This small organ, located at the base of our neck, plays a big role in the proper functioning of our body by constantly producing thyroid hormones. But sometimes (especially during puberty, pregnancy and menopause) its balance can be disturbed and cause specific thyroid diseases. Doctor Michèle Scheffler, endocrinologist, helps us to spot the warning signs.
What is the thyroid for? The thyroid is a butterfly-shaped gland located at the base of our neck, which produces thyroid hormones by using iodine circulating in the blood. These thyroid hormones target all tissues in the human body. “They intervene on the growth of hair, integuments, the functioning of the brain, the intestine, the heart , details Doctor Michèle Scheffler but also on the skin, the genitals, the reproductive functions, our weight, our height ( dwarfism in children), the regulation of our body temperature… ”.
It is therefore impossible to do without thyroid hormones at the risk of becoming amorphous over the months or conversely a real electric battery if they are produced in too large a number.
At home observe your neck, if you feel a lump, notice a deformation, small nodules towards the base of the neck, cervical pain, headache , a sudden change in tone of voice, false routes when eating or drinking, it is good to go see your doctor. Even more so if you have noticed a change in mood, hyperactivity or, on the contrary, severe fatigue
Hyperthyroidism Your thyroid gland is overactive, meaning that it produces too much thyroid hormone.
Symptoms You have the impression that you are living in accelerated mode, You feel emotionally unstable, You have noticed mood disorders, Very nervous, You sleep badly , You have all the hot weather, You are embarrassed by palpitations , You lose weight quickly for no reason. “All these symptoms should not be neglected, warns the endocrinologist, because the cardiac risk is real (tachycardia, arrhythmias with risk of cardiac decompensation). Without forgetting the brain risks. A person can also decompensate an underlying psychiatric illness if their thyroid is disordered ”. In the long run, this life led to 64 on time can lead to general exhaustion.
What causes? Hyperthyroidism may be caused by an autoimmune disease such as Graves’ disease (sometimes accompanied by exophthalmos) or else induced by the presence of a hyperactive “toxic” nodule on a thyroid lobe. The autoimmune disease is distinguished by the development of specific autoantibodies causing an exaggeration of the functioning of the thyroid and its inflammation. “Strangely, autoimmune diseases are most often triggered by an emotional shock, a trauma like a car accident, a serious announcement breaking a harmony in the organism” , saw the doctor.
We think about it less often but hyperthyroidism can also be caused by absorption of iodine , this hyperthyroidism is said to be induced by l ‘iodine. Many medicines do indeed contain iodine. This is the case for drugs to treat heart rhythm disorders but also certain nutritional supplements. Also pay attention to the contrast medium when performing a medical imaging examination. In this case, it suffices to stop the intake of the drug rich in iodine for a return to normal in 6 to 9 months.
“More rarely Quervain’s thyroiditis with its painful acute inflammatory procession of the thyroid, most often occurring in a viral context, is responsible for ‘transient hyperthyroidism to be treated immediately with corticosteroid therapy ”, advises the specialist.
What treatments? Three treatments are generally offered to the patient if an autoimmune disease is the cause of the thyroid disorder. As a first-line treatment with synthetic antithyroid drugs administered daily in the form of tablets. “These are drugs that slow down the autoimmune activity of antibodies,” says the doctor. The first month, a blood test is carried out every week to check the toxicity of the treatment. If all goes well, it is administered between To 18 months then its dosage will be gradually reduced over 4 to 6 months ”.
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The second treatment offered to the patient consists in making him drink in a single and single take (in hospital) a dose of radioactive iodine. “This iodine will immediately attach itself to the iodine-hungry thyroid while destroying, thanks to its radioactivity, the diseased cells. This solution is not possible in case of exophthalmos or during pregnancy ”, explains the specialist.
Finally, surgery may be considered if the first two treatments have not worked or if prompt treatment is necessary. In this case, the surgeon will remove the entire thyroid. Thyroid hormone replacement therapy ( Levothyrox , Thyroxine ) will be in place for life.
As for toxic nodules, they are placed under surveillance (ultrasound, scintigraphy) and treated if necessary (depending on their degree of toxicity and their impact on quality of life) by radioactive iodine or by ablation of the thyroid lobe on which the nodule is placed. Remember, however, that most thyroid nodules occur in a context of euthyroidism. They are closely monitored on clinical examination, on ultrasound associated with fine needle aspiration in the slightest doubt in front of a suspected malignancy nodule.
In the event of hyperthyroidism induced by iodine and secondary to taking a drug, it is sufficient to stop taking the drug rich in iodine and to treat it for a few months with synthetic antithyroid drugs. Always ask your doctor for advice before stopping your long-term treatment. Only he will be able to find a treatment better suited to your pathology which must continue to be treated.
Hypothyroidism Your thyroid gland does not produce enough hormone either by physiological aging or thyroid ablation, or by excess or insufficient iodine intake or during an autoimmune disease called Hashimoto thyroiditis with the appearance of autoantibodies gradually destroying the cells producing thyroid hormones. It is then your whole metabolism that is upset.
Symptoms You get cold all the time, You gain weight, Your hair is increasingly thinning, Your nails are brittle, You have trouble concentrating, you are very tired and gradually you disconnect from your social circle. You feel like you are in a straitjacket . “This sensation is created by the edema that forms within the tissues , explains Doctor Michèle Scheffler. You then have the impression of being swollen like a bibendum without this being noticed from the outside ”. You may also have noticed that your menstrual cycles are lengthened. “An hypothyroidism can indeed prevent ovulation and cause infertility , says the specialist. This is why the TSH and T4 level ( thyroid hormones) in the blood, in patients who tend to have miscarriages. By treating hypothyroidism over a short period of time, it is possible to normalize things ”, rejoices the expert. What causes? Thyroid hormone deficiency is systematically detected in newborns at birth in order to avoid the risk of hypothyroidism (repercussion on the intellectual development of the child and his size with dwarfism).
What treatment? If the hypothyroidism is transient, administration of hormone replacement therapy (Levothyrox) for a few weeks will suffice. If hypothyroidism is linked to an autoimmune disease such as Hashimoto’s thyroiditis, replacement therapy will be prescribed for life.
There is no clinical call sign on the quality of life of the person because very few cancers give the form of hypothyroidism or hyperthyroidism.
Only the presence of a nodule should attract attention without dramatizing. A nodule does not necessarily become cancer (between 0, 01 to 0, for 1000 people) but it should be closely monitored by ultrasound (on average every year) and fine needle aspiration if there is any doubt. “Depending on the results, we choose to either operate on it or monitor it ”, recommends the expert.
8497615 Thyroid disorder the diagnosis? The general practitioner will first perform a clinical examination by auscultating your neck (size, heat or cold on palpation of the skin), listening to your heart, its pulsations, he will check your weight, if there is no abnormal hair loss… He will then order a blood test to check TSH. Finally, he will prescribe an ultrasound to rule out the presence of nodules and goiter.
If a thyroid disorder is observed, he may himself administer thyroid hormone treatment o u refer you to an endocrinologist (in the event of a basal disease or pregnancy or a nodule). “This pathology remains very feminine with a strong impact on the quality of life if it is not treated correctly , insists Doctor Michèle Scheffler . Those around them sometimes have trouble recognizing the person who is usually cheerful and calm and can suddenly have mood swings and become sad. We need the whole entourage to accompany the patient towards recovery. ”