Check thyroid values in case of arrhythmia and unfulfilled desire to have children
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Such a small organ and so many influences on vital metabolic processes – what are the most common disorders of the thyroid gland?
Thyroid disorders are among the most common – one in three adults will develop a thyroid disorder during their lifetime. One in four suffers from an enlarged thyroid gland or lumps of tissue. One in ten suffers from Hashimoto’s thyroiditis, a permanent inflammation of the thyroid gland. Dr. Franz Christoph Rüpeler, Chief Medical Officer, and Dr. Josephine Meister, Chief Physician at the Nuclear Medicine Clinic at the Central Clinic Bad Berka, on modern diagnostic options.
Such a small organ and so many influences on vital metabolic processes – what are the most common disorders of the thyroid gland?
Rubellar: Fortunately, it is the most common benign disease. Goiter with or without mass is generally known. Without a node, this change is called a diffuse stroma, with a nodular goiter. Germany is an iodine-deficient region, unlike Switzerland or the northern European countries. Goiter, that is, an enlarged thyroid gland, is the most common thyroid disease among people over 60 years of age. Goiters as well as normal-sized thyroid glands can have cold nodules. There is a risk that thyroid cancer will develop or already be present. Hot nodes are usually associated with an overproduction of thyroid hormones, with a similar acceleration of metabolic processes. There is also diffuse independence of the thyroid gland – autoimmune Graves’ disease is known as a cause of diffuse independence. There are many infections that affect the thyroid gland (thyroiditis), and these are often autoimmune.
Thyroid cancers have become somewhat more common in recent years: 6 new cases per 100,000 population in men and 11 new cases in women per 100,000 population. Most thyroid cancers differentiate well and have a good prognosis.
Women are affected more than men by lack of function, but children can suffer from it, too – how can you tell?
Master: shortcomings have different sides in children. It is important to note family history and consider a specific genetic predisposition to thyroid disorders. The second topic is the situation during pregnancy and immediately after birth. Thanks to current health care, it is possible to detect abnormalities early in U scans, for example B. If there are developmental delays. In addition, determining the TSH value is part of the newborn screening, so that thyroid dysfunction can be detected at an early stage and appropriate action can be taken. Even with young people who are obese, for example, you should look for clues and, if necessary, monitor the thyroid gland for possible impairment of its function. In general, children and adults differ in many respects, for example with respect to symptoms, but also, for example, with respect to chemical laboratory reference values. For example, the reference value of TSH in children is different from that in adults. As with all patients, it is also important to have a good medical history. Parents who are concerned about the presence of thyroid disease in their children should definitely raise this with their peers in pediatrics.
Medications can help treat hyperthyroidism – when is surgery necessary, and when is radioactive iodine therapy an option?
Robiller: in the case of hyperfunction, for example in the case of diffuse independence, the symptoms are very stressful for the patient: nervousness, weight loss, sweating, and in older patients there is a risk of osteoporosis. You have to weigh when surgery is appropriate and when radioactive iodine treatment makes sense. There are of course advantages and disadvantages. During thyroid surgery, the vocal cord nerve can become injured, resulting in hoarseness with unilateral paralysis. In well-equipped specialized centres, such as the Central Clinic in Bad Berka, such interventions are almost always carried out using intraoperative neuromonitoring to prevent this from happening. Radioactive iodine therapy is indicated for older patients or in general for patients with surgical risks and small thyroid glands. It is always important for us to discuss options in detail with patients.
Singers, moderators, teachers, that is, everyone who works with their voices, have reservations about such operations …
MSc: It is a decision that has to be made with the patient and in a multidisciplinary manner. This assumes that those affected also know the advantages and disadvantages. Of course, a quick result cannot be expected after radioactive iodine treatment, the main effect of which develops only after about six to eight weeks. You should order surgery in individual cases, for example in life-threatening situations. For example, if severe arrhythmias are due to hyperfunction, urgent action is definitely required. As with many other decisions in medicine, it is important that patients are well informed about possible therapeutic measures and can make a decision on an equal footing with physicians.
Was it said that you should eat a lot of fish?
Robiller: Exactly! Sea fish is good, but the resources are limited. You can improve your supply of iodide tablets, especially in case of iodine deficiency and a tendency to goiter. But it will be important to consult your family doctor and have your TSH level checked. An ultrasound of the thyroid gland should probably be done.
What are the symptoms that you should see a doctor for?
Robiller: If you experience unexplained weight gain, lethargy, fatigue, hair loss, and edema, these symptoms indicate an underactive thyroid. Hyperfunction leads to inexplicable weight loss, nervousness, profuse sweating, insomnia, and hair loss. You should then go to the doctor and determine the TSH value.
Meister: Thyroid scans are particularly useful for patients with arrhythmias, especially atrial fibrillation. An overactive thyroid can lead to an irregular heartbeat. You should also keep an eye on your thyroid values if you don’t want to have children, and fortunately, many gynecologists are already well-versed in this regard.
Interview: Anki Geyer