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The Thyroid Gland01:23

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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
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Hormones, the biochemical messengers produced by endocrine glands, are pivotal in regulating bodily functions and maintaining homeostasis. Each hormone's balance is crucial; imbalances can lead to significant physiological disruptions. Major hormones include oxytocin, cortisol, epinephrine, estrogen, testosterone, thyroxine, growth hormone, insulin, and glucagon.
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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
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The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
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The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
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Thyroid gland changes in patients with acromegaly.

Emil Natchev1, Silvia Vandeva1, Roussanka Kovatcheva1

  • 1Department of Endocrinology, Medical University, Sofia, Bulgaria.

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|June 20, 2020
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Summary

Acromegaly patients frequently develop thyroid issues, with 87% having goiter. Thyroid volume is linked to active disease and secondary hypothyroidism, necessitating regular ultrasound monitoring.

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Area of Science:

  • Endocrinology
  • Oncology
  • Internal Medicine

Background:

  • Acromegaly, caused by excess growth hormone (GH), is linked to increased cancer risk.
  • Thyroid abnormalities, including goiter and carcinoma, are reported in acromegaly patients.

Purpose of the Study:

  • To determine the prevalence of thyroid dysfunction and goiter in acromegaly patients.
  • To investigate the relationship between thyroid issues, disease activity, duration, and secondary hypothyroidism.

Main Methods:

  • A cross-sectional study included 146 acromegaly patients (2008-2012).
  • Evaluated acromegaly activity, thyroid function, and performed thyroid ultrasonography for volume and nodule detection.

Main Results:

  • Thyroid dysfunction affected 39% of patients; goiter was present in 87% (17.1% diffuse, 69.9% nodular).
  • Higher thyroid volume was observed in active acromegaly (p=0.036) and correlated with IGF-1.
  • Secondary hypothyroidism was associated with smaller thyroid volume.

Conclusions:

  • Thyroid volume in acromegaly is influenced by disease activity and secondary hypothyroidism.
  • The high prevalence of nodular goiter underscores the need for routine thyroid ultrasound in acromegaly follow-up.