9 questions about the thyroid gland

1. What is the function of the thyroid gland?

Thyroid hormones are produced in this gland. These are hormones that regulate metabolism, among other things, and therefore affect almost every organ in the body. The thyroid gland is butterfly-shaped and lies just above the dimple in the neck, draped around the trachea.

2. What could be wrong?

He can work too slow or too fast. If the gland works too slowly (in other words: it produces too few hormones), many organs also go into the ‘slow position’. You notice this through fatigue, being cold, concentration and memory problems, emotional flatness, slow heart rate, dry skin and fragile nails, painful and stiff muscles and joints, weight gain, a hoarse voice and constipation. The medical name for this is hypothyroidism. If the gland works too quickly (hyperthyroidism), too many thyroid hormones are produced. You notice this, for example, in an increased appetite but still lose weight, an accelerated heart rate, excessive sweating, trembling hands and an internal ‘shaky’ feeling, restless sleep, muscle weakness, loose stools, nervousness and impatience, and a feeling of exhaustion. Other abnormalities include an enlarged thyroid gland (also called a goiter or goiter), and some very rare abnormalities. Thyroid cancer also occurs.

3. What causes the thyroid gland to be disrupted?

This is usually due to an autoimmune disease in which the body makes antibodies against the thyroid gland. About 90 percent of patients with an underactive thyroid have Hashimoto’s (autoimmune) disease. Problems with an underactive thyroid can also arise from iodine deficiency, after surgery or radiation to the thyroid gland, or due to thyroid inflammation (after childbirth). The majority of people with an overactive thyroid gland have (autoimmune) Graves’ disease. Medicines containing lithium (used, for example, in severe depression and bipolar disorder) can also speed up the functioning of the thyroid gland, just like a benign tumor. Inflammation does not so much accelerate the functioning of the gland, but results in more hormones entering the blood, which has the same effect as a gland that works too quickly.

4. What can you do to keep the thyroid healthy?

Make sure you get enough iodine. A deficiency can cause the thyroid to work too slowly. Everyone from 9 years old needs 150 micrograms of this mineral per day; pregnant and breastfeeding women slightly more. If you eat six slices of bread a day – from ‘normal’ bread with 1.2 percent baker’s salt – you get enough iodine, according to the Nutrition Center.

If you eat little or no bread at all, you run the risk of an iodine deficiency, according to the RIVM in a report from 2014. The same applies to people who only eat organic bread (often baked with non-iodized salt) and to home bakers who use their homemade bread. breads do not use special baker’s salt but iodized table salt (this contains too little iodine for your daily requirement). Iodine occurs naturally in seaweed, sea fish and eggs. It is added to iodized salt, baker’s salt and some cold cuts. Good to know: sea salt contains hardly any iodine.

5. Does your age affect the thyroid?

The risk of thyroid problems increases with age. But the gland does not necessarily deteriorate as you get older. And if it does function worse, you don’t always notice it.

But… if health problems do arise due to a malfunctioning thyroid gland, they are often less easily recognized at a later age. This is because the symptoms are mistakenly mistaken for age-related ailments. Think of fatigue, palpitations, weaker muscles, gaining weight or forgetfulness. The symptoms are also sometimes mistaken for menopausal symptoms.

6. How do I find out if my thyroid is working properly?

If you recognize the symptoms, even if only slightly, it is wise to visit your doctor and have the functioning of the thyroid gland checked with a blood test. About 3 percent of the Dutch population has an underactive thyroid (510,000 people) and 1 percent has an overactive thyroid (170,000 people). Patients with autoimmune diseases such as celiac disease and type 1 diabetes have an increased risk of thyroid problems. The same is true for people with thyroid disease in the family. Five times more women than men have thyroid problems.

7. Is a malfunctioning thyroid gland dangerous?

In the long run, yes. People with a too slow or too fast thyroid are more likely to develop cardiovascular disease. An underactive thyroid also increases the risk of osteoporosis. The sooner you know your thyroid isn’t working properly, the better. Action can then be taken. This reduces the chance of more serious complaints and health damage.

8. How is an underactive thyroid put back to work?

He is not put ‘back to work’, but the function of the thyroid gland is taken over by a pill containing the hormone levothyroxine. Setting this drug is a precise job; it can take a while before the right dose is found that will eliminate as many complaints as possible. Some patients have to take thyroid tablets for their entire lives. Patients often need a higher dose as they get older. The thyroid gland often works even slower over the years. In addition, some medicines are absorbed more slowly by the body in the elderly.

There are also medicines (for example with lithium) that have the side effect of slowing down the thyroid gland. Sometimes a different medicine can be prescribed that does not have that side effect. If that is not possible or has no effect, levothyroxine is the solution.

9. And how is an overactive thyroid gland calmed down?

Sometimes thyroid inhibitors help to make the complaints disappear. If the problems are caused by Graves’ disease, the doctor often chooses to completely shut down the thyroid gland with thyroid inhibitors, and let the hormone levothyroxine take over the thyroid function. The treatment is not always lifelong. In 70 to 80 percent of cases, the problems do not return if the patient is treated with medication for a year and then stopped (under doctor’s supervision of course). Sometimes surgery offers a solution, especially in the case of a greatly enlarged thyroid gland. Another treatment is a ‘radioactive sip’ containing radioactive iodine. That sounds creepy, but it isn’t: the radioactive dose is so low that it’s completely safe. This often works well, especially if the thyroid gland is working too fast due to a goiter. There is a chance that after one to a number of years the thyroid gland will work too slowly.