The human body's micro-engine - the thyroid gland, various aspects of thyroid diseases

Thyroid cancer is the most common thyroid malignant tumor in clinical practice, and ranks third in cancer incidence among women. According to relevant statistics, the average incidence of thyroid cancer in my country is 11.44/100,000. In recent years, the incidence of thyroid cancer has increased dramatically, with an average annual increase of about 5.92%, and is gradually becoming younger. Benign and malignant thyroid nodules are relatively hidden, and their diagnosis and treatment are difficult, which can easily lead to misdiagnosis and delay treatment of patients.

What are the causes of high incidence of thyroid cancer?

With the addition of iodized salt, iodine deficiency-related diseases have decreased. The spectrum of thyroid diseases in my country is also changing, just like in other countries. The incidence of thyroid cancer in the population is on the rise. Domestic and foreign scholars believe that there are two reasons for this:

On the one hand, the increased incidence of thyroid cancer is related to changes in diet, ionizing radiation, environment, lifestyle, mental stress, and other factors;

On the other hand, the rates of medical consultation and health examinations among the public have increased significantly, especially the widespread application of high-resolution B-ultrasound and fine needle aspiration cytology diagnostic techniques, which have greatly improved the early diagnosis rate of thyroid cancer.

South Korea launched a national cancer screening program at the end of the last century, incorporating thyroid cancer screening into medical insurance coverage. This has caused the incidence of thyroid cancer to become the leading cancer among women, a prominent example of clinical over-examination and over-diagnosis.

How to supplement iodine for patients with thyroid disease

The Chinese Medical Association's Endemic Diseases Branch, the Chinese Nutrition Society, and the Chinese Medical Association's Endocrinology Branch jointly released the "Guidelines for Iodine Supplementation for Chinese Residents", which states:

Hyperthyroidism: Iodine intake should be limited, and iodine-rich foods (including iodized salt) and iodine-rich drugs should be avoided as much as possible.

Hypothyroidism (Hypothyroidism): Causes of hypothyroidism include autoimmune damage, surgical removal of the thyroid gland, radioactive iodine destruction, external irradiation, iodine deficiency or iodine excess. If hypothyroidism is caused by complete removal or complete destruction of the thyroid gland, the patient needs to receive thyroid hormone replacement therapy. Therefore, whether or not to eat iodized salt has no effect on the thyroid gland. If the thyroid lobe is removed or there is still residual thyroid tissue, a normal iodine diet can be used, including eating iodized salt. For hypothyroidism caused by iodine deficiency, eating iodized salt is the most effective method. Hypothyroidism caused by iodine excess is usually mild, and subclinical hypothyroidism is common. At this time, it is necessary to find the cause of iodine excess and limit iodine intake, such as avoiding drinking high-iodine water or eating too much iodine-rich food.

Autoimmune thyroiditis: If the patient's thyroid function is normal, it is recommended to limit iodine appropriately. Iodized salt can be consumed, and the intake of iodine-rich foods such as kelp, seaweed, and seaweed should be limited.

Thyroid nodules: Most of them have unknown causes. They are more common in women and the elderly, and can be benign or malignant. Excessive or insufficient iodine intake can increase the incidence of thyroid nodules. It is recommended to have an iodine-appropriate diet (including not consuming too much salt). If the thyroid nodules have autonomous functions and are accompanied by hyperthyroidism, iodine intake needs to be limited. Patients with thyroid cancer can generally have a normal iodine diet. If radioactive iodine ablation or lesion removal is performed after surgery, a low-iodine diet is required before treatment. Thyroid disease during pregnancy: Patients must take in enough iodine to supply themselves and the fetus with iodine nutrition. Otherwise, it is easy to cause iodine deficiency in the fetus. Eating iodized salt is the best way.

Thyroid nodules (TN), whose prevalence has been increasing recently

Thyroid nodules are a common disease in clinical practice, mainly benign nodules, with malignant thyroid nodules accounting for about 5%. There are generally two types of thyroid nodules: single nodules and multiple nodules. The incidence of multiple nodules is higher, but single nodules are more likely to cause thyroid cancer in patients. However, with the improvement of my country's physical examination system and the enhancement of health awareness, the clinical detection rate of thyroid nodules has greatly increased compared with the past. Conventional ultrasound examination is convenient and relatively inexpensive. It is currently an important clinical imaging examination method, but its application has certain limitations and is not ideal in terms of detection accuracy.

Thyroid nodules are related to autoimmunity, genetics, metabolism, iodine intake and other factors, and are closely related to gender and age. Studies have found that as BMI increases, the detection rate of TN also gradually increases. The detection rate of TN in people with central obesity is higher than that in people with non-central obesity. Li Fang and other scholars believe that the probability of TN in diabetic patients is much higher than that in the normal population.

Ultrasound-guided fine needle aspiration is widely used in the examination of various diseases. It also has obvious advantages in the early diagnosis of benign and malignant thyroid nodules and has high diagnostic value. However, it requires good slide preparation technology for auxiliary detection in clinical testing. Liquid-based cytology technology has the characteristics of easy operation and little external interference, which can further improve the accuracy of thyroid nodule examination.

Clinical symptoms of thyroid nodules

The main symptoms are:

First, we may experience some changes in our diet. We may eat very much and very fast, or we may eat very little and feel bloated after eating a little. Second, our mood may change. Sometimes we may feel upset, irritable, or depressed. Third, we may not be able to concentrate and easily forget things. We may be confused and careless. Fourth, we may suddenly lose weight or gradually gain weight. Fifth, we may feel upset, with hot palms and soles, dry mouth, thirst, and sweating. Sometimes, we may slowly gain weight and become afraid of cold limbs and feel particularly weak. Sixth, we may have trouble sleeping, have difficulty falling asleep, have many dreams, and feel nervous and scared. Seventh, we may sweat sometimes. Sweat may be irregular and a lot, indicating that your thyroid nodules are relatively large. If you experience the above situation, we can go to the hospital for a three-dimensional or four-dimensional color ultrasound of the thyroid gland to see what diseases the thyroid gland has. Generally, thyroid diseases are mostly benign. If the nodule is low-echoic, with regular margins, or is cystic, the shape is also regular, and the total ratio is also less than 3.3, then it is generally benign. If the nodule has an aspect ratio greater than 1, the margins are very irregular and paginated, and the shape is also abnormal, then you must remember to consult a specialist, or even do a puncture and pathology.

Don't be afraid if these situations occur. Now we have a complete treatment plan for thyroid. If it is malignant, we can completely adopt surgical treatment. If it is benign, we can adopt Chinese medicine treatment. During the treatment process, we must advocate the following points: First of all, we must get enough sleep.

Smoking can cause thyroid dysfunction and induce many thyroid diseases. Data surveys have found that smokers have a higher risk of thyroid disease. Pregnant women with autoimmune thyroiditis and hypothyroidism should also monitor their thyroid function regularly and adjust their levothyroxine dose in a timely manner.

Patients with hyperthyroidism and low-iodine diet before pregnancy should consume iodized salt at least 3 months before the planned pregnancy to ensure adequate iodine reserves during pregnancy. Patients with hyperthyroidism during pregnancy should also take enough iodine, monitor thyroid function regularly, and adjust the dose of antithyroid drugs in time. During pregnancy, the pros and cons should be weighed, and diagnostic measures and therapeutic drugs that will expose patients to high-iodine environments should be carefully selected.

To sum up, there are many factors that cause thyroid diseases, and it is necessary to improve the public's awareness of thyroid diseases so that corresponding preventive measures can be taken to reduce the incidence of thyroid diseases and prevent the occurrence of the disease.