Examination of the thyroid gland
What pathologies of the thyroid gland are most common, and what methods of organ examination are used?You will find answers to these questions in this article.Table of contents:
What is the thyroid gland, and what are its functions?Recommended to read:
The thyroid gland is one of the most important organs of the endocrine system.It is the main depot of such a vital element as iodine.The thyroid gland synthesizes iodine-containing hormones - iodothyronines.They take a direct part in the regulation of metabolism and the growth process of individual cellular elements.In iron, triiodothyronine( T3) and thyroxine( T4) are also produced.The listed hormones are formed in thyrocytes - the follicular cells of the gland.In parafollicular cells, the peptide hormone calcitonin is synthesized.Its function is to protect the bone tissue by incorporating into it phosphorus and calcium compounds.
Note: calcitonin prevents the formation of osteoclasts, the activation of which can cause bone destruction.
Anatomically, this gland is located in the person in the neck area in front of the trachea, under the larynx.Visually it has the form of a butterfly.
Thyroid pathologies can be accompanied by an unchanged endocrine function, but are more often associated with a lowered level of hormones( hypothyroidism) or elevated( thyrotoxicosis, hyperthyroidism).
In several areas of our country and other countries there are areas where a critical amount of iodine is contained in drinking water.In such regions, a pathology such as endemic goiter is often observed.
Note: a pronounced iodine deficiency in some cases leads to the development of cretinism.
A comprehensive thyroid study involves an evaluation of its functional activity and structure.
Evaluation of the structure of the
The structure of the thyroid gland, as well as the presence or absence of neoplasms adjacent to the organ, is evaluated by ultrasound scanning.
Direct indications for the conduct of ultrasound are:
- ongoing treatment for organ cancers;
- presence of palpable nodular formations during examination;
- diagnosed thyrotoxicosis.
Important: is considered to be a palpable local formation, the size of which exceeds 10 mm.
Functional activity research
The most innovative and informative method for research of functional status is scintigraphy.
Note: scintigraphy is a technique that involves functional visualization of tissues.During the diagnostic procedure, radioactive isotopes are introduced into the patient's body.The image is formed due to the radiation, the source of which is these isotopes.
The main indications for scintigraphy of the thyroid gland:
- Suspicion of the so-called."Functional autonomy";
- detection of abnormally located sites( including - in the postoperative period);
- revealing thyrotoxicosis;
- definition of secondary tumor foci( metastasis) in cancer oncological disease.
This diagnostic technique makes it possible to detect the dystopy( abnormal location) of the gland, the presence or absence of nodes, and also to reveal the prevalence of a possible malignant process.
Study of the hormonal backgroundWe recommend to read:
When a doctor suspects dysfunction of the thyroid gland, first of all, the level of thyroid-stimulating hormone is established.If the indices lie within reference values, this indicates that the functional activity of the organ is normal.
Indications for analysis of TSH content:
- probability of thyroid dysfunction;
- high content of prolactin( pituitary hormone);
- gestation period;
- perinatal screening of babies( performed in the maternity hospital before discharge);
- weight change( set of extra pounds);
- cardiac arrhythmia;
- therapy in which the patient receives iodine preparations;
- administration of levothyroxine( for determining the optimal dose);
- anemia( anemia) of undiagnosed genesis;
- edema of unknown origin;
- change in the content of lipid compounds in the blood;
- abnormally high levels of ASAT and ALAT in serum;
- pathological increase in lactate dehydrogenase;
- other changes found during laboratory studies and requiring specification.
What can the level of thyroid stimulating hormone tell?
The material for determining the level of thyroid hormones is the patient's saliva.
Important: reference TSH indices are 0.4-4 μIU / ml, triiodothyronine - 3-8, and thyroxine - 4-11.
If the level of TSH is less than 0.4 μIU / ml, this suggests that the patient has thyrotoxicosis( hyperthyroidism).A low level of thyroid-stimulating hormone requires the establishment of a level of free triiodothyronine and thyroxine.In addition, it is required to detect the presence or absence of antibodies to triiodothyronine receptors.
Changing the hormonal background is an indisputable indication for additional instrumental research - in particular - ultrasound.
The level of the thyroid-stimulating hormone is more than 4.0 μIU / ml, with a high probability of hypothyroidism.The situation requires additional laboratory testing on the level of unconjugated T4 and the presence of antibodies to thyroid peroxidase.
In the absence of pathology, the volume of thyroid gland that adult male is up to 25 cm³, and in women - within 18 cm³.
This endocrine organ has the property of slightly increasing in size during puberty, as well as during pregnancy and during the postmenopause.
Diseases, and pathological conditions in which the specialist is obliged to refer the patient for additional study of this endocrine organ:
- unmotivated mood changes;
- hair loss and eyebrows;
- constantly cold extremities;
- increased fatigue;
- high content of prolactin;Weight gain and obesity;
- autoimmune thyroiditis;
- nodular goiter
- copious monthly;
- memory degradation.
Vladimir Plisov, medical reviewer