Every January since 2016, Thyroid Awareness Month throws a healthcare spotlight on the importance of the proper function of the thyroid gland in promoting wellbeing and good health. It brings the attention of physicians, scientists and the general public to how vital this tiny gland is in modern medicine.
We’ll start by separating the general subject of thyroid function with the more specialized attention given to thyroid cancer, which has earned its own awareness month each year in September. In a future blog, we will also try to cover this part of the subject, but there’s more than enough in talking about non-malignant thyroid disease to keep your attention here.
In the following few paragraphs, we will try to outline a bit about the thyroid facts – what the thyroid gland does when all is going well, how it affects people when things are going wrong, and the secret signs of thyroid disease. As well, we will look at the latest developments and research that are bringing hope to the millions of people worldwide who are suffering from thyroid malfunction.
Where is the thyroid gland, what does it do, and what can go wrong?
Let’s start with the “where.”
The thyroid gland is a “W” shaped body that sits at the base of the trachea in the neck. It belongs to the group known as endocrine glands that secrete hormones directly into the bloodstream.
Note – despite the similarity in names and proximity of the thyroid and parathyroid glands, they have no functional interaction or dependence. The parathyroid glands produce the hormone that controls the level of calcium in the bloodstream.
What does the thyroid gland do?
The hormones produced by the functioning thyroid gland act on almost every cell in the body. They regulate the BMR (basal metabolic rate) by affecting protein, carbohydrate and fat metabolism. In association with growth hormones, it affects how the body develops from infancy. It has a fundamental influence on cardiovascular function, since it increases the rate and strength of heartbeats, the rate of breathing and the intake and consumption of oxygen. Taken together, these will increase blood flow and body temperature.
During the development of a fetus in the womb and during the first few years of postnatal life, the brain is a major target for the thyroid hormones, which play a crucial role in brain maturation. The thyroid hormones are also involved in promoting sleep and thought patterns as well as normal sexual function and maintenance of a regular menstrual cycle.
What happens when the thyroid gland malfunctions?
When it’s not functioning properly, there are two broad areas of thyroid disorders:
Overactive thyroid (the terms used are hyperthyroidism, thyroid inflammation or thyroiditis, thyroid enlargement or goiter) is when the gland is secreting excess levels of hormones, throwing the body processes off balance.
Underactive thyroid (known as hypothyroidism and Hashimoto’s thyroiditis) means that there are insufficient levels of the same hormones and metabolism is disturbed.
Hyperthyroidism can be manifested in indirect symptoms such as sudden weight loss, increased appetite, insomnia, tremors, and irregular heartbeat (palpitations). It can also produce behavioral changes such as anxiety and nervousness or sensitivity to heat. Occasionally it can cause chest pains, diarrhea, hair loss and muscle weakness.
Hypothyroidism can cause symptoms such as tiredness, constipation, a decreased pulse rate, and weight gain. It can manifest in an inability to tolerate cold temperatures and in emotional depression. There may be swelling on the area of the neck due to goiter.
When untreated, hypothyroidism during pregnancy can cause delays in fetal growth and affect the baby’s intellectual development.
When either of these are suspected, it can be confirmed by measuring thyroxine level and thyroid-stimulating hormone (TSH) with blood tests.
What are the available treatments for hyperthyroidism?
Treatment of hyperthyroidism can include drugs such as Methimazole that reduce the levels of hormone output.
Surgery (transoral thyroidectomy) to completely remove the thyroid is sometimes performed. It is a minimally-invasive procedure, but like all surgery does carry a risk, in this case, of damage to the adjacent parathyroid glands and laryngeal nerve, which controls the vocal cords. Alternatively, radioactive iodine-131 can be administered, which then is taken up by thyroid cells and destroys them slowly. Hypothyroidism will be the result of both. If the entire thyroid gland is removed or killed, thyroid hormone supplements will be needed.
What are the available treatments for hypothyroidism?
A deficiency of iodine in the diet is the most common cause of hypothyroidism in the third world. The primary approach in these countries has been to introduce iodized table salt.
Long-term treatment for hypothyroidism, for example, for people who have had the gland removed or shrunk with radioactive iodine-131, generally takes the form of hormone supplements. Examples are Cytomel and Synthroid.
What is the focus of Thyroid Awareness Month?
Helping people recognize the symptoms of thyroid disease is the focus of Thyroid Awareness Month. With this awareness, the idea is that people will then talk to their doctors about testing and treatment.
Ten percent of people worldwide will suffer from some form of thyroid disorder. More than half of the people in America who already suffer from a thyroid disorder are still undiagnosed. Raising awareness of the thyroid is an important step in boosting knowledge about its importance. Raising awareness of the thyroid is an essential step in boosting knowledge about its importance.
By encouraging national societies and thyroid working groups to supply the public with information about the diagnosis and treatment of thyroid diseases and its prevention through proper iodine supplements, it is hoped that the incidence of thyroid diseases will be slowed.
A parallel goal is to give research and educational institutions engaged in thyroid study a higher profile, enabling the recruitment of the finest science and medical personnel, along with the necessary funding, to enable advances in diagnosis and treatment; improvements in thyroid patient care and public education about thyroid health and diseases.
Thyroid Awareness Month is a global project. In the USA, the American Thyroid Association promotes a program to solicit funding for research and serves as an educational resource for public education. Over the past 40 years, research funded by the association has achieved mandatory screening of newborns for congenital hypothyroidism and advanced work in brain development and thyroid hormone function.