I have known about Daniele for years the care, patience and tenacity that characterize his character and character. And now that he is about to become a doctor, it is nice to be able to ask him questions on a subject as delicate as it is essential: the well-being of the thyroid, this - as he calls it - "precious gland" . And it is exciting to know that in the future many will be able to count on his serenity, dedication and knowledge.
The number of women who develop a thyroid disorder throughout their lives is 5 to 8 times more than the total number of men. Every year about 40 thousand surgeries are performed on this precious gland. There is much confusion on this side, obesity and overweight are confused with the malfunctioning of a gland that for most of life can even unconsciously underestimate or even ignore its location in our body.
We asked Daniele Ceccaroni, who will soon be discussing his thesis at the University of Perugia, where he studied for six years and now practices internship in the clinic for about four years. We wanted to feel a fresh and brilliant brain, not on the run, committed to a theme that touched him closely (he too, ironically, underwent a thyroidectomy for nodular pathology).
Can you shed light on the disease of Basedow-Graves with simple words? Is surgery the last resort or the first possibility one thinks of?
Basedow-Graves' disease is a stimulating autoimmune disease that generates an over -production of thyroid hormones. The specific therapy in this case is medical, surgical therapy is always the last resort . The drugs go to block the main synthetic enzymes including above all the enzyme thyroperoxidase which assembles tyrosine (an amino acid) and iodine to create thyroid hormones. In Basedow-Graves' disease, when the response to drugs is good, it usually has immediate effects.
However, if the therapy does not work and lasts a long time, you can also have an important alteration of the laboratory blood values due to liver toxicity and it is preferred to opt then for thyroidectomy, which is usually performed only in cases of cancer. In these cases, to avoid this surgery, it is possible to perform a laser treatment on an ultrasound guide.
The drugs for hyperthyroidism therefore, unlike what happens in hypothyroidism, are real drugs with certain possible side effects. This is why constant laboratory tests are carried out especially at the liver level, also because in many patients there is an increase in transaminases within the first two years, so it is necessary to monitor.
This does not happen in hypothyroidism, also of autoimmune etiopathogenesis, as in the case of Hashimoto's thyroiditis . Hypothyroidism is in fact treated simply by administering the thyroid hormone in the missing dose, thus avoiding possible side effects from overdose.
The immune system and stillness in the mind. What relationship is there?
An essential relationship, very close . Very frequently this type of thyroiditis emerges after some important stress, for example after the loss of a loved one or after more or less significant psychological trauma, however following stressful situations. The forms of defense of the organism decrease and the control on the preclinical forms also decreases, triggering the true manifestation.
Is there a relationship between thyroid problems and infertility?
Yes, there can be, and it is an often overlooked link. In case of suspected female infertility, one immediately thinks of problems with the ovaries or uterus, while the possibility of thyroid failure, of a TSH ( Thyroid-stimulating hormone, or the thyrotropic hormone secreted by the cells of the anterior pituitary) too high which causes a slowing of the metabolism which makes it difficult to get pregnant.
Recently, Italy seems to be a more homophobic country, in total contrast with the rest of the world. I happened to talk to doctors convinced that sexual "conduct" can, in the long run, lead to hormonal imbalances. But does sexual orientation really end up affecting the hormonal balance? Or is this perspective the result of an old medical approach whereby the couple is only a man-woman?
Unfortunately, even in the medical field there are the same barriers that exist at the corporate level. You can find the open doctor or the one who sees in the man in union with the woman the only possibility of couple.
As far as I'm concerned it is one of the expressions of sexuality, one of the many forms, it cannot be demonized, at most we can once again emphasize the risks of greater transmissibility of HIV or herpes type 2 for male homosexuals. But having said that, there are no studies that confirm or deny that a homosexual is more or less at risk of developing thyroiditis or nodules.
There is little talk of thyroid disorders regarding men ...
Attention should be paid to the formation of nodular forms for men , which can lead to certain types of malignant thyroid tumors that can be healed 100% in time, as in the case of papillary thyroid carcinoma. The latter affects men at a young age and is associated with ultrasound situations with a single nodule with precise characteristics, such as low echogenicity, without halos, with spot microcalcifications.
Both for this type of tumor and for others such as follicular carcinoma, a link has been established with the Chernobyl nuclear explosion. From 85 to today, tumors have increased by almost 42%, of which 58% is represented only by papillary carcinoma; that event was very significant and it would be important to also check the impact of the Fukushima disaster, it would be a litmus test.
Iodized salt. Yes or no?
Yes. We study region by region the percentage of iodiodicity (iodine deficiency) on the Italian territory and the Ministry of Health confirms that the census reveals a greater iodiodicity in the inland areas of central Italy and not facing the coasts, which do not benefit from the air rich in iodine. By now there is the practice of buying iodized salt and it is also the first rule in the treatment of nodular pathology.
But is it possible that a person develops a nodule throughout his life and this is reabsorbed or dissolved without the individual noticing it?
Yes, nodules are very dynamic processes . Very briefly, when the thyroid lacks iodine to create the right amount of hormones it serves, gaps are created that become nodules; they can be solid or mixed (with liquid component, bleeding spills).
It is possible that at times the cysts reabsorb on their own or that the higher volume nodule undergoes an autonomous dynamic disintegration process. Even the characteristics of solid nodules can change; in an ultrasound history of thyroid nodule of which the benign needle aspirated nature has been verified, it is very likely that this nature will not change.
Attention: it is however possible that the characteristics of the nodule change, that calcifications, morphological and echographic variations are created. When in doubt, when there is any change in this sense, or even an increase of 30% of the dimensions, it is better to resort to the aspirated needle, because it is the only test that makes us know with certainty the nature of the nodule.
You told me that there is a connection between anti-cellulite products and thyroid disorders. Can you explain us better?
Yes, there can be. Many of the anti-cellulite products on the market should always be viewed with a certain distrust, the composition of the drug must first be evaluated, because in fact, even if they are sold without a prescription, they act at body level considerably. They are usually composed of marine algae that contain a lot of iodine; applying these products too often the skin, which has its vitality, absorbs iodine and this excess iodine can go to disturb the thyroid function.
If we take too much iodine, the function of our thyroid is lowered in proportion to the iodine we have introduced and this creates a situation of hypothyroidism. In these cases we speak of iatrogenic hypothyroidism . The same phenomenology occurs with a drug used for arrhythmias, amiodarone, which has a large iodine charge and is very easy to have an impact on the thyroid.
A man's and almost doctor's advice to women in relation to the prevention of thyroid disorders.
I feel like giving advice as good for men as for women. It has to do with the possibility of cultivating one's own center and not being overwhelmed by the events of life.
Stress situations are expensive on a psychological level. We often come from people who suddenly feel tired and accuse sudden drops in energy which are followed by the unmasking of pathologies that are already under way in a sub-clinical way and that then become manifest, this typically in Hashimoto's thyroiditis.
Avoiding stress can definitely delay the symptoms of the disease. And I will never get tired of saying it - get excited about this gland so precious for life, know it, understand where it is and what it does. And check it out. At least once in a lifetime ultrasound should be done on the neck.
So the inner tranquility plays a fundamental role?
Yes, especially for hypothyroidism. Hyperthyroidism in some ways we recognize it, rarely it happens to be subclinical, it has less unintelligible symptoms such as hot sensation, shortness of breath, insomnia , amenorrhea, leakage of the eye from its physiological site (especially when associated with cigarette smoking), intestinal disorders, weakened hair and nails, hair loss, these last symptoms are identical to hypothyroidism.
Hypothyroidism is much more confusing with a sort of initial depressive state when it is the thyroid that is not working properly: the most frequent symptoms are fatigue, listlessness, inattention, tendency to lethargy, weight gain, feeling cold.
I believe that yoga and oriental disciplines of this type play a fundamental role: the person knows himself, becomes familiar with the parts of his body, begins to manage his daily life differently .
The autoimmune disease called Hashimoto's thyroiditis: symptoms, causes and therapies
To know more
> The endocrine glands, what they are and what they are for
> Properties and use of iodized salt
> Soy and thyroid health
