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OsteoBlog: Thyroid


The thyroid is a butterfly shaped gland situated just below the Adams apple in your throat, wrapped around the windpipe (trachea).

It is about the size of a plum cut in half and is flanked by 2 pairs of much smaller parathyroid glands (responsible for calcium uptake and metabolism).

What does it do?

The thyroid gland produces and stores hormones that affect your metabolic rate and energy levels. It is involved in regulating:​

  • reduction of cholesterol

  • carbohydrate and fat uptake in gut

  • blood pressure

  • cardiac activity

  • protein synthesis

  • growth

  • blood calcium levels

  • brain development

  • sleep and sexual function

It is, therefore, incredibly important and when it malfunctions, can have far reaching consequences to health and wellness.

How does it work?

The thyroid produces two hormones called T3 (triiodothyronine) and T4 (thyroxine). T4 is converted to active T3 in the gland and body cells. The hormones are derived from iodine and tyrosine.

The calcium regulating hormone calcitonin is also produced here.

The release of these hormones is regulated by the pituitary gland in the mid brain, which in turn is regulated by the hypothalamus above it (control module).

Thyroid stimulating hormone (TSH) is released by the pituitary in response to low levels of T3/4 in the blood.

Disorders of the thyroid gland:

According to the British Thyroid Foundation (www.btf-thyroid.org) as many as 1:20 people will have thyroid disease at some point. Women, aged between 40-50 are 10 times more likely to be affected than men.

The thyroid can be affected by many diseases that can alter the rate of hormone production - speeding it up (over-active/hyperthyroidism) or slowing it down (under-active/hypothyroidism). These diseases range from small, harmless swellings or goitres and autoimmune inflammatory conditions, to life threatening cancer.

Diagnosis of thyroid problems can take some time, but most are treatable and can be well managed with the correct medications and treatment approaches.

Hypothyroidism/ myxoedema/ under-activity -

Too little thyroid hormone is produced and the body's metabolism takes a downturn and slows. Causes include Hashimoto's disease (thyroiditis and autoimmune destruction), pituitary or hypothalamic failure (perhaps from tumour), genetic dysfunction, deficiency of iodine, treatment for over-activity of thyroid such as surgery, lack of conversion from T4 to T3 and the psychiatric drug lithium.

Menopausal women often develop an under-active gland and this condition can go unnoticed and untreated due to other more prevalent symptoms experienced at this time.

What to look for:

  • weight gain and associated depression/anxiety

  • slow thought processes and mood swings

  • breathlessness, dizziness and palpitations

  • loss of libido

  • dry eyes and skin and hair loss

  • muscle and joint pain

  • loss of appetite

  • constipation

  • goitre and sore throat, husky voice

  • very low energy levels and cold intolerance

Diagnosis:

Blood tests for TSH, T4, T3 and thyroid antibodies will provide an accurate picture of function and possible referral to a local endocrinology department. It is important to investigate the underlying cause of dysfunction, which may require further blood tests, biopsy or scanning. Levels of vitamins such as D and B12 can mimic thyroid symptoms when in deficiency, so these should also be tested.

Treatment:

Levothyroxine (T4) is the standard treatment in the UK and patients require regular blood testing to begin with, in order to get the correct dosage. The drug takes 7-10 days to become effective.

Smoking does not help the ailing thyroid and coffee can interfere with hormone absorption.

When thyroid balance is restored you should start to feel much better and be able to live a full life with occasional check ups by the GP.

Hyperthyroidism/ Graves disease/ over-activity -

Excessive production of thyroid hormone causing metabolic and other processes to speed up.

The autoimmune condition Graves disease is commonly responsible for the overactive thyroid and often occurs in younger women with a family history of the disease. Other causes include thyroiditis, toxic nodules (goitre), exposure to excess iodine, amiodarone (cardiac drug), taking too much thyroxine medication.

What to look for:

  • lump in the neck, causing a cough or sore throat

  • rapid heart beat (may be irregular)

  • anxiety, irritability

  • sleep problems

  • protruding eyes (exopthalmia)

  • diarrhoea

  • proximal muscle weakness in limbs

  • shaky hands, red palms

  • sweating and heat intolerance

  • weight loss despite increased appetite

  • menstrual changes

Diagnosis:

Blood testing for thyroid hormone levels, ultrasound scanning and ruling out other diseases that mimic hyperthyroidism such as adrenal gland tumours.

Treatment:

Very much depends on the cause of the condition but first line treatment of beta- blocker drugs will slow down life threatening cardiac symptoms, followed by anti thyroid drugs such as carbimazole or propylthiouracil. These drugs can have some nasty side effects including increased vulnerability to infections, and administration should be carefully monitored.

Oral ingestion of radioactive iodine will be taken up by the gland and then slowly destroyed by it. Treatment for under-activity is then commenced.

Partial or full thyroidectomy is indicated for cancers and treatment resistant conditions again necessitating thyroid replacement drugs.

An over-active thyroid endangers life more than an under-active one, so swift diagnosis and treatment by a specialist is very important, followed by life long medical check ups.

Some complications of hyperthyroidism include heart failure, osteoporosis, irregular heart rhythms and miscarriage.

As always if you think you are suffering with any of the symptoms mentioned then please contact your GP as soon as possible.

Resources:

www.nhs.uk/conditions/thyroid

www.webmd.com

www.btf-thyroid.org

www.thyroiduk.org

For osteopathy in High Wycombe and beyond, please contact Lucy from OsteoFusion on 07833 321604 or visit www.osteofusion.co.uk

Thanks for reading.

#hyperthyroidism #hypothyroidism #thyroidgland #goitre #gravesdisease #hashimotosthyroiditis #levothyroxine #carbimazole #autoimmune #T3 #T4 #TSH #endocrine #iodine #pituitarygland #hypothalamus

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