A small organ with a big impact: a look at the thyroid gland

An organ shaped like a butterfly influences our state of mind, our weight, and our sleep pattern. And because the thyroid gland is so small and inconspicuous, most people do not immediately think of it if their hearts are racing, if everyday life becomes overwhelming due to fatigue, or a normal room temperature feels like a heat wave. In many cases, if we feel unwell, the cause is not old age, menopause, or depression — it is the inconspicuous thyroid gland. If it is not functioning correctly, the body’s metabolic balance is disturbed. This has serious consequences for our health and our sense of well-being. However, there are many things we can do to prevent that from happening.

Distributing this kind of preventive information is the focus of International Thyroid Awareness Week, which in 2015 is jointly supported for the seventh time by Merck KGaA, Darmstadt, Germany and the Thyroid Federation International (TFI). The aim of this week of action, commencing with World Thyroid Day on May 25, is to once again focus public attention worldwide on this small organ, located beneath the larynx. “The basic problem is the lack of knowledge about the many effects that a malfunctioning thyroid gland can cause,” explains Bettina Frank, who is managing the information campaign at Merck KGaA, Darmstadt, Germany. “Our goal is to inform people about thyroid problems and their precise effects. People who have these problems suffer for years in their daily lives and despair of a cure, but the right therapy might provide them with a simple approach to a solution.” 

“The thyroid gland is the body’s engine,” explains George Kahaly, chief of the endocrine outpatient clinic at the Gutenberg University Medical Center in Mainz, Germany. “It is important for the metabolism and for burning calories.” As an endocrine organ, it produces the hormones thyroxine (T4) and triiodothyronine (T3), and, for this process, it needs the trace elements iodine and calcitonin. It secretes these messenger substances directly into the blood. For this reason, it is up to 100 times better supplied with blood vessels than, for example, the arm or leg muscles. In addition, it has a small depot in which it stores hormones containing iodine in order to balance out short-term deficiencies.

T3 and T4 are primarily important for regulating the body’s metabolism and its growth and development processes. They are involved in the regeneration of bone mass and the formation of nerves, they influence the processing of carbohydrates, proteins, and fats, and they regulate the physical and mental maturation of a fetus. The tiny thyroid gland is the pace-setter for a broad range of physical processes ranging from the consumption of oxygen in the cells to the regulation of body temperature and the maintenance of emotional well-being. 

According to the World Health Organization, 750 million to a billion people worldwide do not get enough iodine — the element the body needs in order to produce the hormones T3 and T4 — because there is not enough iodine in their food and drinking water. The German Society for Nutrition (DGE) recommends an intake of between 180 and 200 micrograms of iodine per day for adults (somewhat more for pregnant or breast-feeding women) and between 40 and 200 micrograms per day for children and young people. 

In countries like Germany, for example, most adults today consume these amounts daily, thanks to iodized table salt and iodized animal feed. However, iodine deficiency causes many children and young people to suffer from goiter — a pathological enlargement of the thyroid gland. The process is simple: If the individual consumes insufficient iodine over a relatively long period of time, the thyroid gland does not produce enough hormones. In order to compensate for this deficit, the thyroid gland grows pathologically. In some cases, nodules form in the thyroid gland. 

Thyroid cancer and autoimmune diseases can also interfere with the thyroid gland’s production of hormones and cause its dysfunction. Hyperactivity, known medically as hyperthyreosis, produces excessive amounts of T3 and T4 in the body, which force the body into a state of permanent peak performance. “Profuse sweating, restlessness, high blood pressure, and heart disease are the result,” explains Kahaly. By contrast, insufficient amounts of T3 and T4 cause the body to operate at a low gear. 

“In this case, there is too much sugar in the blood because the body is burning too few calories,” Kahaly says. This impaired function, which is known as hypothyreosis, causes fatigue, depression, and lethargy. It is regarded as a risk factor for Alzheimer’s disease. In pregnant women, it can damage the fetus. Both hyperactivity and hypoactivity of the thyroid gland can cause men and women to become infertile. Therefore, if a couple is unable to conceive, physicians should examine both partners’ thyroid function as a possible cause of the problem. Both forms of thyroid gland dysfunction can be treated with medicine as soon as the causes of the condition have been determined.     

“Thyroid problems have become a fairly common complaint,” warns Kahaly. “However, many general practitioners are poorly informed themselves, and the information available to patients is not differentiated enough.” He believes that there is a need for action in this area, and that the awareness-raising campaign is a step in the right direction. Frank agrees. “Patients should also note that their health and their state of mind can be affected by problems of the thyroid gland,” she says. In her experience, the symptoms are ambiguous in far too many cases, and if the symptoms are investigated at all, the search for causes goes in the wrong direction. The awareness-raising campaign aims to change people’s attitudes. In recent years, several hundreds of millions of people worldwide have been reached through brochures for patients and a very informative website (www.thyroidweek.com) in 11 languages. 

• Fatigue
• Sensitivity to cold
• Weight gain
• Depression
• Constipation
• Disturbed menstrual cycles
• Fertility problems
• Painful joints or muscles
• Thin and brittle hair or fingernails
• Scaly skin
• Swollen face, hands, and feet
• Decreased interest in sex (loss of libido)

• Weight loss
• Anxiety and irritability
• Very fast heartbeat
• Trembling hands
• A feeling of weakness
• Hair loss
• Increased digestive activity
• Fast growth of fingernails
• Thin and very smooth skin
• Unusually heavy sweating