Latest news with #Thyroid-StimulatingHormone
Los Angeles Times
14 hours ago
- Health
- Los Angeles Times
Why Do We Get Goiters? Causes Go Beyond Iodine Deficiency
You see the patient. They have a goiter—an enlarged thyroid. But they live in an iodine-rich country. Eat a good diet. Their labs are normal. So why the swelling? For years, the answer we gave was simple. Too simple. Iodine [1] [2] [3]. Or a lack of it. The thyroid needs iodine to make its hormones. No iodine, the gland gets desperate. It grows bigger, hypertrophies, to try and soak up every last molecule from the blood. A neat story. Except it wasn't the whole truth. We started seeing holes in the theory. Goiters in places with plenty of iodine. People in deficient areas with no goiter at all. The story started to fall apart. Then the U-shaped curve data hit [8]. Too little iodine? Bad. But too much iodine? Also bad. This complicated things. Suddenly, our big public health fix—iodized salt—could actually be part of the problem for some. The thyroid wants what it wants. No more, no less. The mess extends to the gland itself. Goiters aren't all the same. Some are diffuse, a smooth swelling. Others are nodular. Lumpy. For a long time, we figured nodules were just the end stage of that long, desperate growth from iodine deficiency [10]. But that never felt quite right either. By 2001, we were already pointing out that the iodine story just didn't explain the facts on the ground [5]. Something else was at play. That 'something else' turned out to be a mix of things. Genetics, for one. We always suspected it; goiters run in families. But a 2011 genome-wide study gave us the proof [9]. It didn't just hint at a link. It found actual genetic addresses—four of them—tied directly to thyroid size and goiter risk. It's in the code. Some people are just built to have a bigger thyroid. Nothing to do with their diet. Then there's the hormonal engine. Thyroid-Stimulating Hormone, or TSH. It's the signal from the pituitary gland that tells the thyroid to work. When the gland is sluggish for any reason, the pituitary starts yelling. It cranks up TSH. And that constant hormonal shouting is a powerful growth signal [2] [3] [6]. It makes the thyroid swell. It's a key pathway. A final common denominator for a lot of goiters. And you can never, ever talk thyroid without talking about autoimmunity. This is the body attacking itself. In Hashimoto's, the immune system slowly chews up the gland, and the resulting inflammation and repair attempts make it swell. In Graves' disease, the immune system makes an antibody that acts like TSH on steroids, flooring the accelerator and making the whole gland grow [4]. These are huge causes of goiter. And they have nothing to do with iodine. It's a completely different mechanism of disease. So, the simple model is gone. We're left with a more complex, messier, but more accurate picture. A goiter isn't a disease. It's a sign. A physical clue that points to a whole menu of possible problems. We still check nutrition. Iodine is still critical. So are other things like selenium and iron [2] [3]. We don't worry so much about broccoli or cabbage—the so-called goitrogens—unless there's a real iodine deficiency to begin with. We're even questioning old villains like smoking; one big study found no real link in an iodine-rich population [7]. Now, we're even linking nodular goiters to things like metabolic syndrome, tying the thyroid into the body's overall systemic health [6]. What does this change? It changes how we work. We have to be better detectives. A goiter diagnosis is just the start. Is TSH driving this? Is it autoimmune? Is there a family history? Are the nodules suspicious [4]? The management has to fit the cause. For a small, quiet goiter, the right answer is often just to watch it. If it's iodine, we supplement [1] [2]. Sometimes we use thyroid hormone to suppress that TSH shouting. And for the big ones, the ones causing symptoms or cosmetic issues, surgery is still the best tool in the box [4]. The neat and tidy story of goiter is history. It's messy now. It's genetics. It's immunity. It's hormones. The real shift isn't a new pill. It's a change in thinking. It's realizing the enlarged thyroid isn't the problem itself. It's a symptom of a deeper story we have to figure out, one patient at a time. [1] Hughes, K., & Eastman, C. (2012). Goitre - causes, investigation and management. Australian family physician, 41(8), 572–576. [2] Knobel M. (2016). Etiopathology, clinical features, and treatment of diffuse and multinodular nontoxic goiters. Journal of endocrinological investigation, 39(4), 357–373. [3] Medeiros-Neto, G., Camargo, R. Y., & Tomimori, E. K. (2012). Approach to and treatment of goiters. The Medical clinics of North America, 96(2), 351–368. [4] Bible, K. C., Kebebew, E., Brierley, J., Brito, J. P., Cabanillas, M. E., Clark, T. J., Jr, Di Cristofano, A., Foote, R., Giordano, T., Kasperbauer, J., Newbold, K., Nikiforov, Y. E., Randolph, G., Rosenthal, M. S., Sawka, A. M., Shah, M., Shaha, A., Smallridge, R., & Wong-Clark, C. K. (2021). 2021 American Thyroid Association Guidelines for Management of Patients with Anaplastic Thyroid Cancer. Thyroid : official journal of the American Thyroid Association, 31(3), 337–386. [5] Derwahl, M., & Studer, H. (2001). Nodular goiter and goiter nodules: Where iodine deficiency falls short of explaining the facts. Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association, 109(5), 250–260. [6] Yildirim Simsir, I., Cetinkalp, S., & Kabalak, T. (2020). Review of Factors Contributing to Nodular Goiter and Thyroid Carcinoma. Medical principles and practice : international journal of the Kuwait University, Health Science Centre, 29(1), 1–5. [7] Karatoprak, C., Kartal, I., Kayatas, K., Ozdemir, A., Yolbas, S., Meric, K., & Demirtunc, R. (2012). Does smoking affect thyroid gland enlargement and nodule formation in iodine-sufficient regions?. Annales d'endocrinologie, 73(6), 542–545. [8] Yu, X., Fan, C., Shan, Z., Teng, X., Guan, H., Li, Y., Teng, D., Jin, Y., Chong, W., Yang, F., Dai, H., Yu, Y., Li, J., Chen, Y., Zhao, D., Shi, X., Hu, F., Mao, J., Gu, X., Yang, R., … Teng, W. (2008). A five-year follow-up study of goiter and thyroid nodules in three regions with different iodine intakes in China. Journal of endocrinological investigation, 31(3), 243–250. [9] Teumer, A., Rawal, R., Homuth, G., Ernst, F., Heier, M., Evert, M., Dombrowski, F., Völker, U., Nauck, M., Radke, D., Ittermann, T., Biffar, R., Döring, A., Gieger, C., Klopp, N., Wichmann, H. E., Wallaschofski, H., Meisinger, C., & Völzke, H. (2011). Genome-wide association study identifies four genetic loci associated with thyroid volume and goiter risk. American journal of human genetics, 88(5), 664–673. [10] Teumer, A., Rawal, R., Homuth, G., Ernst, F., Heier, M., Evert, M., Dombrowski, F., Völker, U., Nauck, M., Radke, D., Ittermann, T., Biffar, R., Döring, A., Gieger, C., Klopp, N., Wichmann, H. E., Wallaschofski, H., Meisinger, C., & Völzke, H. (2011). Genome-wide association study identifies four genetic loci associated with thyroid volume and goiter risk. American journal of human genetics, 88(5), 664–673.
India.com
25-05-2025
- Health
- India.com
World Thyroid Awareness Day 2025: History, Significance, Symptoms, Diagnosis, And Treatment Options You Should Know
World Thyroid Awareness Day 2025: Every year on May 25, the world observes Thyroid Awareness Day, a crucial initiative to raise awareness about thyroid disorders and the importance of early diagnosis and treatment. Thyroid conditions affect millions globally, yet many cases remain undetected due to vague symptoms that often mimic other health issues. In 2025, this day is more important than ever, given the growing number of people affected by thyroid dysfunction due to stress, lifestyle changes, and environmental triggers. History and Significance World Thyroid Awareness Day was established in 2008 by the European Thyroid Association (ETA) in collaboration with other international thyroid societies. The aim was to promote better understanding of thyroid health, reduce stigma, and emphasise the importance of regular screening, especially in high-risk populations. The thyroid gland, a small butterfly-shaped gland located in the neck, may be small, but its hormonal function regulates metabolism, heart rate, digestion, and overall energy levels. When the thyroid malfunctions, it can result in a wide range of health issues. Common Thyroid Disorders and Symptoms There are primarily two common thyroid disorders: Hypothyroidism – when the thyroid does not produce enough hormones. Symptoms include: 1. Fatigue 2. Weight gain 3. Depression 4. Dry skin 5. Cold intolerance 6. Constipation Hyperthyroidism – when the thyroid produces too much hormone. Symptoms include: 1. Rapid heartbeat 2. Weight loss 3. Nervousness 4. Sweating 5. Tremors 6. Insomnia Goiter, thyroid nodules, and thyroid cancer are also serious conditions linked to thyroid dysfunction. Diagnosis and Testing Diagnosing thyroid disorders typically involves a blood test to measure TSH (Thyroid-Stimulating Hormone) and, if needed, T3 and T4 hormone levels. In cases of suspected nodules or goiter, ultrasound, radioactive iodine uptake tests, or biopsies may be performed. Treatment Options Thyroid diseases are manageable with proper treatment and follow-up care. Options include: 1. For Hypothyroidism: Lifelong hormone replacement therapy (Levothyroxine) 2. For Hyperthyroidism: Anti-thyroid drugs, radioactive iodine therapy, or in some cases, surgery 3. Diet and lifestyle: A balanced iodine-rich diet, regular exercise, and stress management support overall thyroid health. Why Awareness Matters Early detection of thyroid disorders can prevent complications such as infertility, heart disease, and cognitive decline. World Thyroid Awareness Day is a reminder for individuals to prioritise regular health checkups, listen to their bodies, and seek expert care when symptoms appear. In 2025, let's commit to making thyroid health a priority—not just for ourselves, but for our loved ones and communities. (This article is meant for informational purposes only and must not be considered a substitute for advice provided by qualified medical professionals.)
News18
22-05-2025
- Health
- News18
The Connection Between PCOS and Thyroid Disorders
Last Updated: PCOS is a hormonal imbalance that can lead to frustrating symptoms like irregular periods, unwanted hair growth, acne, and sometimes challenges with conception. Ever feel like your body's playing a confusing game with your hormones? If you're experiencing symptoms like irregular periods, persistent acne, increased body hair growth, or difficulty conceiving, you could be dealing with a hormonal imbalance like Polycystic Ovary Syndrome (PCOS) and thyroid dysfunction, which are common partners-in-crime for many women. To get the correct diagnosis, it's important to understand how these conditions are connected. Dr. Pramila Kalra, HOD & Consultant, Department of Endocrinology, Ramaiah Memorial Hospital, shares all you need to know: How PCOS and Thyroid Disorders Are Linked PCOS is a hormonal imbalance that can lead to frustrating symptoms like irregular periods, unwanted hair growth (often on the face or chest), acne, and sometimes challenges with conception. Thyroid disorders, especially an underactive thyroid (hypothyroidism), are often caused by autoimmune conditions like Hashimoto's thyroiditis — where antibodies attack the thyroid — a condition more common in women. If you have PCOS, you're significantly more likely to also have a thyroid issue. Sometimes, this thyroid issue can be subclinical, meaning it's a mild impairment that may not present typical symptoms but still interferes with hormonal balance. An underactive thyroid can throw off the hormones that regulate your ovaries. When your thyroid isn't functioning properly, your body may produce more Thyroid-Stimulating Hormone (TSH) and another hormone called prolactin. This disrupts the delicate balance of Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH) — crucial players in your monthly cycle. When this balance is disturbed, ovulation can stop, and ovarian cysts (a hallmark of PCOS) may form or worsen. Insulin resistance — where the body's cells don't respond effectively to insulin — is a common feature of both PCOS and hypothyroidism. When both conditions coexist, the level of insulin resistance and dyslipidemia (such as elevated cholesterol) is often greater than in PCOS alone. Thyroid hormone replacement therapy for hypothyroidism has been shown to improve insulin sensitivity and correct other metabolic disturbances in patients with concurrent PCOS. If you're juggling both PCOS and hypothyroidism, you may face a tougher battle with insulin resistance and notice higher cholesterol levels. Treating hypothyroidism with thyroid hormone replacement can help improve your body's insulin response and ease other metabolic abnormalities. Why a Thorough Check-Up Is Crucial Given the symptomatic overlap between PCOS and thyroid disorders — such as menstrual irregularities and ovarian cysts — thyroid function assessment is a critical step before confirming a PCOS diagnosis. Diagnostic investigations typically include blood hormone level analysis (including thyroid hormones), serum testosterone, DHEAS levels, and ultrasonography of the ovaries and thyroid gland. Accurate differentiation and diagnosis are essential to ensure women receive appropriate and targeted treatment for all coexisting conditions. Before a PCOS diagnosis is confirmed, a thorough thyroid function check (usually a simple blood test) is essential. Additionally, evaluating other hormone levels is important to rule out disorders that may mimic PCOS. First Published: May 22, 2025, 16:26 IST
