
- High emotional excitability;
- Pulse instability, unreasonable heartbeat;
- Losing weight with a normal diet;
- Ophthalmopathies: convex eyeball, wide palpebral fissure;
- tremor of the limbs.
Manifestations of thyrotoxicosis are characteristic of such conditions as Graves' disease, intake of excess iodine from food or uncontrolled intake synthetic drugs thyroxine and triiodothyronine (drug-induced thyrotoxicosis).
Autoimmune diseases
The group of autoimmune diseases still remains one of the most poorly understood widespread pathologies. The basis of the autoimmune process is a disorder of one of the links of immunity, accompanied by the active production of specific antibodies aimed at destroying thyrocytes. To date, there is no exact data on the causes of the disease, but it is known that factors predisposing to it are inherited.
Chronic autoimmune thyroiditis(Hashimoto's struma) is a condition characterized by the destruction of thyroid follicles due to a long-term inflammatory process of an autoimmune nature. This disruption of the thyroid gland leads to the death of thyrocytes, gradual tissue destruction and, accordingly, the development of a decrease in the productive function of the organ. Due to a lack of thyroxine and triiodothyronine, signs of thyroid dysfunction corresponding to hypothyroidism appear. In some cases, a goiter develops that is not accompanied by hormonal imbalance and often does not manifest itself at all (subclinical type).
Diagnostic methods
In the study of endocrine tissue function, use various methods clinical, instrumental and laboratory diagnostics. During the patient’s initial visit, the endocrinologist collects data on general condition body, presence chronic diseases and carefully examines the symptoms that bother the patient. After completing the interview, palpation is carried out - superficial feeling of the front surface of the neck. Goiter of the first and second degrees, as well as some large pathological formations in the tissue can be diagnosed already at this stage.
The next stage of diagnosis is the use of informative instrumental and laboratory methods. Wide Application It has ultrasonography due to its high information content and accessibility. During an ultrasound, it is examined internal structure(architectonics) of the organ, its size and location, pathological formations and inclusions (cysts, calcifications, tumors, nodes) are recorded, as well as diffuse changes stroma. Using Doppler sonography, the characteristics of the general blood flow of the thyroid gland are studied and foci of vascular proliferation are identified. For a more detailed study internal structure elastography is used for each pathological focus - diagnostic method, based on determining the elastic properties of biological structures.
Instrumental and clinical trials are studied together with the results of general and biochemical analysis blood. Blood measurements of thyroxine, triiodothyronine, thyrotropin, as well as several types of antibodies are prescribed. If signs of a tumor or large node are detected, a fine-needle examination may be necessary. aspiration biopsy, during which the material is collected and cytological examination in order to determine the nature of the outbreak.
Modern methods of treatment
Based on all diagnostic data, after confirming the diagnosis, the endocrinologist creates an individual complex therapeutic measures. Depending on the nature of endocrinopathies, they can be used following methods treatment:
- Replacement therapy - drug replenishment of the lack of biologically active substances in hypothyroidism;
- Symptomatic therapy – the use of drugs to eliminate or reduce the intensity of specific symptoms;
- Suppressive therapy, which uses medications that can suppress excessive production in hyperthyroidism.
For hyperplasia, tumor, bulky cysts or nodes, surgery. Depending on the extent of the pathology, lobe resection or removal of the entire thyroid gland (ectomy) is used, followed by replacement therapy.
Thyroid diseases affect the entire body. Chronic fatigue, weight fluctuations, unusually high or low blood pressure - the reasons for this may be thyroid dysfunction.
What is the thyroid gland?
The thyroid gland is located between the larynx and trachea, covering them with itself, like a shield - hence the name of the gland. In adults, it weighs about 20 grams, but despite its small size, it performs many functions.
The thyroid gland retains iodine and produces thyroxine, triiodothyronine and thyrocalcitonin - hormones responsible for:
- metabolism;
- sexual function;
- energy and heat generation;
- functioning of the nervous system;
- development of the skeleton and muscles.
The most common thyroid disorders are hypo- and hyperthyroidism, caused by a deficiency and excess of thyroid hormones, respectively. The first slows down the reactions occurring in the body: the heart rate drops, food stops being absorbed, hair falls out, and the skin becomes dry. The second provokes reverse processes: metabolism accelerates: the patient loses weight, no matter how much he eats; he develops tachycardia, photophobia appears, the person becomes anxious and irritable. The symptoms of the problem are not too noticeable, but then, when they appear in full force, the changes will affect the entire body.
Causes
Women are at risk: they develop thyroid diseases 8 times more often than men. The causes of problems may be:
- stress;
- pollution environment;
- poor nutrition;
- lack of physical activity;
- hormonal imbalances;
- abuse of alcohol, cigarettes and toxic substances.
The role of heredity is great: if there are cases of thyroid disease in the family, you need to be checked even more often.
Symptoms
Normal thyroid hormone levels should be checked at least once a year. But you should consult a doctor if you have:
- discomfort in the neck: pain, hoarseness, cough, swelling;
- uncontrolled weight fluctuations;
- problems with the gastrointestinal tract: irregular bowel movements, abdominal pain, nausea, vomiting;
- feeling of chronic fatigue;
- apathy or anxiety;
- problems with potency or irregular menstrual cycle;
- hair loss;
- change in skin structure.
Thyroid diseases manifest themselves as a complex of symptoms, so you should only worry if several signs of the disease appear.
Euthyroidism
Euthyroidism is one of the most insidious thyroid diseases. Problems in the gland are indicated by an excess or deficiency of hormones, but with euthyroidism their production occurs normally.
Patients complain about:
- sudden weight loss;
- hoarseness of voice;
- feeling of a lump in the throat;
- difficulty breathing;
- chronic fatigue;
- dilated veins in the neck.
On initial stages The disease does not manifest itself in any way externally. But euthyroidism is dangerous for:
- nervous system: provokes the appearance panic attacks, anxiety, apathy, memory problems;
- cardiovascular: increased blood pressure, tachycardia, increased risk of heart attack;
- reproductive: leads to problems with potency or menstrual irregularities, in severe cases - to infertility.
Euthyroidism often causes miscarriages - the disease is especially dangerous in the first trimester of pregnancy.
Stages
The disease has 3 stages of development:
- Asymptomatic. The patient has already shown some signs of the disease, but examination and palpation do not show any problems. Euthyroidism can only be determined by ultrasound.
- Enlarged thyroid gland. It does not appear visually, but upon palpation the doctor can already detect an increase in volume.
- The growth of the gland becomes noticeable to the naked eye. The veins in the neck area swell, the bulging goiter leaves no other diagnosis options.
The disease is diagnosed after hormone tests, ultrasound, biopsy and scintigraphy.
Euthyroid goiter appears on late stages euthyroidism. The thyroid gland increases significantly in size, but at the same time performs its functions as usual.
Initially, the goiter is soft and symmetrical. But for more later stages diseases appear in it first as single nodes, then as multiple ones, and then some unite into one huge node.
Most common cause diseases are considered to be a lack of iodine in the body. In some cases, goiter disappears after a course of iodine-containing medications. If the disease developed against the background hormonal disorders, then she is treated with hormonal therapy. In rare cases, when the tumor compresses Airways, threatening the patient's life, it is removed surgically.
Hypothyroidism
Hypothyroidism develops when there is a lack of the hormone thyroxine. There are primary, secondary and tertiary hypothyroidism, and only in the first case is the thyroid gland “to blame” for the disease.
Primary hypofunction manifests itself more clearly than other types. Its symptoms:
- sudden weight gain with the usual diet;
- hypovitaminosis;
- increased fatigue;
- inhibited reactions to stimuli;
- constant feeling of cold;
- pale or waxy skin;
- lack of sweating;
- swelling;
- frequent dizziness;
- fragility and thinning of hair and eyebrows;
- slow heart rate;
- low blood pressure;
- inflammation of the respiratory tract;
- hoarseness of voice;
- irregular bowel movements;
- muscle pain and muscle cramps;
- menstrual or erectile dysfunction;
- decreased concentration;
- depression or apathy.
Co hidden form A person lives with illness for years: from a long list of symptoms, he may only experience fatigue and lethargy.
In most cases, the cause of hypofunction is autoimmune disease, but sometimes iodine deficiency leads to hypothyroidism. Used for treatment replacement therapy and, in severe cases, radiation.
A special case of thyroid dysfunction is hypoplasia - underdevelopment of the gland, which prevents it from producing hormones in the required quantities.
Hyperthyroidism
Excessive production of hormones from the thyroid and other glands provokes the development of hyperthyroidism. The causes of the disease can be:
- excess iodine in the body;
- abuse of hormonal drugs;
- pituitary tumors.
Symptoms of the disease:
- sharp weight loss with the same diet;
- muscle weakness;
- anxiety;
- difficulty concentrating;
- tremor of the limbs;
- exacerbation of reflexes;
- tearfulness;
- swelling of the eyelids;
- eyelid retraction;
- increased skin temperature;
- excessive sweating;
- hair loss;
- decreased muscle strength;
- feeling of neck compression;
- labored breathing;
- tachycardia;
- increased blood pressure;
- frequent bowel movements;
- menstrual or erectile dysfunction.
The development of the disease occurs over several months, but sometimes hyperfunction appears spontaneously, for example, after contact with large amounts of iodine. In the later stages of the disease, goiter may appear.
Tumors
90% of thyroid tumors are benign. Cancer of this gland is rare - in 3% of cancer cases.
On early stages the disease is invisible, but later tumors become noticeable on palpation. Symptoms cancer The thyroid glands in women and men are in many ways similar to the manifestations of goiter: the tumor can also compress the airways.
The likelihood of developing tumors increases with:
- constant iodine deficiency;
- radiation exposure;
- hormonal disorders;
- genetic predisposition.
Tumors are much more common in women than in men.
Types of tumors
The benign or malignant nature of the tumor is determined by histological examination.
| Benign | Malignant |
| Adenomatous goiter. The proliferation of thyroid cells leads to the formation of nodular goiter. Usually the tumor is benign, but in rare cases there are “inclusions” of cancer cells. |
Papillary carcinoma. The most common type of oncology. It affects one lobe of the thyroid gland and develops slowly, which makes it possible to detect it in the early stages. In advanced cases, it metastasizes to the lymph nodes. |
| Follicular adenoma. Its symptoms resemble adenomatous goiter. |
Follicular carcinoma. Develops due to iodine deficiency. It is quickly detected, but affects the lungs and bones with metastases, which makes the prognosis for the patient no less favorable. |
| Cyst. Usually it is a secondary cyst, which is formed due to deformation or hemorrhage in the goiter. |
Medullary carcinoma. Metastases affect the lungs, liver and lymph nodes almost immediately after the tumor appears. At timely diagnosis quite high chances of recovery. |
| Anaplastic carcinoma. An aggressive type of cancer that develops rapidly and metastasizes to the throat, lungs, and bones. Almost incurable. |
The disease is detected by biopsy, blood test and ultrasound.
Autoimmune diseases
In autoimmune diseases, the body considers its own tissues and cells to be foreign and uses the immune system to fight them. Causes of autoimmune thyroid diseases:
- genetic predisposition;
- high levels of stress;
- exposure (radiation, solar, etc.);
- iodine deficiency.
The most common autoimmune diseases are diffuse toxic goiter and Hashimoto's thyroiditis.
Hashimoto's thyroiditis (autoimmune thyroiditis)
About 30% of people suffering from thyroid diseases have autoimmune thyroiditis. Previously, it was considered a disease of the elderly, but now this diagnosis is given to children and adolescents. It has been proven that men are less likely to develop Hashimoto's thyroiditis than women. Those at risk are those who have a genetic predisposition to this disease and other endocrine pathologies (for example, diabetes).
Symptoms of thyroid disease in women can be “masked” as other diseases for a long time: sometimes only infertility indicates thyroiditis. Clinical picture The course of this disease is in many ways reminiscent of hypothyroidism.
When palpated, the goiter is slightly denser than a healthy thyroid gland should be. Nodes can be felt in it, but touching does not cause discomfort at the patient. To make a final diagnosis, blood is taken for hormones.
Diffuse toxic goiter (Graves' disease, Graves' disease)
The body's immune reaction provokes an increase in the amount of thyroid hormones, which causes a disease resembling hyperthyroidism to develop.
If a girl suffers from Graves' disease, there is a high chance that her child will inherit hyperthyroidism.
Substitution is used for treatment hormone therapy In severe cases, the goiter is removed surgically.
Diagnostics
The first stage of the examination is palpation and examination of the patient, after which the patient can be sent for additional studies. To make a diagnosis, instrumental and laboratory diagnostic methods are used.
You cannot self-medicate: uncontrolled use of hormones will worsen the patient’s condition.
Treatment methods
Treatment of thyroid diseases occurs:
- medication (iodine-containing and hormonal drugs);
- surgically (removal of tumors);
- radioiodine therapy (irradiation).
Treatment with medications helps in the early stages of disease development. Radioiodine therapy is considered the most effective, but it is traumatic for the body.
Nutrition
For thyroid health, it is recommended to consume foods rich in iodine. You should refuse food that interferes with the absorption of this chemical element and slowing down the production of hormones. Proper nutrition- one of mandatory conditions prevention of gland diseases.
If there is an excess of iodine in the body, it is better to refuse products containing it or subject them to heat treatment: it evaporates the element from the food.
Treatment with folk remedies
Folk remedies should not be the main method of treating thyroid diseases. They are used only with the permission of a doctor, so as not to harm the prescribed course of medications.
Among the home treatments are the use of alcohol tinctures and herbal infusions, application of compresses:
Compresses made from an alcoholic tincture of celandine or a decoction of walnut shells and oak bark are applied to the neck.
There are 19 common symptoms that may indicate pathological processes occurring in the thyroid gland. Let's look at each of them in more detail.
Symptom 1 - physical exhaustion
The feeling of constant fatigue can be a symptom of various dysfunctions, but it is always present with thyroid diseases. Due to a lack of thyroid hormones, you may constantly feel tired and sleepy.
There is no full activation of muscles and the functioning of the body as a whole, so a person feels exhausted after sleep and during the day.
Symptom 2 - psychoemotional disorders
Symptom 6 - decreased libido
This is one of side effects from thyroid diseases. Very often, the reason for lack of interest in sex is hypothyroidism. Additionally, desire is reduced by constant body aches and lack of energy that occur with this disease.
Symptom 7 - vision problems
Due to a rapid heartbeat, a person may have the feeling that everything in front of their eyes is shaking. This symptom is characteristic of hyperthyroidism.
Symptom 8 - gastrointestinal disturbances
Due to improper functioning of the thyroid gland, digestion processes can be disrupted. Patients with hypothyroidism often suffer from constipation. When there is an excess of hormones, the opposite processes occur: diarrhea, flatulence appear, and the stomach constantly rumbles.
Symptom 9 - dry skin
This symptom occurs in hypothyroidism. Due to the fact that most metabolic processes have slowed down, sweating decreases and the structure of the skin changes. It becomes flaky and itchy.
Symptom 10 - change in the menstrual cycle
Symptom 13 -
With an excess of hormones, you constantly feel hot and the skin produces a lot of sweat. This is due to the burning of a large amount of energy. With a lack of hormones, the body lacks energy reserves and, as a result, the person is constantly cold and shivering.
Symptom 14 - discomfort in the neck
With thyroid pathologies, there may be a feeling that there is a lump stuck in the throat or the walls of the throat themselves are swollen. In such a situation, you need to visually inspect the neck yourself.
While looking in the mirror, drink water, and watch for protrusions or bulges in the area of the thyroid gland. If they are present, most likely the organ has enlarged for some reason, which is a pathology.
Symptom 15 - weight gain
Weight gain can be observed even if a person eats as usual. In such a situation, changing your diet and working out in the gym usually do not help reduce weight, no matter how hard the person tries.
Symptom 16 - trouble sleeping
Excess hormones cause insomnia. With their deficiency, constant fatigue is observed, the patient cannot get enough sleep, no matter how much time he sleeps.
Symptom 17 - poor condition of hair and nails
What to do if you notice symptoms?
If any of these symptoms bother you, then it is possible that your thyroid gland needs treatment. First of all, you should contact an endocrinologist who will conduct an initial examination and collect anamnesis.
After such an examination, the specialist may prescribe an ultrasound scan of the organ. This is necessary to study the structure of the organ and its size. Based on the test data, the specialist will be able to prescribe the appropriate treatment.
