Thyroid disease symptoms
Thyroid refers to the endocrine glands like the hypothalamus, pituitary, parathyroid (parathyroid) gland, adrenal glands, an island of the pancreas, gonads - ovaries in women and testes in men.
thyroid gland - a small organ located in the neck, front and sides of the trachea, just below the thyroid cartilage, and consists of dvuhdoley, connected by an isthmus.Normally, the thyroid gland is almost palpable.
The thyroid gland consists of connective tissue permeated nerves, blood and lymphatic vessels;in connective tissue are thicker fine bubbles - follicles.On the inner surface of the walls are arranged follicular cells - thyrocytes that synthesize thyroid hormones.
Thyroid hormones are necessary for protein synthesis and secretion of growth hormone;they contribute to the utilization of glucose by cells, stimulate the heart, the respiratory center, enhance fat metabolism and so on. d. How to treat thyroid disease folk remedies, see here.
thyroid activity is regulated in the following way.When the b
All these complex mechanisms are required to reside in the blood as the active thyroid hormone, as the body needs at the moment.
The thyroid gland also produces the hormone calcitonin.Its main action - reducing high blood levels of calcium.It
- congenital anomalies (lack of thyroid or hypoplasia, wrong location; cleft-lingual thyroid duct);
- endemic goitre (associated with the lack of iodine in the natural environment);
- sporadic goiter (goiter, which is found in a small number of people who live in areas where iodine is sufficient);
-bazedova disease (in other words, diffuse toxic goiter or hyperthyroidism), associated with an increase in thyroid function;
-gipotireoz (decreased thyroid function);
- inflammatory diseases - thyroiditis;
- thyroid tumors and lesions.Damage may be open (when broken skin integrity) and closed (when it is not broken, seemingly such lesions can be invisible).
Normally this body we can not see and is not detectable.
At first degree increase thyroid clearly palpable, but invisible to the eye.
When second-degree increase in iron well palpable and visible to the eye when swallowing.
When third-degree increase in the thyroid gland can see even the person far from medicine;it looks like a "thick neck", but can not greatly disturb the patient.
In fourth-degree increase in thyroid goiter dramatically changes the contours of the neck.
At fifth degree goiter becomes large, sometimes gigantic sizes.Outside view of the patient's attention is drawn to;people can torture shortness of breath, feeling of heaviness, tightness in the chest, feeling of a foreign body;goiter may interfere with the functioning of blood vessels, nerves and internal organs.
The Russian doctors use the classification given for a long time.However, the most important are the exact dimensions of the prostate, some with the help of ultrasound.Visual inspection is far less important, because this error may occur.The doctor is sometimes difficult to determine the thyroid in young adults and well muscled.At the same time, thin it can be well seen.In addition, the possibility of determining the size of the thyroid gland in each particular patient depends on the structure of the neck, the thickness of the muscle and body fat also plays a role of the thyroid gland in the neck.
Stressing the importance of determining the approximate size of the thyroid gland during the inspection, in 1992 the World Health Organization has proposed a simpler classification of goiter:
0 degree - the thyroid gland is palpated (ie determined by the fingers during the inspection), the size of stakes in size correspond to the last (nail) patient phalanx fingers.
I -degree Sizes shares exceed the size of the last phalanges of the patient's fingers.
II degree, the thyroid gland is palpable and visible.
US is not the first method of examination that the doctor prescribes for each patient.But if the patient showed an increase in body, the doctor usually appoints thyroid ultrasound.Thyroid volume in this case is calculated as follows: it is calculated by measuring the size of each three major thyroid lobe.First, calculate the amount of each share individually by the formula:
share volume = length x width x thickness x 0.479.
Before that measures the size of each lobe of the thyroid gland (length, width and thickness), the size of the isthmus is not attached diagnostically important.After that, the calculation of the volume fractions add up with each other and get the value of the entire volume of the thyroid gland.
believed that women thyroid volume shall not exceed 18 ml and for men - 25 ml.Anything more than that, -increase the thyroid gland, or goiter.Children gland sizes are determined by the special tables.
With varying degrees of thyroid enlargement of its functions can not be changed (this condition is called euthyroid goiter, or euthyroid), reduced (this is called hypothyroidism) or increased (in this case, the functional state of the thyroid gland is characterized as hyperthyroidism).Level gland functions dependent on its level of hormones more hormones released into the blood, the above function.
1. Medical examination.The doctor examines not only the patient but also clarifies the nature of his complaint, finds out when they were first introduced, increased or decreased over time.After inspection and conversation with the patient doctor makes a diagnosis and to appoint the necessary tests or refer patients to the hospital for examination.
2. Complete blood count.
3. General analysis of urine, both of these studies relate to the so-called "mandatory diagnostic mimimum" that the doctor usually appoints all patients.
4. Determination of basal metabolic rate.The main exchange is the energy level, which is necessary for the body to sustain life in peace and quiet after a 12-hour fast.The method is based on determining the oxygen consumption and carbon dioxide emissions for a certain period of time.Then the body's energy costs are calculated in kilocalories per day.Research carried out by means of special devices, so-called "metabolimeter".This takes into account specific parameters of tables that are composed based on a certain gender, age, body weight and length.The local therapist all these calculations, of course, will not hold.Typically, the basal metabolic rate is determined by a physician, endocrinologist, often under-patient hospitalization in a specialized unit.
5. Determination of blood biochemical parameters (liver enzymes, bilirubin, blood protein, urea, creatinine, and so on. D.).It allows you to detect changes in organs and tissues, which often occur in various thyroid diseases.
6. Determination of blood cholesterol.At elevated thyroid cholesterol level is lowered at a reduced - increased.However, the method is not one hundred percent, because many elderly patients have elevated levels of cholesterol in the blood associated with atherosclerosis, but not with thyroid disease.The method is more informative in children.
7. Determination of the length of the Achilles reflex may serve as an additional method for the evaluation of thyroid function.The method is fairly simple, friendly, affordable.
8. Ultrasound examination of the thyroid gland to determine its size, the magnification, the presence or absence of knots in it, and so on. D.
9. X-ray study also allows you to define the size and the degree of thyroid enlargement.In children, in addition to chest radiographs are often held as X-rays of the hands, allowing you to identify the so-called "bone age": in some diseases of the thyroid gland it can keep up with or ahead of his passport.Bone age reflects the physical development, the growth of which in children can vary for different diseases.
10. Computed tomography and magnetic resonance imaging of the thyroid gland.It can help you determine the position of the thyroid gland, its contours, size, structure, determine the density of nodes.
11. Determination of iodine bound to serum proteins.It characterizes the functional activity of the thyroid gland.
12. Radioimmunological methods for the determination of thyroid hormones.Determined content thyroxine, triiodothyronine, sometimes a more detailed analysis.Highly informative is the definition of thyroid-stimulating hormone in the blood serum.It is now also used this method, as the definition of anti-thyroid antibodies (more about them is written in the "diffuse toxic goiter").
13. The study of the absorption of radioactive iodine by the thyroid gland does not apply everywhere.In children, this method is used only on strict conditions (ie if necessary)!
14. Puncture biopsy of the thyroid gland is that carried out the puncture of the thyroid gland, and then studied its structure under the microscope.
15. Rentgenolimfografiya thyroid - a X-ray associated with the introduction of the thyroid gland contrast media.Typically the oil iodine-containing drug-Lipiodol.
16. Additional methods of research:.. Electrocardiography, electroencephalography, etc. It is worth remembering that not all methods must be used for each patient, and a single, universal method, which with absolute precision would be allowed to determine one or another disease of the thyroid gland,does not exist.The doctor chooses the methods of investigation that are most suitable for the particular patient, taking into account the possibility of a medical institution.
main and most sensitive method for the diagnosis of diseases of the thyroid gland is to determine the level of thyroid stimulating hormone (TSH), T4 and T3 hormones in the blood.Normal
TSH (from different sources, depending on the laboratory and method): 0,2-3,2 mIU / l;0.5-5.5 mIU / L.
Thyroid hormone controls the pituitary thyroid activity.If the concentration is increased, this indicates a decrease in thyroid function.That is, thyroid stimulating hormone, as it were "struggled" is trying to spur its activities.Conversely, at higher thyroid function stimulating hormone "may rest", according to its concentration in the blood is reduced.
case of violation of the thyroid gland is measured as the content of its own hormones in the blood.
Norm: 50-113 ng / ml;5-12% micrograms (mcg 4.11%);65-156 nmol / l (51 - 142 nmol / l) - depending on the method.
Thyroxine T4 - is a form of thyroid hormone;it is formed in the thyroid gland, but does not have much effect on the metabolism.A more active form of the hormone - triiodothyronine (T3).T4 is converted to T3 by the liver.
and T4 and T3 circulate in the blood mainly in a bound state, and hormones are not active in this form.Therefore, the overall level of thyroxine says little about the hormonal activity of the thyroid gland.Thyroxine level changes with the content of carrier proteins and their concentration, in turn, varies with many conditions: pregnancy, medication, for many diseases.
Hormone same thyroid activity is determined by the concentration of free T3 and T4.
Increased total thyroxine concentration in serum notes however with increased thyroid function (hyperthyroidism), sometimes in acute thyroiditis or acromegaly.
Reduction of this parameter occurs when the primary and secondary hypothyroidism (lowered thyroid function), as well as reducing the concentration of thyroxine - binding protein (carrier protein).
OK: 0.8-2.4 ng% (0.01-0.03 nmol / L).
T4 thyroid gland hormone activity depends on the concentration of free T4.
Increased levels of free thyroxine is celebrated in hyperthyroidism (increased thyroid function), sometimes with the active thyroid.
Reducing this figure occurs in hypothyroidism (low thyroid function).
OK: 0.8-2.0 ng / mL.
T3, T4 as it associated with proteins in the blood, so the change in the content of serum proteins affects the total triiodothyronine level as well as at the level of thyroxine.
Norm: 2-4,8 mg%.
TSG - is the main carrier protein for thyroid hormones T3 and T4 in blood plasma.When changing the concentration of the carrier protein and T4, respectively, the concentration changes.Due to this there is the regulation and maintenance of the level of free hormone, which is required for normal body functioning at the moment.
TSH concentration rises during pregnancy, viral hepatitis;sometimes increased concentration of TSH is caused by heredity.In addition, elevated levels of TSH, if a woman takes birth control hormones estrogen or do any drugs.
narcotic drugs and some drugs (eg, clofibrate, methadone) also increase the level of TSH in the blood.
Decrease TSH concentrations indicated in the following diseases and conditions:
Medicines that reduce the level of TSH in the blood - is aspirin and furosemide, anabolic steroids and other steroids at high doses.
antibodies - substances that the immune system produces to fight the antigens.Against a specific antigen are well-defined antibodies, so their presence in the blood leads to the conclusion that with which it is "enemy" fighting body.Sometimes, antibodies formed in the body during illness, remain forever.In other cases - for example, in autoimmune diseases - are identified in the blood of certain antibodies against the body's own antigens, which can be based on an accurate diagnosis.
If you want to confirm the nature of autoimmune thyroid disease, it is used to determine the level in the blood of antibodies to the cells - antithyroid antibodies, or antibodies to thyroglobulin.
Perhaps no field of modern medicine, which would have been applied ultrasound - ultrasound.Ultrasound method is harmless and has no contraindications.According to the results of ultrasound can determine the size and shape of many organs, altered areas and fluid in the pleural or peritoneal cavity, kidney stones and gall bladder.
If you suspect that the majority of diseases thyroid ultrasound is mainly used to determine that the thyroid node is (or is not) cyst.Usually require other, more complex diagnostic methods.
This study is based on the thyroid's ability to capture iodine I131.In normal thyroid function iodine absorption of 6-18% after 2 hours, 8 - 24% after 4 hours and 14-40% after 24 hours.When thyroid function reduced the absorption of radioactive iodine is reduced.You must know that the same results can be, and if the patient is taking medications that contain iodine or bromine or iodine simply oiled skin.The study was conducted through a half or two months after the abolition of such drugs.
scintigraphy - thyroid scan using radioactive iodine or technetium.