THEa thyroid is an endocrine gland placed at the base of the neck that regulates, thanks to its hormones, numerous functions of the metabolism. In Italy they are About 6 million people suffering from thyroid pathologiesespecially women. The most widespread is hypothyroidismor the reduced thyroid function, which it concerns about 5% of the populationwith a greater impact among women. And its prevalence increases with age. But if it is true that, according to research Doxamany people ignore what are the pathologies related to this gland, it is also true that, In many cases, an excess of diagnostics and drug therapy is used Even where it could be done without it. On the occasion of the World thyroid day that occurs on May 25thlet’s find out what there is to do to improve care.
Hypotyroidism vs hyperthyroidism
«When we talk about thyroid, an epidemiological disproportion is observed. About 6 out of 10 patients with thyroid dysfunctions develop hypothyroidismWhile only 1 in 10 presents hyperthyroidismalthough the latter is clinically more evident and potentially serious. In fact, it manifests itself with tachycardia, weight loss not consequent to diet, tremors, sleep disorders. When the clinical picture is serious, it is advisable to intervene pharmacologically. Subclinical hypothyroidismInstead, it represents one of the most controversial areas.
It is characterized by an isolated increase in TSH hormone In the face of normal values of the other thyroid hormones, FT3 and FT4. Often accompanies Nighty symptoms such as tiredness or modest lipid alterations. In some cases, it can be associated with autoimmune conditions, such as celiac disease or rheumatoid arthritis. However, the treatment is still the subject of discussion, since the clinical evidence to support are less solid than other endocrine pathologies “, underlines the Professor Gianluca AimettiPresident of the Sie Italian society endocrinology.
Thyroid: there are no guidelines
“Today Therapeutic decisions are often entrusted to the clinical “feeling”, rather than consolidated guidelines. Unlike pathologies such as diabetes, where, for example, glycated hemoglobin under 7% is a well -defined therapeutic objective, equally strong criteria are lacking in the tycoopathies. In particular, a precise target for TSH and decision -making algorithms based on evidence is missing. This leads to a uneven use of therapies. Also the diagnostic approach to thyroid lump often suffers from excessive medicalization. Most nodules, Especially after the age of 50, it is not malignant and rarely needs needleaspirate. However, the abuse of ultrasounds and inconclusive reports is widespread, with consequent overexposure to unnecessary exams. The thyroid ultrasound should be performed by those who know thyroid pathologies, otherwise they risk generating more doubts than certainties “, warns the expert.
Thyroid and body weight
«Thyroid dysfunctions increase with age, but their incidence grows even in fertile agewhen a high TSH can involve problems of infertility or complications to childbirth. In these cases, the replacement treatment may have a reason, although it is necessary to avoid diagnostic excesses in the absence of symptoms or clinical signs. The introduction of theartificial intelligence and structured collection of clinical data it could offer an important contribution To establish more rational protocols on when, how and with which doses to treat. Finally, it is necessary to demystify the relationship between hypothyroidism and overweight. Many patients present themselves with unrealistic expectations: they believe that the treatment of hypothyroidism can automatically resolve weight gain but it is not so. If the patient is unable to lose weight and has a high TSH, proceed immediately with the therapy, while you should wait and see what happens », concludes Professor Aimetti.
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