Weekly Technology Talk丨How is your thyroid?

The thyroid gland is a vital endocrine organ in the human body. The thyroid hormones it secretes are used to regulate the body's metabolism and growth and development. Thyroid disease is a chronic disease that is difficult to identify but highly harmful and needs to be given more attention.

Understanding the thyroid gland

The thyroid gland is the largest endocrine gland in the human body. It is divided into two lobes, with an isthmus in the middle, and is H-shaped or butterfly-shaped. It is located in front of the trachea, on both sides of the larynx, parallel to the 5th, 6th, and 7th cervical vertebrae. It is relatively superficial, only about 1-1.5 cm below the skin. The thyroid hormones it secretes play an important role in regulating body growth and development, promoting body metabolism, and maintaining the functions of various organs throughout the body. It can be seen that the normal thyroid function and thyroid hormone secretion are crucial to the health of the human body.

What is hypothyroidism?

Hypothyroidism, abbreviated as hypothyroidism, is a syndrome of systemic decreased metabolism caused by decreased synthesis and secretion of thyroid hormones or weakened tissue function.

The prevalence of hypothyroidism in my country is 17.8%, of which the prevalence of subclinical hypothyroidism is 16.7% and the prevalence of clinical hypothyroidism is 1.1%. The prevalence in women is higher than that in men, and the prevalence increases with age. The causes of hypothyroidism are complex, with primary hypothyroidism being the most common, accounting for about 99% of all hypothyroidism, of which autoimmunity, thyroid surgery and hyperthyroidism (hyperthyroidism) treatment account for more than 90% of the causes of hypothyroidism.

Serum thyroid-stimulating hormone, total thyroxine, and free thyroxine are the preferred indicators for diagnosing hypothyroidism. The main alternative treatment for hypothyroidism is levothyroxine, which often requires lifelong medication.

The harm and intervention of subclinical hypothyroidism

Subclinical hypothyroidism is an independent risk factor for dyslipidemia, cardiovascular disease, and abnormal fetal brain development during pregnancy, and belongs to the field of endocrine system diseases in clinical medicine. The "Harm and Intervention of Subclinical Hypothyroidism" project, jointly completed by the Provincial Hospital Affiliated to Shandong First Medical University and the First Affiliated Hospital of China Medical University, has carried out more than ten years of clinical and basic research, innovatively proposed the theory that thyroid-stimulating hormone directly regulates lipid metabolism, clarified the key mechanism of subclinical hypothyroidism causing target organ damage, and provided a basis for precise diagnosis and treatment; formulated early intervention strategies for subclinical hypothyroidism, established the diagnosis and screening standards for subclinical hypothyroidism during pregnancy in my country, and reduced missed diagnosis and treatment.

The results won the second prize of the National Science and Technology Progress Award in 2018, and were included in the 2017 edition of China's "Guidelines for the Diagnosis and Treatment of Hypothyroidism in Adults", the 2014 edition of the European Thyroid Association's "Guidelines for the Management of Subclinical Hypothyroidism in Pregnant Women and Children", and the 2017 edition of the American Thyroid Association's "Guidelines for the Diagnosis and Treatment of Thyroid Diseases in Pregnancy and Postpartum" and other guidelines. They have been promoted and applied in more than 200 hospitals across the country, achieving significant social benefits. In 2013, TSH was included in the "National Free Pre-pregnancy Eugenics Health Checkup" project by the National Health and Family Planning Commission, making an important contribution to improving the quality of the population.

Prevention of thyroid disease

The early symptoms of thyroid disease may not be obvious, but there are still some clues that can serve as warnings. If the following situations occur, you should be vigilant and seek medical screening as soon as possible.

1. Possible symptoms of hypothyroidism: weakness, fatigue, sleepiness; always feeling cold; memory loss, depression; weight gain; dry skin, brittle nails; frequent constipation; tight and swollen hands and feet; swollen neck; slow heartbeat; heavy menstrual flow or irregular menstruation in women;

2. Possible symptoms of hyperthyroidism: palpitations, shortness of breath; general fatigue; shaking hands; intolerance to heat, sweating, moist skin; eating more, easy to get hungry; weight loss; increased frequency of bowel movements; irritability; repeated arrhythmias, such as atrial fibrillation, etc.

3. Symptoms of thyroid enlargement: thickening of the neck and cervix; tightness of the collar; difficulty breathing, swallowing, and swelling of the head, face, and upper limbs: caused by the enlarged thyroid gland compressing the trachea, esophagus, and surrounding blood vessels;

4. People who are prone to thyroid disease should go to the hospital for regular check-ups for early diagnosis and treatment. For example, those with a family history of thyroid disease; those over 60 years old; those who have received thyroid radiotherapy; those who have undergone thyroid surgery; those who have had thyroid dysfunction; those with autoimmune diseases such as type 1 diabetes, rheumatic diseases, etc.

(Text: Zhang Yanfang, review expert: Song Yongfeng, President of the Central Hospital Affiliated to Shandong First Medical University)

China Association for Science and Technology Department of Science Popularization

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