Disorders of the thyroid gland: an excess of hormones or hypothyroidism?

If body weight arrives, despite the reduction in calories or correction of nutrition, all efforts to combat weight are unsuccessful, drowsiness or chills occur – perhaps these are manifestations of hypothyroidism. But the problems of the thyroid gland can be the opposite: an excess of hormones provokes sweating and emotionality, palpitations and shortness of breath. A visit to the doctor, an ultrasound scan of the gland and blood tests that determine the concentration of thyroid and pituitary hormones will help identify the problem.

The most noticeable symptom is weight gain.

Experts believe that about 11-12% of the population of our country have problems with the work of the thyroid gland. And more than half of these patients have never been examined in their lives, respectively, and they do not cure the organ disorders. The thyroid gland is responsible for the production of T3 (triiodothyronine) and T4 (thyroxin), two hormones that, among other things, are responsible for regulating the metabolic rate. In other words, they determine the amount of calories a person burns each day to keep active. Accordingly, problems with the thyroid gland can easily cause significant weight loss or, more often, weight gain, which is extremely difficult to fight. But how do you know what exactly   thyroid   provokes weight gain and other body changes? It is important to consult a doctor to thoroughly analyze all the symptoms, history of the disease and to pass blood tests to determine the level of hormones.

How does the thyroid gland

To understand the need for blood tests and instrumental tests that are included in the diagnosis of hyperthyroidism (an excess of thyroid hormones) or   hypothyroidism   (lack of hormones), it is useful to first understand the complex biological and chemical interaction in which thyroid hormones are involved.

The process begins in the hypothalamus – a small part of the brain that produces thyrotropin-releasing hormone. This releasing hormone stimulates the pituitary gland, located at the base of the brain, to produce thyroid-stimulating hormone (for short, called TSH). Then the TSH passes through the bloodstream to the thyroid gland, located in front of the neck, with the result that the gland releases T3 and T4 — the hormones that affect the metabolism.

How do gland hormones work?

Inside the body, enzymes convert part of T4 to T3 – a more biologically active form of the hormone. Meanwhile, the amount of releasing hormone and TSH produced is largely controlled by the amount of the hormones T3 and T4 in the body. This is a complex process, and problems can arise at every step of the way. For example, while thyroid disease can reduce the production of T3 and T4, regardless of the level of TSH, problems with the pituitary gland can prevent the concentration of TSH from becoming so high as to activate the synthesis of thyroid hormones. And dysfunction in the hypothalamus can disrupt the entire process even before it starts, then almost all hormones are not released.

Symptoms and risk factors for hyper- or hypothyroidism

Symptoms of thyroid disease exist in two opposite ways. On the one hand, there is hyperthyroidism (an excess amount of thyroid hormones), which causes the body’s cells to go into a kind of metabolic overload. Loss of body weight, anxiety, irritability, sweating, sleep problems, and fast, irregular heartbeat – all these are common symptoms. Any combination of these (and other) manifestations may exist in people with hyperthyroidism. The most common form is called Graves Disease , which often causes swelling at the base of the neck associated with an enlarged thyroid gland.

On the other hand, hypothyroidism (too few thyroid hormones) is possible, which causes a slowdown in the metabolic processes of the same cells. Hypothyroidism results in weight gain, depression, poor memory, hypersensitivity to cold, fatigue, muscle weakness, a significant slowdown in heart rhythm. The most common cause of hypothyroidism is Hashimoto thyroiditis . It is an autoimmune condition in which the immune system destroys the cells of the thyroid gland, preventing its hormone production.

Although the causes of thyroid problems are for the most part unknown, women face them five to eight times more often than men. Those with a family history of thyroid disease are also at increased risk of hyper – or hypothyroidism.

What you need to know about the examinations: why we need blood tests

Currently, a dispute arises about what should and should not be checked to identify problems of the thyroid gland. For example, although   a blood test that measures TSH concentrations is often used to detect thyroid problems, physiological TSH concentrations do not necessarily indicate that the thyroid gland properly produces the necessary hormones. It only means that the pituitary gland gives the gland adequate commands.

For this reason, based on the patient’s symptoms, medical examinations, and family history, some doctors are doing other research. The most frequently performed test, in addition to TSH, is a blood test for free T4. This is necessary because free T4, which does not join plasma proteins and circulate freely in the blood, is the only form of a hormone that is able to penetrate cells and exert its effect. Total T4 can also be assessed, but it is usually less useful in assessing the functions of an organ. A blood test for T4 is not quite perfect and should be used in tandem with TSH.

Moreover, since the thyroid gland also produces T3, and some T4 turns into T3 in the body, it may be useful to evaluate the T3 level in the blood. In some people, hypothyroidism may be caused by a decrease in the rate of conversion of T4 to T3. Thus, in these patients without the T3 test, hypothyroidism can be easily missed. However, a blood test for T3 is most often used to diagnose hyperthyroidism or determine its severity in a particular patient. And, unfortunately, the T3 study is not always accurate.

In addition, other ways to get a more complete picture of the functionality and health of the thyroid gland include studies on thyroid antibodies, absorption of radioactive iodine, and ultrasound.

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