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Thyroid Awareness Month Diminutive gland plays important health role by Michael Baker Public Relations As January draws to a close, so does Thyroid Awareness Month. The health care community devotes the first month of every year to increasing awareness of a small, butterfly-shaped gland located beneath the Adam’s apple. The thyroid’s annual position as one of the first health-related issues addressed may confuse some people. Glands, by reputation, do not dominate the stereotypical landscape of hot-button health concerns. But the thyroid's diminutive size belies its importance, and overlooking it may be a huge mistake. According to Kathie Hermayer, M.D., associate professor in the Division of Endocrinology, the thyroid assumes responsibility for numerous biological functions. Using two hormones—thyroxine and triiodothronine—the gland helps regulate the body’s cardiac and gastrointestinal activities, metabolism, mood, and women’s menstrual cycles. Much like a car, the thyroid gland rarely receives much attention unless it operates inefficiently, and similarly, the effects of thyroid irregularities can be quite unpleasant. “The thyroid can be responsible for slight weight gain, brittle fingernails, joint pain, and even anemia,” Hermayer said. “On a smaller scale, overactive or underproductive thyroids can also result in diarrhea or constipation.” Abnormal thyroid glands also can develop any of four types of thyroid disease: hypothyroidism, hyperthyroidism, thyroid nodules, and thyroid cancer. Hypothyroidism and hyperthyroidism occur when the thyroid decreases or increases, respectively, the regular production of its two hormones. Such fluctuation often produces a variety of health problems.  Hashimoto’s thyroiditis is a particularly grueling form of hypothyroidism and can be dangerous when not regulated, leading to myxedema coma.  In extreme cases, hyperthyroidism can be deadly. Severe cases of hyperthyroidism sometimes create what Hermayer calls a “thyroid storm.” “In a thyroid storm, the body becomes hypermetabolic, which can place a great deal of stress on the heart,” she said. “It’s an extremely dangerous situation because more than 50 percent of these cases result in death.” Thyroid nodules—extraneous cellular tissue or fluid-filled cysts that form on the gland—also represent a common problem. The majority of the nodules are benign but may progress to become nodular goiters. Nodular goiters can create significant problems, inhibiting a person’s ability to swallow or even breathe. A fourth concern, thyroid cancer, has proven relatively responsive to treatment, Hermayer said. Of the four types of thyroid cancer, two (papillary and follicular) respond to treatment with radioactive iodine, surgery or both. A third type, medullary thyroid cancer, may be hereditary in origin. A fourth, anaplastic thyroid cancer, remains so severe that most patients die within six months of its diagnosis. Because the thyroid holds such an important place in a person’s overall health, Hermayer offered some tips to assist the gland’s regular production. “One variable is to monitor your iodine intake,” she explained. “Excessively high or low amounts of iodine in your diet can influence the thyroid’s functions.”  For example, shellfish and kelp contain a high amount of iodine, as do certain cough syrups and multivitamins. Some supplements contain more than one-third of the recommended daily allowance of iodine. “I’m not suggesting that we start shunning all multivitamins,” she added. “And it’s perfectly healthy to visit a seafood restaurant every now and then, but maybe it’s not a great idea to eat lobster every day.” For those who have experienced troubling symptoms and are concerned about potential thyroid problems, Hermayer recommends getting a blood test to measure the body’s thyroid stimulating hormone (TSH) levels.  The thyroid determines the amount of hormones to release based on the amount of TSH in the body. Too much TSH is generally the result of thyroid hormone underproduction, inducing hypothyroidism. Too little TSH results from thyroid hormone overproduction, inducing hyperthyroidism. Blood tests and other preventative measures could help avoid significant health problems in the future. Although Thyroid Aware-ness Month has almost passed, thyroid health should remain a top priority. From metabolism and moods to cardiac and sensory responses, every biological function of the human body depends upon the thyroid in some way.  The gland’s familiar shape suits it, serving as a reminder that even the small things in life, the things that people rarely think about, can have a significant impact on the bigger picture.    Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.