Swelling in the thyroid gland

Thyroid disorders as the cause of excess weight

Thyroid gland is an organ related toendocrine system. The thyroid gland is an organ of internal secretion, it produces specific hormones, which are special regulatory proteins.

This gland is located on the front surfaceneck from 2 to 6 cartilaginous tracheal rings, below the thyroid cartilage. It is an active and around the clock working factory for the production of hormones. In this connection, it needs a constant inflow of iodine, oxygen, amino acids, and other elements. The thyroid gland weighs from 20 to 60 grams, but a day passes through it 140-150 liters of blood!

How does the thyroid regulate body fat?

Thyroid hormones directly orindirectly, affect all biological processes in our body. This is a powerful regulator of the speed of metabolic processes. In addition, the hormone that directly regulates the activity of the thyroid gland also has a certain effect on many tissues of our body.

Hypothyroidism and overweight

Hypothyroidism (hypo- means a decrease) is the opposite of hyperthyroidism that occurs in the body with a low content of thyroid hormones.
Hypothyroidism occurs from 1.5% to 2% in women and in 0.2% of men. These violations are more common due to age. Up to 10% of women over 65 years of age may have some signs of hypothyroidism.

More rarely, hypothyroidism occurs amongyouth. For example, hypothyroidism in newborns, causes the condition described as cretinism. It is characterized with mental retardation, jaundice, poor appetite, shortness of breath, and other symptoms. In adolescence, hypothyroidism is characterized by growth retardation and the emergence of problems with the child's mental development. Some drugs can cause hypothyroidism, affecting the production of the thyroid hormone. These include some cardiac drugs, lithium preparations, etc.

Symptoms of hypothyroidism include: weight gain, hypothermia (low body temperature), chilliness, jaundice of the skin, hypercholesterolemia, early atherosclerosis, etc. However, weight gain in hypothyroidism is not too large and is partly due to myxedematous edema, not fat accumulation. This edema (myxedema) develops due to the accumulation in the tissues of mucopolysaccharides - glucosaminoglycans, dramatically increasing the hydrophilicity (water-filling) of tissues.

Such disorders in connective tissue arisefrom the action of thyroid-stimulating hormone, the amount of which varies greatly in the forms of hypothyroidism. Myxedema is also characterized by a thickening of the skin, a puffy face. Of course, hypothyroidism is accompanied in many cases and the deposition of additional amounts of fat mass, but the main weight gain is still due to mucous edema.

Usually hypothyroidism develops slowly. Often the first symptom of the disease is hearing impairment, which causes the patient, first of all, to contact the otolaryngologist. This decrease in hearing occurs due to the swelling of the auditory tube (Eustachian) and the organs of the middle ear. Difficult nasal breathing may also occur, which is associated with swelling of the nasal mucosa, a low hoarse voice - due to swelling and thickening of the vocal cords and other symptoms. In severe cases of hypothyroidism, periorbital edema is observed (swelling of the tissues in the eye cavities), puffy face, large lips and tongue with dentinal impressions along the lateral edges, swollen limbs, difficulty in nasal breathing, etc.

In the treatment of hypothyroidism, the body weight is reduced byaccount for the loss of excess fluid, not fat. Also in patients with hypothyroidism receiving treatment with levothyroxine (L-T4), the degree of TSH suppression does not affect body weight.

In studies, patients with a lower levelTSH had a higher level of basal metabolism, but there was no difference in weight, and also in the body fat and lean body masses. In contrast, it should be noted that with a low level of thyroid hormones, not only the total metabolism but also the appetite decreases, which compensates for the potential risk of gaining excess weight

Such conclusions are confirmed by the observation thatpatients receiving suppressive therapy in connection with thyroid tumors, weight gain for 3-5 years corresponds to the usual level, despite the reduction of thyroid hormones in the blood.

Thus, as you yourself understand, with a generalsignificant obesity and the absence of additional symptoms of hypothyroidism, there is no reason to associate weight gain with hypothyroidism of the thyroid gland and prescribe hormone therapy. Only an insufficient function of the thyroid gland confirmed by laboratory testing may require correction. And this correction does not always consist in the appointment of thyroid hormones!

Fig. Myxedema in a patient with hypothyroidism
(reduced function of the thyroid gland)
(illustration from the textbook)

Hyperthyroidism (hyper-signifies an increase)indicates an increase in thyroid production of thyroid hormones. With an increase in the level of thyroid hormones, the metabolic rate, as well as energy expenditure at rest and under physical exertion, respectively, increases. With hyperthyroidism, this leads to weight loss with a decrease in the amount of fat. Also, many processes in the body are accelerated, body temperature rises (by the way, an increase in the body's basic temperature is one of the symptoms of thyroid dysfunction), heartbeat is accelerated, there is a shiver in the hands. Along with this, appetite increases, but in spite of this, patients often lose some weight (a kind of metabolic weight loss, not obesity). In this situation, additional energy will be spent on maintaining a high body temperature.

Slimming with thyroid hormones

Such an effect of thyroid hormones onmetabolism was the reason for creating methods of losing weight with their use. For this, the patient with excess weight additionally, despite their normal hormonal level in the blood, was given thyroid hormones, which caused a condition similar to hyperthyroidism and led to some reduction in body weight. However, weight loss with mild hyperthyroidism is not too strong, while at the same time, with significant hyperthyroidism, other symptoms begin to predominate - from the heart, the central nervous system, the gastrointestinal tract, etc. (It is in connection with these more palpable disorders that patients turn to doctors .)

Is it correct to use thyroid hormones for weight loss?

In my opinion, the appointment of thyroid hormonesglands, with their normal number in the blood - is a devastating effect on the entire regulatory system of our body. Weight loss caused by this method will be short-lived and will quickly return to the initial indicators, and what is even more likely to exceed them. In addition, the impact of increased amounts of thyroid hormones on many organs and tissues will lead to their reorganization and adaptive decrease in receptor sensitivity, which will subsequently cause withdrawal syndrome after the course termination.

It should also be noted that attempts to use thyroid hormones in dietary supplements for weight loss often cause thyrotoxicosis with the possibility of developing thyrotoxic periodic paralysis.

It is quite clear that the appointment of hormones canbe justified only in cases where the thyroid gland can not, for some reason, produce enough of them. In any case, this should be done with the participation of an endocrinologist.