Please pay attention to thyroid function during physical examination

Author: Huang Guiling

First review: Tai Jing

Final judge: Zhao Yinlong

"Have you lost weight? Are you flustered? Are you in a bad mood?"

"Are your eyelids swollen, you feel tired and cold?"

Maybe there is something wrong with your thyroid function!!!

The busy modern life has brought a great impact on the thyroid gland, and the incidence of hyperthyroidism and hypothyroidism is quietly increasing. Thyroid function testing can detect changes in thyroid function in time to prevent further damage to various organs in the body.

The thyroid gland is the largest endocrine gland in the human body. It is located in the front of the neck and on both sides of the trachea. It is H-shaped and is also known as the "butterfly gland". Although the thyroid gland is a very small gland in our body, it is related to the functions of multiple tissues and organs in the human body. The thyroid gland can regulate the body's material metabolism and energy metabolism, growth and development, central nervous system and other systems, the physiological functions of organs, etc.

The function of the thyroid gland is achieved through the thyroid hormones it secretes. Thyroid hormones are produced in the thyroid gland and released into the blood under the command of thyroid-stimulating hormone secreted by the pituitary gland to start working. Maintaining normal levels of thyroid hormones is very important to ensure the normal functioning of the body.

Thyroid function test is to evaluate the health of the thyroid gland from the perspective of thyroid function. It is different from the morphological diagnosis of the thyroid gland. The size of the thyroid gland and thyroid nodules are evaluated from the morphological aspect. Various thyroid diseases such as thyroiditis, thyroid nodules, and thyroid cancer may or may not be accompanied by changes in thyroid function.

What does thyroid function testing include?

Through a tube of blood, the thyroid hormone level can be detected to understand the functional status of the thyroid gland, referred to as "thyroid function". Thyroid function tests include free triiodothyronine (FT3), free thyroxine (FT4), triiodothyronine (TT3), thyroxine (TT4), thyroid stimulating hormone (TSH), thyroglobulin (TG), thyroglobulin antibody (TGAb), thyroid peroxidase antibody (TPOAb) and thyrotropin receptor antibody (TRAb).

The significance of thyroid function tests

Thyroid hormones (FT3, FT4, T3, T4) are hormones synthesized and secreted by the thyroid gland and have physiological regulatory effects.

Thyroid stimulating hormone (TSH) is secreted by the pituitary gland to regulate thyroid hormones. These five hormones are used to determine hyperthyroidism and hypothyroidism.

Thyroid dysfunction

Hyperthyroidism

Changes in indicators : TSH decreases, TT4, TT3, FT3, FT4 are normal (seen in subclinical hyperthyroidism) or one or more of them increase.

Symptoms: In hyperthyroidism, the secretion of thyroid hormone increases, and symptoms of high metabolism appear in organs throughout the body, such as goiter, exophthalmos, irritability, insomnia, irritability, talkativeness, tachycardia, hyperphagia but significant weight loss, high body temperature, and excessive sweating.

Hypothyroidism

Changes in indicators: TSH increases, TT4, TT3, FT3, FT4 are normal (seen in subclinical hypothyroidism) or one or more of them decrease.

Symptoms: When hypothyroidism occurs, insufficient secretion of thyroid hormones causes symptoms such as fear of cold, less sweating, lower-than-normal body temperature, fatigue and drowsiness, few words and lazy speech, slow movements, decreased intelligence and memory, swollen eyelids, and dull and apathetic expression.

Other indicators of thyroid function tests are also important for the diagnosis of thyroid diseases.

Assessment of thyroid health is important

Thyroglobulin (TG) is a glycoprotein secreted by the thyroid follicular epithelium. It is usually stored in the thyroid follicles and plays a role in synthesizing and storing thyroid hormones. It is a specific protein. It can be secreted in the normal thyroid gland and in thyroid tumors. Therefore, if this indicator is elevated, there is a risk of tumor and further examination is required.

Thyroglobulin antibodies (TGAb) and thyroid peroxidase antibodies (TPOAb) are thyroid autoantibodies. Elevated levels are seen in thyroiditis and autoimmune thyroid disease (Hashimoto's thyroiditis). Studies have reported that elevated TGAb and TPOAb test values ​​can be considered a potential risk factor for thyroid disease in the normal population and should be taken seriously.

Thyrotropin receptor antibody (TRAb) is mainly used to diagnose Graves' hyperthyroidism.

Children need to be alert to insufficient thyroid hormone secretion

Thyroid hormone is an important hormone that promotes the growth, development and maturation of the body. Lack of thyroid hormone during bone growth causes delayed or incomplete epiphyseal closure. Even when the patient reaches adulthood, the bone structure still retains the characteristics of a child. Lack of thyroid hormone in childhood can easily lead to cretinism, which manifests as cerebral dysplasia or hypofunction.

Pregnancy and childbearing need attention to thyroid hormone

Women of childbearing age should ensure that their thyroid hormone levels are within the normal range. Abnormal thyroid function can lead to an increased incidence of adverse pregnancy outcomes such as miscarriage.

Pregnant women should continuously monitor their thyroid hormone levels during prenatal checkups to ensure normal fetal development, avoid abnormal neurological development, and avoid serious adverse outcomes for the pregnant woman and fetus.

The Guidelines for the Prevention and Treatment of Thyroid Diseases during Pregnancy and Childbirth state:

Subclinical hypothyroidism during pregnancy and delivery increases adverse pregnancy outcomes. As TSH levels increase in early pregnancy, the risk of miscarriage gradually increases. If TPOAb or TGAb is positive, the risk of miscarriage increases further.

Subclinical hypothyroidism during pregnancy and delivery may affect the intellectual and motor development of offspring. If subclinical hypothyroidism is effectively treated in early pregnancy, especially before 8 weeks of pregnancy, it can be beneficial in reducing the risk of miscarriage and improving the intelligence of offspring.

Poorly controlled hyperthyroidism during pregnancy and delivery is associated with gestational hypertension, miscarriage, premature birth, low birth weight, intrauterine growth restriction, stillbirth, thyroid crisis, and congestive heart failure.

Relationship between thyroid hormone and metabolic diseases

Hypothyroidism can lead to dyslipidemia, insulin resistance, heart failure and other diseases in the body.

The occurrence of thyroid diseases (hyperthyroidism, hypothyroidism, etc.) can lead to increased uric acid levels.

Diabetes combined with thyroid disease is common in endocrinology, especially in patients with type 1 diabetes who often have chronic lymphocytic thyroiditis (Hashimoto's thyroiditis), which causes hypothyroidism.

The incidence of thyroid disease is increasing year by year, and the public's health awareness should be improved!!!

Factors causing thyroid dysfunction

There are many factors that cause thyroid dysfunction, and we should be careful to avoid them in our daily life.

1. Improper iodine intake, such as iodine deficiency or high-iodine diet.

2. Damage to the thyroid gland caused by environmental factors, such as radiation damage.

3. Irregular life.

4. Anxiety and mental stimulation can change the normal regulation of thyroid function and the body's immune system, inducing the occurrence and aggravation of thyroid diseases.

Regular physical examination of thyroid function can timely detect changes in thyroid function and avoid the harm caused by hyperthyroidism or hypothyroidism to various organs of the body!!!