In thyroid autonomy, cells of the thyroid gland produce hormones in an uncontrolled manner, which can severely impair the metabolism. Thyroid autonomy due to iodine deficiency is the most common cause of hyperthyroidism. Drug and surgical procedures are available for the treatment of thyroid autonomy.
Areas of the brain such as the hypothalamus or the pituitary gland control the hormone production of the thyroid gland.
Messenger substances (transmitters) from the hypothalamus and pituitary gland stimulate cells of the thyroid gland to release thyroid hormones or to reduce hormone production.
Thyroid hormones control important metabolic processes in the body. Even in healthy people, there are isolated cells in the thyroid tissue that escape the overriding control of the hypothalamus and pituitary gland.
However, their activity hardly affects the metabolism. The situation is different when entire sections of the thyroid gland act autonomously and produce hormones independently.
The thyroid gland is an endocrine gland located in the neck below the larynx and in front of the windpipe @ Rasi /AdobeStock
The following forms are possible:
Thyroid autonomy often leads tohyperthyroidism (hyperthyroidism).
Another common cause of hyperthyroidism is Graves' disease, in which the body mistakenly produces antibodies against the TSH receptor in the thyroid gland (autoimmune thyroidopathy).
The most important cause of thyroid autonomy is iodine deficiency. This leads to an iodine deficiencygoitre.
The iodine deficiency leads to uncontrolled growth of the cells within the thyroid gland. The body therefore tries to absorb more iodine through more cells. Eventually, cells become uncoupled from the control circuit (autonomous) and begin to produce hormones in an uncontrolled manner when iodine is supplied.
Another cause of unifocal thyroid autonomy is genetic changes that make it difficult for the cells to perceive messenger substances in the brain. The loss of control also leads to increased cell growth and autonomous hormone production.
Symptoms often only appear late in life, as thyroid autonomy develops quite slowly. Asa rule, nodular growthsdevelop in the thyroid tissue, which cause swallowing difficulties or breathing problems. Those affected then usually consult a doctor.
In addition, the unchecked hormone production in thyroid autonomy leads to noticeable changes in the body's metabolism.
Those affected show signs such as
Radiology is responsible for visualizing autonomously active areas within the thyroid gland. There, doctors can visualize the active cells with the help of radioactively labeled iodine (scintigraphy).
Zones within the thyroid gland that show a high degree of autonomy are visualized as "hot nodules" using scintigraphy. It is also possible to determine thyroid autonomy using a number of blood parameters.
The values for thyroid hormone and thyroid-stimulating hormone (TSH) play a central role here. In suspected cases, autoantibodies that can lead to inflammation of the thyroid gland, such as Graves' disease, are also examined.
Scintigraphy is a functional imaging diagnosis of the thyroid gland using a gamma camera @ Werner /AdobeStock
Drug treatments (e.g. thyrostatic drugs) cannot cure the cause of thyroid autonomy. They are therefore often only used for a certain period of time, for example to prepare for surgery.
The number of autonomous cells in the thyroid gland can be reduced either chemically or surgically.
Chemical procedures include radioiodine therapy and sclerotherapy using alcohol.
If curative treatment is not possible, thyroidectomy may be an option. This involves doctors surgically removing the thyroid gland, which ultimately necessitates a lifelong intake of thyroid hormones.
In rare cases, a thyrotoxic crisis can occur. This is a life-threatening emergency with palpitations, cardiac arrhythmia and even cardiovascular failure. These patients require emergency medical treatment.
Reasons for a thyrotoxic crisis are
Thyroid autonomy specialists deal with the hormonal balance and metabolism of humans. For this reason, they belong to the specialist fields of endocrinology and diabetology.
Depending on the accompanying diseases, pulmonology, cardiology and other areas of internal medicine may also be important. Radiology plays a particularly important role in diagnostics and radioiodine therapy.
The Leading Medicine Guide's quality assurance is ensured by the following acceptance prerequisites.
