By Dr. Anna Lo
As an endocrinologist, I often get asked by non-medical folks what kind of diseases I see in my practice. Endocrinology is a field in medicine that deals with the diagnosis and treatment of hormonal disorders, which can cause a myriad of problems and symptoms, and therefore negatively impact one’s overall health. These hormonal imbalances require careful and meticulous work-up so that we can address the problem accordingly and restore the body’s homeostatic functioning.
The thyroid gland is a butterfly-shaped organ normally situated in the lower portion of the anterior neck which secretes thyroid hormones. Thyroid hormones travel through the blood stream and affect different tissues in the body.
Thyroid hormones play a vital role in maintaining the body’s metabolic rate. The thyroid gland gets its signal from the brain, particularly from the master hormonal gland called the pituitary gland, and from another higher center in the brain, called the hypothalamus.
The hypothalamus-pituitary-thyroid axis works as a cohesive unit to ensure that a normal range of thyroid hormones is secreted and maintained. Problems can arise when any part of this axis is affected.
There are several conditions that can cause dysregulation of thyroid hormone secretion.
Excess production of thyroid hormones, “hyperthyroidism,” can speed up the body’s metabolism causing symptoms like unintentional weight loss, palpitations, increased nervousness and anxiety, tremors, difficulty of breathing, sleeping disturbances, irregular menstruation, and eye problems.
On the opposite end, some patients end up having less than normal production of thyroid hormones, “hypothyroidism,” which slows down metabolism causing significant weight gain, profound weakness and fatigue, forgetfulness, dry hair and skin, and cold intolerance.
Some patients may develop an enlargement of their thyroid gland or “goiter” due to these hormonal disturbances.
There are a variety of entities that can cause either hyper- or hypothyroidism in patients.
Autoimmune conditions such as “Graves’ disease” and “Hashimoto’s thyroiditis” are immune-mediated processes that lead to hyperthyroidism and hypothyroidism, respectively.
Nutrition also plays a role as in the case of iodine deficiency. Iodine is vital and a key factor in thyroid hormone production. Its scarcity in diet amongst certain countries contributes to a global health problem, with millions of people suffering from hypothyroidism worldwide.
As mentioned, hyper- and hypothyroidism affect the production of thyroid hormones. Apart from these, some patients develop distinct lesions or lumps in the thyroid itself referred to as “thyroid nodules.”
Most of these thyroid nodules are harmless, but some can increase thyroid hormone production or even turn out to be cancerous. Therefore, clinically significant bumps in the neck should be thoroughly evaluated.
Thyroid disorders are quite common and affect an estimated 20 million Americans in the United States, according to the American Thyroid Association
Women are five to eight times more commonly affected than men. Undiagnosed thyroid disease can cause not only significant symptoms, but also long-term health complications, such as cardiovascular disease, impaired bone health, and even mental issues.
If you feel you are having any issues with your thyroid, ask your primary care physician about it, and if necessary, seek a hormone specialist.
Thyroid diseases are common and can be distressing. However, most of the disease entities are manageable if proper care and actions are taken in a timely fashion.
By Dr. Anna Lo