The thyroid: a small organ, a giant impact

Every May 25, World Thyroid Day is celebrated, a date aimed at raising awareness about the importance of this small but fundamental organ for our lives. The thyroid is a butterfly-shaped gland located at the base of the neck, which produces hormones that influence almost every cell, tissue and organ in our body. Although it weighs only 25 gr., the thyroid hormones manufactured by the thyroid are distributed through the bloodstream, reaching various organs and tissues. Its function is to regulate the body’s metabolism and affect critical aspects such as energy level and heart rate. Therefore, any imbalance in thyroid activity can have repercussions on the body. Little is said about thyroid problems, despite being one of the most common disorders worldwide. According to the World Health Organization (WHO), approximately 750 million people suffer from some disease associated with the thyroid, and it is estimated that about 60% of them are unaware of their condition. The most well-known hormonal disorders related to the malfunction of this gland are hypothyroidism and hyperthyroidism. Hypothyroidism occurs when there is a decrease in the production of thyroid hormones. Depending on where the disorder originates, it can be classified as primary (failure in the thyroid gland), by far the most frequent, secondary (failure at the pituitary level) or tertiary (failure at the hypothalamic level). The latter two generate progressive symptoms that progress very slowly. The signs at the onset of hypothyroidism are usually nonspecific, such as tiredness, weight gain, constipation, cold intolerance, hair loss, pregnancy loss in the first trimester or menstrual alterations. On the other hand, hyperthyroidism is a medical condition characterized by increased activity in the thyroid gland, which leads to abundant production of thyroid hormones. Its excess has a significant impact on the functioning of the organism, leading to a variety of disorders and signs. Some of the common symptoms of hyperthyroidism include unintentional weight loss, nervousness and anxiety, tachycardia or fast heartbeat, intestinal pains, nausea, heat intolerance, thinning and brittleness of hair, difficulty falling asleep and chronic insomnia. This condition can have a negative effect on the quality of life of affected individuals, as it can generate an imbalance in metabolism, causing excessive acceleration of bodily processes. In both cases, treatment will depend on the cause and severity of the symptoms. Radioactive iodine is used in the treatment of hyperthyroidism, surgery is required if necessary and antithyroid drugs can also be used for the treatment of hyperthyroidism. Endocrine and metabolic disordersStress impacts on antibodies, that is, on autoimmune diseases. In the case of the thyroid, it may be due to the appearance of antibodies that inflame the gland or stimulate it. The first is Hashimoto’s disease and the second is Graves’ disease.Stress can trigger the appearance of antibodies that affect thyroid functioning, causing inflammation (hypothyroidism) or stimulation (hyperthyroidism). We must understand that these diseases often have a hereditary component and that stressors can act as triggers. Specifically, hypothyroidism can have different manifestations depending on its cause. In some cases, when antibodies are produced against the thyroid gland, hypothyroidism tends to be progressively definitive. On the other hand, in other situations such as viral diseases there is also subacute thyroiditis, where the thyroid can become acutely inflamed, causing pain in the gland and transient hypothyroidism until its function is restored; Or it may even occur silently, with or without obvious symptoms. In these circumstances, hypothyroidism may be transient and recover completely. It should also be mentioned that during the postpartum period, autoimmune hypothyroidism can be generated in patients with a predisposition. Another reason for hypothyroidism is having received radioactive iodine as treatment. However, controls are important as over time both types of hypothyroidism can become permanent. These specific cases are related to particular events or procedures. It should be noted that the only case of hyperthyroidism that can be transient is that of subacute thyroiditis. These spacesEntities manifest sore throat and neck, in addition to the history of having suffered some upper respiratory virus. From there, the thyroid becomes inflamed and discharges all the hormones it had inside, going through a period that is left without functioning, repairing the tissue and then returning to function normally. In summary, hypothyroidism can vary in its course and presentation. From progressively definitive cases to transient episodes that resolve completely, the thyroid can undergo different changes in its functioning in response to various factors. Another issue to keep in mind is that some medications can alter the functioning of the gland, amiodarone for example, can produce hyper or hypo and in the case of lithium, hypothyroidism is generated. As an endocrinologist, I want to highlight the importance of raising awareness about the indispensable functioning of the thyroid in our body and the impact it has on our health. It is essential that there is an open and fluid communication between doctor and patient, where doubts and queries are shared to achieve better follow-up and adequate treatment. Preparation and constant training are key. In the framework of World Thyroid Day, I invite you to reflect on the significant role of this gland in our body. We must know its functions, possible alterations and symptoms in order to provide adequate treatment and thus take care of our health and ensure optimal well-being.Dr. Laura Maffei (M.N.º 62441), endocrinologist with extensive experience and reference in
its area at national and international level; Director of Maffei Medical Center (@dralauramaffei).

Original source in Spanish