CAMAGÜEY. - With the interest to find several answers related to the thyroid gland, we come up to Dr. Ernesto Juan Abad Rodríguez, specialist in Endocrinology, who is at the head of the Provincial Center of Attention to the Diabetic, of this city.

He announced to us that: "It is the only gland placed in the previous face of the neck, in front of the larynx, with the form of an h, because it has two side lobes, the central line and the isthmus joins them. It must not be felt nor seen, only it is discerned when it increases of size”.

- What is its function?

- It is practically universal, it regulates the metabolism of the body, intervenes in almost all the functions of the organism. It has to do with the growth, the development and equally with the intellectual, the adulthood, the reproduction, the state of mind of the individual. Practically it intervenes in all the functions of the organism.

- Tell me about the complaints?

- The most frequent are of anatomical or functional character. In the first mentioned one we find the goiter, the nodule that can be the only or multiple and the cancer. In the second one, they present before themselves for an excess of its function that is the hyperthyroidism or of its decrease that is the hypothyroidism, both are seen with the same frequency, although with certain tendency towards the hypothyroidism.

“Others are of autoimmune type, like the calls thyroiditis, and these also happen for infectious factors, and if it eliminates the infection it goes away. Sometimes there answers to an infection in the throat and appears a sub-acute thyroiditis, which is very painful”.

- What symptoms do they indicate that it is not working well?

- The current thing is that they arise due to the alteration of the functions; for example, the hyperthyroidism is characterized because everything is of more. In this case increases the cardiac frequency, the movement, the appetite, and there are diarrheas; nevertheless, weight gets lost for the biggest energy consumption, and in case of the woman it provokes less menstruation.

“In the hypothyroidism it is everything opposite. There is less hair because it falls down, diminishes the activity, the cardiac frequency, one feels weariness, constipation, and major abundance of the menstruation, and on having spent less energy, puts on weight, although he eats less”.

- How is it diagnosed?

- By the clinic exam. The specialist, before the symptoms and clinical examinations, manages to say if he is a hyperthyroid or hypothyroid patient. Then there are indicated studies that determine the cause and there is adopted the treatment to be continued, but it does not modify the diagnostic criterion. These investigations are oriented to know the origin of the suffering.

“The goiter is the simple increase of size of this gland. It is felt and by its characteristics there is known if it is a colloid, for being softer on having been full of a substance that takes this name, and if there is thyroiditis presents alterations of the surface and undulations and, perhaps a bit more hard.

“The nodules answer to the increase of located size, and not always it is one, and sometimes they are multiple. Different would be the cancer of thyroid gland, which is related to the nodules. It is difficult that in a goiter we find cancer”.

- How and why does the person come to the doctor?

- The normal thing is to come to the family doctor if he feels something in his organism that does not go well, and if this one thinks that it has some of these complaints he sends the clinical doctor, who if he believes it opportunely sends him to the endocrinologist of his area of health, even, the rural ones, where there is this type of medical attention.

- What happens when a nodule is detected?

- When it is palpable, we continue it, because when they are tiny and overdrafts like a find we do not give him this importance. It must have more than 10 millimeters so that they have clinical importance. Both the goiter and the nodules sometimes functions normally.

- Anyhow is it necessary to realize complementary examinations?

- Of course, the thyroid gland ultrasound to corroborate the presence of the nodule, to determine his anatomical characteristic, measures the size and with less than 10 millimeters, they are not born in mind, as I said now, although the conduct to be continued is to watch it to know if it grows or changes in something.

“Also we indicate the puncture, which is the biopsy known as BAF or CAF and is realized by thin needle, this way we know not only if there is cancer or not, but of what type is.

“In the functional ones we face the analyses related to the T3 (triiodothyronine), T4 (tetraiodothyronine) and TSH (the last one is the hormone that produces the pituitary gland that regulates the function of the thyroid gland, and is called a stimulant hormone of the thyroid gland), when this one rises it means that the thyroid gland works below it should and if it diminishes means that it works well or more that it should. Imagine that the pituitary gland orders THS to stimulate the function of the thyroid gland and at the same time, this one is in charge to say to the pituitary gland how the function is, when it is normal they are regulated, if there is no answer of the thyroid gland, the pituitary gland sends more and more in search of this answer; before the opposite it says that there is much, does not need any more”.

- Someone of mentioned one heals?

- When the person suffers from a diffuse poisonous goiter, which is hyper-functioning and toxicant for so many hormone, or it is nodular the surgical criterion solves the situation in not few occasions; also, the application of the radioactive, liquid iodine to be taken, has curative effects.

- What are the most common causes?

- The hereditary factor, the autoimmune illnesses as the diffuse goiter, the chronic thyroiditis (of Hashimoto), in the latter case it can happen to the hyperthyroidism, then to a normal phase and further on to the hypothyroidism, among others.

“The diet influences also, as well as the waters. If someone with thyroiditis consumes food very rich in iodine it does a hyper-function. Another cause is the endemic goiter, in a place where there is no sufficient iodine, that's why it increases of size”.

- And this examination in the heel that they do to the newborn babies: on what is it based?

- It is to determine the congenital hypothyroidism. It is very important. If the child does not have sufficient thyroid hormone, his brain does not develop and the cretinism supervenes.

- If some anomaly is detected to him?

- The Program of Precocious Detection of Congenic Hypothyroidism, instituted to detect it early there is based in determining the TSH, is this method that you say and other by means of the umbilical cord. If the THS is raised one begins to give him the thyroid hormone up to three years and is solved, already at this age the brain is developed. At the age of three, we can give ourselves the luxury of quarreling by means of precise examinations, if he continues with the illness, then the treatment continues, and if not, it is suspended.

“The thyroid gland is very noble, you put it in rest with medicine for years and on having suspended them, it begins again as if nothing had happened”.

- Does it prefer of sex?

- We find the biggest tendency in the women; nevertheless, on having appeared in the man, the behavior is more aggressive, it damages more.

- And predilection for the age?

- In the third and fourth decade of the life.

- If there is cancer?

- In dependency of its type. Some resolve with the administration of iodine, without operating, it is like that the radioactivity kills it. Others are operable, it depends.

“If some of these symptoms appears, the best thing is to come to the doctor and to trust. One always looks for the remedy, or for the improvement”.