The thyroid is a small gland, with a very big job. It is located below the skin and muscles at the front of your neck. Thomas O'Dorisio, MD, a professor and endocrinologist with University of Iowa Hospitals and Clinics, talks about the thyroid's role in our bodies:
What role does the thyroid play in our general good health every day?
The thyroid is critical in maintaining the proper metabolism of virtually all the tissues or our body and major organs, including the heart and muscle. It maintains daily the metabolism, the way we metabolize and burn our calories that we take in. It also affects several systems, including blood pressure, heart rate, overall feeling of wellbeing, fatigue, etc. If we're fatigued, it has a major role in regulating and maintaining overall wellbeing.
What is considered thyroid disease?
It's a good question because it entails and involves the thyroid gland which is just above your collar bone in the center of your neck. For the most part in the United States, most of the problems we encounter are due primarily to the thyroid gland. I say this carefully because the regulator of the thyroid--that is the hormone that secretes the thyroid hormones from the thyroid gland--comes from the pituitary. But for the most part, the primary problem is the thyroid gland itself.
The most common problem of that is that the body does not recognize its own tissue--in this case the thyroid gland--it starts to attack it. When that happens, the gland starts to not work and the hormones quit coming out of the thyroid and the pituitary hormone tries to make it work and can cause the gland to enlarge. An enlarged thyroid gland is called a goiter, and it affects women predominantly over men in the United States--as high as 50 to 1 dysfunction of the thyroid gland. I think as well that it's one of the things that over the years (this is a very slow process) contributes to subtle weight gain, because the calories are not handled well when the thyroid gland does not work.
How is thyroid disease detected or diagnosed?
We're very fortunate in the United States. We have very sophisticated blood tests. Almost all of the diagnoses and function of the thyroid gland are made with simple blood tests in the body. These can be done at any time and we're very fortunate because that connection between the pituitary and the thyroid gland, the three hormones if you will, are almost in a moment to moment regulation. It's one of the few feedback pathways, one of the few pathways in the body, which really do reflect the activity of the thyroid gland and the biochemical status and probably the physical status of the person suffering from thyroid disease.
Is thyroid disease in children or teens a more significant problem than in adults?
That's a great question and it is--yes. Because especially in families where the mom or the aunt or a niece may have had thyroid problems. It puts the girl children, especially, at risk for developing subtle low-thyroid conditions in their teen years which then can play on their ability to manage their weight. And I think can lead to weight gain very subtly.
How is thyroid disease treated?
We're very blessed there as well since we have had thyroid preparations that date back almost 50 years. Initially they used to use extracts from pig thyroid and there's still one such extract available, but now we have the very highly pure synthetic forms of the thyroid hormone. The thyroid hormone that the thyroid makes predominately is called thyroxin and in the circulation, it converts to the biologically active hormone.
So you really only have to replace, when the thyroid is not working and doesn't make that hormone, you only have to replace it back with the pill and that then replaces the function of the thyroid gland--by making the biologically active hormone also secreted by the thyroid gland and in circulation.
What happens if thyroid disease is left untreated?
Untreated for the most part, it may go undetected for years, and that's where I think the issues arise. Because when we commonly see them, folks are in their fifth and sixth decade of life and they apologize that their weight has gained due to inactivity or this or that. And then a simple blood test will pick up many times that their thyroid is not working well.
In fact, in earlier times they used to say weight gain is due to a glandular disorder. That's not too far from the truth. The thing that makes it so insidious is that you can live a very long life with low-thyroid function (just below the radar), and have very few side-effects (except for fatigue), and in the extreme state it can lead to some mental problems, mental issues such as depression, because of the feeling of feeling tired all the time. So it can play on the emotions quite often as well.
Is UI Hospitals and Clinics involved in any research with regard to the thyroid? What types of research?
There is actually a remarkable piece of research being done in psychiatry where they're looking at some of the genetics of abnormal regulation more in the pituitary area and the brain. And there is some very scanty literature, but it's also part of this program going on in psychiatry with Dr. Rob Philibert, and he is doing work where--and in light of some of the psychiatric literature--giving a little bit more of the biologically active hormone has worked to help people who are on antidepressants. It makes them work better.
So there's clearly a very important association with the hormone from our thyroid in our bodies in terms of maintaining emotional stability. At the outset I said that thyroid is very important in all tissues of the body. That's a much more difficult one to capture but there is some evidence that does suggest that replacing thyroid hormone, a little bit more thyroid if the gland is not working, may help stabilize emotional swings, which are very common. I mean it's just part of life, as you know. |
