What is the thyroid gland? Where is the thyroid gland? What can go wrong with the thyroid gland? What are the effects on people when things go wrong? How do I deal with these problems? Should I eat more or less iodine-containing foods if I have a problem with my thyroid? These are some of the questions that my patients often ask me. The thyroid gland is the largest endocrine gland in the body. It is like a beautiful butterfly, attached to the body below the laryngeal nodes and below the front of the trachea. It produces, stores and secretes thyroid hormones and regulates the body’s metabolism to maintain the normal physiological activities of tissues and organs. It has been likened to the engine of the human body. The thyroid gland is normally invisible and cannot be touched, but when pathology occurs, the thyroid gland in most cases appears diffusely or nodularly enlarged. The thyroid gland is the most blood-rich organ in the body, and blood flow through the thyroid gland can increase 100-fold in hyperthyroidism. The doctor may palpate tremors in the upper pole of the patient’s thyroid gland and auscultate a vascular continuity blowing murmur. Thyroid disorders are a group of relatively common endocrine diseases, mainly including hyperthyroidism, hypothyroidism, thyroid nodules, and thyroid cancer. For example, the American Thyroid Association recommends that adults should have their thyroid function checked from the age of 35 and reviewed every 5 years; the American Association of Clinical Endocrinologists recommends that women of childbearing age should have their TSH tested before conception or during the first 3 months of pregnancy; the American College of Physicians recommends that women over the age of 50 who have 1 or more conditions that can be The American College of Physicians recommends that women over the age of 50 should have their thyroid function checked if they have one or more systemic symptoms attributable to thyroid disease. In China, thyroid disorders are also receiving increasing attention. The March 2011 earthquake and nuclear leak in Japan led to concern about iodized salt, resulting in a “salt panic” in some areas, which shows how closely iodine is related to the human body. Iodine is necessary for the synthesis of thyroid hormones, which are taken up by the epithelial cells of the thyroid gland after entering the body and are concentrated in the thyroid gland for synthesis into thyroid hormones. Both iodine deficiency and iodine excess can lead to thyroid disorders, such as an increase in the incidence of simple (endemic) goiter and cretinism when iodine deficiency is present, and an increase in the incidence of thyroiditis and thyroid nodules when iodine excess is present. The normal human body’s iodine requirement also varies depending on the age group. So, how do you know if you have a thyroid disorder? If you have any of the following symptoms, you may have hyperthyroidism: nervousness, irritability and insomnia, palpitations, tachycardia, arrhythmia, fatigue, fear of heat, excessive sweating, weight loss, hyperphagia, increased stool frequency or diarrhea, periodic paralysis (in men), scanty menstruation in women, diffuse or nodular enlargement of the thyroid gland, proptosis, and anterior tibial mucinous edema. It is a group of clinical syndromes caused by excessive production and secretion of thyroid hormones by the thyroid gland, referred to as hyperthyroidism. The most common type is Graves’ disease. The causes of hyperthyroidism are different and the treatment varies. Your endocrinologist will advise you whether to combine Chinese and Western medicine with medication or 131I radiation therapy or surgery depending on your overall condition. Untreated hyperthyroidism can lead to cardiac arrhythmia (irregular rhythm of heart muscle contraction) and even heart attack. In addition, hyperthyroidism increases the risk of osteoporosis (loss of bone mass and increased likelihood of fractures), especially in postmenopausal women. Hyperthyroidism during pregnancy can lead to miscarriage, fetal growth retardation in utero, premature birth and hyperthyroid crisis (a significant increase in thyroid hormones in the blood to dangerous levels). You may have hypothyroidism if you have any of the following symptoms: fatigue, coldness, slowness of movement, slowness of speech, constipation, weight gain, or bradycardia. These manifestations are the result of a generalized hypometabolic syndrome, or hypothyroidism, caused by a decrease in the synthesis and secretion of thyroid hormones or insufficient tissue utilization. Hypothyroidism, which affects approximately 5% of women who become pregnant, increases the risk of preterm delivery. Hypothyroidism can also cause the placenta to detach from the uterine wall before delivery of the fetus (placental abruption), a very serious complication that can threaten the life of both mother and fetus. The most worrying aspect of hypothyroidism during pregnancy is that it can cause impaired mental and growth development in the offspring. Depending on the cause of hypothyroidism, the treatment varies, with some patients requiring lifelong thyroid hormone supplementation. Some patients require lifelong thyroid hormone supplementation. If the hormone dose is appropriate, it will not affect the health of the body. Complications of long-term untreated hypothyroidism can be serious and include slow heart rate and even coma, elevated systolic blood pressure and increased blood cholesterol levels (both of which are risk factors for atherosclerosis and heart disease), infertility and Alzheimer’s disease (which is an increased risk for women). How do you detect a thyroid nodule? Here I will teach you a simple method: take a sip of water, face the mirror, raise your head gently and make a swallowing motion. If there is a nodule in the thyroid, it will move up and down with the swallowing motion. Of course, thyroid ultrasonography is the most sensitive method. The vast majority of thyroid nodules are benign, with malignancy accounting for only about 5%. The most important clinical aspect is to identify benign and malignant nodules. The following are risk factors for malignant thyroid nodules: history of head and neck radiation, age <20>45 years, bilateral thyroid nodules, large thyroid nodules (>4 cm), new or enlarged neck masses, family history of thyroid cancer or multiple endocrine adenoma (MEN)-2 in men, vocal cord paralysis, hoarseness, fixed nodules that are not easily separated from surrounding tissue, invasion of the extrathyroidal gland, suspicious lymph node involvement, iodine deficiency (follicular adenoma). iodine deficiency (follicular thyroid cancer). In case of malignant thyroid nodules, early surgery is recommended. After surgery, radioactive iodine therapy for residual lesion removal and sodium thyroxine suppression for 10 years or more, whole body scans and thyroglobulin (Tg) tests within 1 year are recommended. Since the thyroid gland is so important, we must do a good job of thyroid health care for a healthier life: 1. Pay regular attention to your thyroid gland by performing simple self-tests; people with a family history of thyroid disease and women preparing for pregnancy should go to the hospital for regular TSH and ultrasound checks; 2. Pay attention to iodine intake: patients with hyperthyroidism should have a low iodine diet and women during pregnancy should increase their iodine intake appropriately; 3. Maintain an optimistic attitude towards work and life; 4. Find the right intervention method: go to a tertiary care hospital for regular check-ups and treatment, and proper treatment will improve your quality of life. 5. Patients with thyroid disorders have different symptoms when often mistaken for other conditions such as pregnancy, menopause or depression. 6. Although symptoms of abnormal thyroid function vary widely and are sometimes misdiagnosed, abnormal thyroid function can actually be diagnosed by a very simple measurement of blood thyroid hormone levels. Physical examination reveals typical signs and can also provide support for a correct diagnosis. 7. There are effective treatments for both hypothyroidism and hyperthyroidism. We hope that the above brief introduction will enhance your understanding of the thyroid gland and thyroid disorders and provide useful assistance for your health.