You may not feel a problem with your thyroid gland – your doctor has told you what to look for.

– Let’s first get acquainted with the thyroid gland: what functions does this organ perform and why is it so important to us?

– The thyroid gland is one of the endocrine glands without which the body would not survive. The thyroid gland is very small, weighing about 15-20 g, located in the front of the neck. It consists of two sections and an intermediate zone. The thyroid gland produces hormones that are necessary to maintain metabolism. In practice, it would be possible to compare the thyroid gland with a heat boiler, in winter the house cannot function without heat, so the body cannot function without the thyroid gland.

– Professor, is it true that thyroid disorders in women are on the rise? You have to hear that almost every second you are diagnosed with one or another thyroid disorder.

– In fact, thyroid diseases are many and varied. They represent a fairly large proportion of various chronic noncommunicable diseases. The trace mineral iodine is necessary for the normal production of thyroid hormones. The problem is that the distribution of iodine in the soil is very uneven. Basically, it is missing in many places. As a result, we get less and the thyroid gland responds, trying to compensate for the deficiency and increasing the volume of its work. When iodine deficiency is severe, the majority of the population has an enlarged thyroid gland. There are plains in Lithuania, a little more iodine in the plains than in the mountainous areas. Therefore, we have practically no such areas where iodine deficiency is very severe, but there is a small iodine deficiency in practically most of Lithuania. And this can also lead to an enlargement of the thyroid gland. The thyroid gland is more common in women than in men. Many countries around the world, including Lithuania, have introduced an iodized salt program to reduce iodine deficiency. Edible salt contains iodine and can make up for its deficiency.

– Is it worth asking how much iodine is in the body? If we live in Lithuania and consume iodized salt, can we be sure that we will not have iodine deficiency?

– Iodine deficiency is not usually studied and, in the face of thyroid disease, doctors evaluate the function of the thyroid gland itself. In the case of goiter, thyroid functionality often remains within normal limits. This can be determined by analyzing thyroid hormones, which is often the case in clinical practice. Clearly, with an enlarged thyroid gland when it is functioning normally, it is important to ensure that a person gets enough iodine. It is best to add iodized salt to ready-made foods, as iodine can evaporate during cooking. In some cases, potassium iodide can also be used. However, this is not the same as the tablets we receive in the event of an unforeseen nuclear disaster with our neighbors. Therefore, potassium iodide prophylactic tablets are available, but they are mostly limited to food, iodized salt, and shellfish. If we consume excessive amounts of food that make it difficult to absorb iodine, there may also be a shortage. For example, you could use cabbage and string, too much of which can reduce iodine absorption.

– Is it easy for a person to diagnose a thyroid disorder? What are the symptoms?

– If there is only goiter without thyroid dysfunction, the diagnosis is not so easy. The person does not feel any symptoms, he can only see the deformity in the neck area when the thyroid gland is already very large. Sometimes this is seen during swallowing and sometimes at rest. If symptoms are already occurring, there are other conditions. This may be related to a decrease in thyroid activity or an overactive thyroid gland, both of which are quite common, much more common in women than men. The symptoms of hypothyroidism progress gradually, often initially nonspecific, and progress slowly. Extreme cases are rare, but can be life-threatening.

– What are thyroid nodules and why do they occur? It could be dangerous?

– There may be different types of thyroid nodules; there may be one and there may be more. Nodules occur quite often, the older a person is, the greater the risk. The key is to diagnose whether the nodules are benign or not. If there is a young man, a nodule, a man, the risk of a nodule is malignant, higher than if it is an older woman. Furthermore, if that area has ever been irradiated, it also increases the risk, as do various autoimmune processes. However, sometimes the reasons are not always very clear. We can feel the thyroid nodules when they reach a size of 1 cm or more, which makes it difficult to feel smaller.

– Let’s talk about the cases in which the thyroid gland slows down. What are the reasons for this? Are they always clear?

– Thyroid gland slowing down or hypothyroidism may be due to surgery to remove the thyroid gland. Sometimes doctors look to hypothyroidism to control the course of another disease. However, in this case, the patient takes thyroid preparations for the rest of his life and thus the body functions well. Another common cause is autoimmune thyroiditis, chronic inflammation of the thyroid gland. The patient does not feel the onset of this disease, but the immune system no longer recognizes the thyroid gland as its organ, begins to treat it as a foreign body, and begins to attack the thyroid gland. Over time, thyroid cells break down; in some cases, this can take years and sometimes much faster, depending on the individual characteristics of the body. Depending on how many cells are no longer performing their function, both symptoms occur.

– Are there early symptoms? Have you mentioned fatigue, weight gain, or is it already an advanced form of the disease?

– If these symptoms are tolerated and the person can still live with them, these will be early symptoms. They are usually nonspecific. Some of them are associated with lifestyle, fatigue, work, and the like. However, as the disease progresses, the symptoms become more pronounced, the person becomes listless, drowsy, memory deteriorates, does not want to move, does nothing, greatly reduces the reaction to environmental stimuli, nails , hair breakage, dry skin, heart rate slowdown. These conditions are already dangerous. The good news is that our family doctors have the tools to detect changes early and test for hormones. When such a disease is diagnosed, the rest of life must be lived with replacement therapy, that is, thyroid hormones, and it must be used continuously because the thyroid gland itself no longer produces enough of them.

– Do we already have any knowledge of how the coronavirus and its consequences can affect the thyroid gland?

– I think we will discover some of the effects in a while. The further, the more knowledge emerges, the research is carried out. So far, there are no specific signs that the virus is damaging the thyroid gland, but I don’t rule out that knowledge is still emerging.

– If hormone replacement therapy is possible after slowing down the thyroid gland, what treatment is available for an overactive thyroid gland?

– Treatment in this case is already a little more troublesome, because then you need to suppress the thyroid with special preparations. They suppress thyroid function, but sometimes treatment lasts for several years. Sometimes treatment is applied temporarily until a decision is made about how to continue to treat the disease. Sometimes the thyroid gland is removed. Excessive activity can be resumed by stopping the drug, which can result in the administration of radioactive iodine, which burns excess cells. Alternatively, the thyroid gland can be operated on and removed. With surgery, the result is achieved faster, but incisions are needed. With iodine, the result is slower, but surgery is not required.

– What symptoms should not be ignored and a family doctor should be consulted since they can be the consequences of a thyroid disorder?

– As for the decrease in thyroid function, it is especially common in older people, women. Sometimes all those complaints are “canceled” by age. Weakness, fatigue, dry skin, rapid heart rate, constipation, weight gain, slower metabolism. Another extreme is an overactive thyroid gland. In this case, the metabolism speeds up, the person becomes active, agile, takes care of everyone around him, but not himself, sweats more, loose stools, eats more, but does not gain weight. Eventually, cardiovascular disorders and palpitations occur. This is already worrying. I would suggest paying attention to those symptoms.