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Hypothyroidism/ Hyperthyroidism

Hypothyroidism/ Hyperthyroidism: Description

The thyroid gland is a butterfly-shaped organ that is located in front of the trachea and thyroid cartilage in the neck. The thyroid gland produces hormones which, among other things, control metabolism and the regulation of body temperature, oxygen consumption, water balance or brain functions. Thyroid diseases are often accompanied by non-specific and varied symptoms and complaints of various origins. These include hypothyroidism (underactive thyroid from hormone deficiency), hyperthyroidism (overactive thyroid from hormone overproduction), goiter (struma), thyroid nodules, acute or chronic thyroiditis (Hashimoto's thyroiditis, an autoimmune disease) and Graves' disease (autoimmune hyperthyroidism). The thyroid gland produces, among others, the active hormone triiodothyronine (T3) which is converted into thyroxine (T4). If necessary, the stored T4 can be reconverted into the active T3 form.

Hypothyroidism/ Hyperthyroidism: Symptoms

Some thyroid diseases proceed for a long period of time without symptoms, while others are metabolic disorders (both hypo- and hyperfunction) associated with oppressive feelings (when the organ is enlarged) or pain (when inflamed).

Those affected by hypothyroidism may complain of cold sensitivity, fatigue, poor concentration, constipation, weight gain or depressive moods. Characteristics of hyperthyroidism are inner restlessness, palpitations, irritability, weight loss, hair loss or excessive perspiration.

Hypothyroidism/ Hyperthyroidism: Causes and Risks

Hypothyroidism can have several underlying causes depending on its genesis (primary, secondary or tertiary). Primary hypothyroidism, the most common form, may be either a congenital or acquired disorder of the gland, caused by thyroiditis, wrong medication or iodine deficiency. The thyroid gland, which consists in large part of the trace element iodine, extracts that from food and stores it - which in turn is critical for the production of thyroid hormones.

Secondary hypothyroidism, significantly less common, occurs due to a malfunction of the pituitary gland: this is no longer able to produce the hormone TSH, which is responsible for the stimulation of the thyroid gland, in sufficient quantities. Tertiary hypothyroidism, which is extremely rare, is a disorder of the hypothalamus in which the impulse to produce hormones can fail entirely.

 

Hyperthyroidism (overactive thyroid) can heighten the risk of atrial fibrillation and heart failure, because the increased overproduction of thyroid hormones can lead to overloading the heart.

Hypothyroidism/ Hyperthyroidism: Examination and Diagnosis

After a medical history interview, clinical tests to determine the functioning status of the thyroid must be carried out. In cases of suspected thyroid dysfunction, the TSH concentration must first be determined, for which ultrasonography and thyroid scintigraphy can be arranged to allow further clarification. In an ultrasound examination, the size of the thyroid gland can be determined and possible changes such as cysts or adenomas made visible. Thyroid scintigraphy serves in clarifying and differentiating the abnormalities of the thyroid gland that were already detected with ultrasound.

Hypothyroidism/ Hyperthyroidism: Treatment

The methods used for treating the thyroid depend on the associated disease present, and comprise medicinal, surgical and radioiodine therapy, which can also be combined. With iodine deficiency-related thyroid disease, the taking of the most low-side-effect iodide tablets is recommended. In disease-related disorders of thyroid hormone production and the resulting metabolic disorders, substitution therapy is carried out in which hormone pills are taken to replace the body's own hormone thyroxine. In hyperthyroidism, the intake of anti-thyroid drugs is necessary to slow down or block production of thyroid hormones.

In cases of goiter, thyroid nodules or Graves' disease, thyroid tissue can be reduced and thyroid function curbed through radioiodine therapy. This particular form of iodine, radioiodine, acts via radioactive rays and destroys any thyroid tissue in the radiation range (max. 2 mm).

Surgical intervention may become necessary with goiter, pronounced hyperthyroidism or for node removal. In case of thyroid cancer a total hysterectomy can also be carried out.

Hypothyroidism/ Hyperthyroidism: Course and Prognosis

When, due to illness, the organ cannot send out the right amounts of chemical messengers, the bodily functions can get out of balance; the course of thyroid disease can, especially at the initial stage, be accompanied by various insidious, diffuse symptoms and complaints. Every thyroid disorder can have long-term consequences and, without appropriate therapy, severe effects on the body.

Medical Center - University of Freiburg

Phone: +49 761 270 21310
Fax: +49 761 270 19310

info-ims@uniklinik-freiburg.de

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