Thyroid diseases are common health issues that affect the function or structure of the thyroid gland. The thyroid is located at the front of the neck, shaped like a butterfly, and is responsible for secreting hormones that regulate metabolism, growth and development, and energy expenditure. When the thyroid functions abnormally or its structure is altered, it can lead to various symptoms, and in severe cases, may even affect the function of other organs throughout the body. Understanding the basic knowledge of thyroid diseases can help with early detection and treatment.
Thyroid diseases encompass a variety of conditions, including hyperthyroidism, hypothyroidism, thyroid nodules, thyroiditis, and thyroid cancer. These conditions may be related to genetics, immune system abnormalities, environmental factors, or aging. In recent years, due to increased lifestyle stress and environmental pollution, the incidence of thyroid diseases has been gradually rising, becoming an important public health concern worldwide. This article will provide a comprehensive overview of thyroid diseases from the perspectives of etiology, symptoms, diagnosis, and treatment.
Genetic predisposition is a significant risk factor for thyroid diseases. If there are patients with thyroid diseases in the family, the likelihood of offspring developing the disease may increase. For example, autoimmune thyroiditis (such as Hashimoto's disease and Graves' disease) is associated with specific gene polymorphisms. Additionally, immune system abnormalities may mistakenly target thyroid tissue as foreign, triggering chronic inflammatory responses that ultimately lead to hormonal imbalance.
Environmental exposure and lifestyle habits can also trigger thyroid problems. Residents in iodine-deficient areas are prone to goiter due to insufficient iodine intake, while excessive iodine intake may induce thyroid dysfunction. High stress levels, lack of sleep, and poor dietary habits can affect the regulation of the hypothalamic-pituitary-thyroid axis. Furthermore, certain medications (such as amiodarone) or environmental pollutants (like uranium and lead) may interfere with thyroid function.
Typical symptoms of hyperthyroidism (excessive secretion of thyroid hormones) include palpitations, hand tremors, unexplained weight loss, sweating, and irritability. Patients may experience frequent urination, insomnia, and increased heart rate leading to elevated blood pressure. Some may develop exophthalmos (Graves' ophthalmopathy) or skin redness and swelling, which need to be distinguished from other systemic symptoms.
In hypothyroidism, the body's metabolic rate decreases, and common symptoms include fatigue, cold intolerance, weight gain, memory impairment, and muscle pain. Patients may also have dry skin, brittle hair, or menstrual irregularities. Severe cases can lead to myxedema, resulting in altered consciousness or respiratory difficulties.
The core of diagnosing thyroid diseases lies in blood testing. Routine tests include thyroid-stimulating hormone (TSH), T3, T4 levels, and antibody measurements (such as anti-thyroid peroxidase antibodies). Low TSH with elevated T3/T4 suggests hyperthyroidism, while the opposite indicates hypothyroidism. Diagnosis of autoimmune diseases requires combining antibody levels with clinical presentation.
Ultrasound can evaluate the size of the thyroid, the nature of nodules, and blood flow distribution. Radioactive iodine scans differentiate between “hot” and “cold” nodules, aiding in the assessment of benign versus malignant lesions. In suspected cancer cases, fine-needle aspiration biopsy (FNA) is a key diagnostic tool that directly analyzes cellular changes in tissue samples.
Patients with hypothyroidism usually require long-term oral intake of synthetic thyroid hormones (such as levothyroxine) to compensate for hormone deficiency. Hyperthyroidism may be treated with antithyroid drugs (such as methimazole) to inhibit hormone synthesis. Severe symptoms can be managed with beta-blockers to alleviate palpitations and other symptoms.
Malignant or large thyroid nodules causing compression may require partial or total thyroidectomy (thyroid lobectomy or total thyroidectomy). Radioactive iodine therapy is common for hyperthyroidism or benign goiters, using iodine-131 to destroy overactive thyroid tissue. Postoperative patients need lifelong thyroid hormone replacement therapy.
Although some thyroid diseases cannot be completely prevented, the risk can be reduced through the following measures:
Avoid exposure to environmental toxins such as industrial chemicals or radiation-contaminated areas. Women during pregnancy or menopause may experience fluctuations in thyroid function; close monitoring of hormone levels is advised. Regular self-examinations of the neck for painless lumps and awareness of changes in weight, temperature, and other metabolic indicators are recommended.
If you experience the following, seek medical attention promptly:
Even mild symptoms warrant evaluation if there is a family history of thyroid cancer or autoimmune diseases. Doctors may further arrange ultrasound or blood tests to assess thyroid function.
If high fever, arrhythmia, altered consciousness, or other signs of thyroid storm occur, immediate medical attention is necessary. Thyroid storm may be triggered by uncontrolled hyperthyroidism and requires hospitalization for high-dose medications and supportive care. Early diagnosis and treatment can effectively reduce the risk of complications.
If you experience unexplained rapid weight changes, palpitations, hand tremors, cold intolerance, or persistent fatigue, seek medical care promptly. These symptoms may be related to hyperthyroidism or hypothyroidism, especially if they persist for more than 4 weeks or affect daily life. Blood tests to confirm thyroid hormone levels are recommended.
How should patients with thyroid disease control iodine intake in their diet?Iodine intake should be adjusted according to the type of disease: hyperthyroid patients should avoid high-iodine foods (such as seaweed), while hypothyroid patients generally do not need to restrict iodine but should follow medical advice. Excessive or insufficient iodine can affect medication efficacy. Consulting a nutritionist for a personalized diet plan is recommended.
What are the effects of missing doses of thyroid medication during treatment?Missing doses of thyroid hormone replacement drugs (such as levothyroxine) may cause symptoms to rebound, such as fatigue or slowed metabolism. It is advisable to take the missed dose as soon as remembered, but if it is close to the next scheduled dose, skip the missed dose and resume the normal schedule the following day. Long-term irregular medication intake can increase the risk of cardiovascular disease. Setting reminders is recommended to maintain stable blood drug levels.
What are the potential risks of thyroid dysfunction during pregnancy for the fetus?Hypothyroidism during pregnancy may increase the risks of miscarriage, preterm birth, or developmental issues in the fetus. TSH levels should be strictly controlled within the standard range for pregnancy. Pregnant women should have blood tests every 6-8 weeks and adjust medication doses under the supervision of obstetricians and endocrinologists.
Can Traditional Chinese Medicine acupuncture or herbal therapy treat thyroid diseases?Currently, there is insufficient scientific evidence to support acupuncture or herbal therapy as direct treatments for thyroid diseases. These methods may be used as adjunct therapies to alleviate symptoms but cannot replace Western medical hormone replacement or antithyroid medications. Patients should avoid stopping prescribed medications on their own and discuss the risks and benefits of integrated treatment plans with their healthcare providers.
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