Ms. Wang:My daughter is 23 years old and recently found that the root of her neck is a little thick. Do I need to treat it? Dr. Zhang:The thyroid gland is a very important endocrine gland in the human body, located on both sides of the trachea in the neck. This gland secretes thyroxine, which regulates metabolism, promotes growth and development, and maintains the health of the body. The main raw material for the synthesis of thyroxine is iodine. In general, an adult’s daily intake of 100-150 micrograms of iodine is sufficient to ensure the normal needs of the thyroid gland and to produce sufficient amounts of thyroxine. If the supply of iodine in the body is insufficient for a long time, the secretion of thyroxine cannot meet the normal needs of the body, the pituitary gland will secrete a large amount of “thyroid stimulating hormone”, which will lead to compensatory hyperplasia and hypertrophy of the thyroid gland, so that the neck becomes thicker. Adolescent girls are most likely to develop simple goiter. The main reason for this is that when they enter puberty, their body’s need for thyroxine increases, causing a relative lack of iodine in their bodies. An effective way to prevent this disease is to insist on long-term consumption of iodized salt. For those who have already suffered from adolescent goiter, those with mild symptoms can be left untreated. Those with obvious goiter can try levothyroxine under the guidance of a doctor. Adolescents in their adolescence can prevent adolescent goiter if they eat more iodine-rich foods, such as kelp, jellyfish, sea fish, sea shrimp, and nori. I am 42 years old, and two months ago I suddenly found that my neck had become thicker. My husband said that I had a thyroid problem, probably caused by iodine deficiency, and that I should eat more seaweed and seaweed. What are the types of thyroid disorders, what are the symptoms, and how should I treat them? What should I pay attention to in my daily diet? Dr. Zhang:Thyroid disorders mainly include nodular goiter, thyroiditis, hyperthyroidism, hypothyroidism, thyroid tumor and thyroid cancer. Hyperthyroidism and hypothyroidism are the two prevalent thyroid disorders. Hyperthyroidism is the overproduction of thyroid hormones, resulting in rapid metabolism and symptoms such as protruding eyes, rapid heartbeat, fear of heat, excessive sweating, palpitations, anxious temperament, hyperphagia, and weight loss. On the other hand, hypothyroid patients have low secretion of thyroid hormones and slow metabolism, which may cause symptoms such as low energy, memory loss, coldness, swelling, weight gain, dry skin and loss of appetite. Both hyperthyroidism and hypothyroidism may have symptoms of thickening of the neck (goiter), but the treatment principle is the opposite, so a clear diagnosis is crucial. If you have an enlarged thyroid gland or a swollen thyroid gland, you will need further tests to determine the nature of the thyroid disease, such as blood tests to check thyroid function and, if necessary, radionuclide and ultrasound examinations of the thyroid gland, or even thyroid aspiration cytology. It is recommended that you go to the hospital as soon as possible for relevant tests to clarify the diagnosis. If hyperthyroidism is confirmed, you must consume a low iodine diet and forbid iodine-rich diet such as seaweed, seaweed and shellfish, otherwise it will easily aggravate your hyperthyroidism. I’m 33 years old and a nurse in a hospital intensive care unit. I developed hyperthyroidism three years ago and have been taking medication to treat it, but my condition keeps recurring. What are the causes of hyperthyroidism? What factors can trigger hyperthyroidism? What can I do to help my recovery? Dr. Zhang:The development of hyperthyroidism can be summarized as a combination of genetic background, autoimmune and environmental factors. The genetic background is the internal cause of the disease, i.e. there are genetic susceptibility factors involved, i.e. someone in the family has thyroid disease. Environmental factors are more complex. Clinically, we can find many patients with hyperthyroidism have some triggering factors before the onset of the disease, such as mental stimulation, excessive stress, and overworked and stressed work. Infection and trauma are also important triggering factors for hyperthyroidism. Many patients with hyperthyroidism have a history of acute infection or trauma before the onset of the disease. In addition, iodine can also trigger hyperthyroidism. In view of the above causes of hyperthyroidism, it is recommended that you slow down your pace of life, reduce stress, relax and combine work and rest. Hyperthyroidism patients with normal indicators should not stop their medication at will Ms. Li:I am 47 years old, and half a year ago I developed fear of heat, excessive sweating, palpitations, anxious temperament, and wasting, etc. At first I thought it was menopause, but when I went to the hospital, it turned out to be hyperthyroidism. I have been on medication for 3 months now, and when I went to the hospital for a review, all indicators such as T3 and T4 have returned to normal, can I stop taking the medication? Dr. Zhang:Anti-thyroid medication is the basic treatment for hyperthyroidism. The total course of treatment for hyperthyroidism is generally considered to be 1.5-2 years, and can be longer. Nevertheless, the relapse rate is still as high as 50-60%. Although your condition is now under control, you should not stop taking your medication blindly and should adjust the dosage under the guidance of your doctor. It is important to remind that patients with hyperthyroidism should go to the hospital for a review every 1-2 months after the indexes have returned to normal, and then reduce the dosage of medication under the guidance of the doctor according to the condition. Stopping the medication without permission will lead to recurrence of the disease, while not adjusting the dosage under the guidance of the doctor will probably turn hyperthyroidism into hypothyroidism. Hypothyroidism in pregnant women can lead to impaired fetal mental development Ms. Lin: I’m 28 years old and was found to have hypothyroidism during a medical checkup last year and have been taking medication to control it as prescribed. Recently, I went to the hospital for a review and all indicators have basically returned to normal. Can I get pregnant now? Dr. Zhang:If all your indicators are back to normal, you should be able to get pregnant, but you should check your thyroid function regularly according to your doctor’s prescription. The probability of miscarriage and fetal mortality in late pregnancy are greatly increased when hypothyroidism patients are in pregnancy, and it is very likely to lead to impaired mental development and growth disorders in newborns. Ms. Kang: I am 32 years old and I had my right thyroid nodule removed in 2004, and now I have a 4cm nodule on my left side. I am planning to have a baby, I don’t know if I can get pregnant now. Dr. Zhang:Generally, nodules of 3cm or more are not very effective with medication, so surgery is the best option. You can go to the hospital for further examination. If you are planning to get pregnant, it is better to choose after the surgery. This is because nodules may cause hypothyroidism after surgery, and hypothyroidism has a very negative effect on the fetus. You can take alternative medication for hypothyroidism after surgery and wait until you reach normal markers before getting pregnant. One in six women may suffer from hypothyroidism. Women over 35 years old should pay close attention to the thyroid gland. It influences the body’s energy metabolism by secreting the right amount of thyroid hormones. Thyroid disorders are the second most common disease in the endocrine field. Among the thyroid disorders, hypothyroidism and hyperthyroidism are the most common. The symptoms of hyperthyroidism are more obvious, such as protruding eyes, staring, rapid heartbeat, abnormal weight loss and hair loss, and are well known by people, while hypothyroidism is more harmful to the health of patients because of the hidden nature of the symptoms. According to statistics, there are more than 50 million patients with primary thyroid disease in China, and as many as 40 million of them are primary hypothyroid patients. However, due to the low public awareness of thyroid disease, only 5% of people receive formal treatment for it. Women are more likely to have thyroid disease than men, and it is more common in women after pregnancy and childbirth. One in six women in the population is likely to develop hypothyroidism. The high risk group for hypothyroidism is the group of women over the age of 35. Since the initial stage of hypothyroidism may start with some mild symptoms, it makes women gradually suffer from mental depression and body dysfunction, and even causes women of childbearing age to be unable to have normal pregnancy and childbirth. At this stage, if not detected and treated, hypothyroidism can eventually lead to myocardial infarction, a greatly increased risk of fluid failure in the heart, kidneys and other organs, and even cognitive impairment in old age. When hypothyroidism occurs in pregnant women, it can lead to disorders of fetal brain development and increase the risk of premature birth, stillbirth, growth disorders, and placental abruption. Therefore, it is very important to test for normal thyroid function before preparing for pregnancy.