Let's talk about the normal size of the thyroid gland on ultrasound. Functions of iodinated thyroid hormones. What hormones does the thyroid gland produce?

The thymus gland (thymus or thymus gland) is an organ of human immunity and hematopoiesis, responsible for the synthesis of certain types of white blood cells. The gland is located directly behind the sternum in the superior mediastinum. Rarely, there is an atypical location of thymus lobules in the thickness of the thyroid gland, in the fatty tissue of the posterior mediastinum, or between the muscles of the neck. This arrangement is called aberrant and occurs in a quarter of the world's population. Predisposing factor for aberrant location thymus- this is birth defects hearts.

The organ has a pinkish-gray color and a soft texture with a lobed structure. A healthy thymus consists of two large lobes and is shaped like a fork with two teeth, which gave rise to the second name of the organ. A damaged gland can change its shape. From above, the lobes are covered with a connective tissue capsule with bridges extending into the thickness of the gland. The bridges divide the lobes into smaller lobes. The mass of the gland in a newborn and infant is about 15-17 g, the size does not exceed 4-5 cm, and the thickness is 0.5 cm. The thymus reaches its maximum size by the onset of puberty - 8-16 cm in length, and the mass increases by two times. After that, in adults, the gland gradually undergoes a reverse development - involution - and practically merges with the fatty tissue surrounding it. Involution can be physiological (age-related) and accidental - under stressful effects on the body.

The blood supply to the thymus is carried out by branches of the internal thoracic artery, aorta and thyroid arteries. outflow blood is coming along the internal thoracic and brachiocephalic veins. It is innervated by branches of the vagus nerves and the sympathetic trunk.

Histology of the thymus

The thymus develops from the ectoderm and contains cells of epithelial and hematopoietic origin. Conventionally, the entire substance of the thymus gland is divided into cortical and cerebral. The cortex contains:

• cells that form the hemato-thymic barrier - supporting cells;
• stellate cells that secrete hormones;
• “nanny” cells, between the processes of which T-lymphocytes develop and mature;
• T-lymphocytes - white blood cells;
• thymic macrophages.

The medulla contains a large number of maturing T-lymphocytes. When these cells go through all the stages of their development, they are sent into the bloodstream through venules and veins, ready to carry out immune function.

Thus, the T-lymphocyte appears and begins to mature in the cortical substance, and then, as it matures, it passes into the medulla. This process lasts about 20-22 days.

As they move from the cortex to the medulla and from the medulla to the general circulation, T-lymphocytes undergo selection - positive and negative selection. In the course of it, the cells "learn" to recognize the alien and distinguish their own from the alien. According to scientists, only 3-5% of T cells pass both stages of selection and enter the systemic circulation. Selection allows you to determine which of the cells fully perform their function, and which do not need to be released into the bloodstream.

What processes are regulated by the thymus?

The main role of the thymus is in the differentiation and maturation of T-cell immunity cells - T-lymphocytes. Proper development and selection of these cells leads to the formation of many receptors for foreign substances and, as a result, to an immune response upon contact with them.

The second function of the thymus gland is the synthesis of hormones, such as:

• thymosin;
• thymulin;
• thymopoietin;
• insulin-like growth factor-1;
• thymic humoral factor.

Thymus hormones affect the function of T-lymphocytes and the degree of their activity. A number of studies have shown an activating effect of thymic hormones on the central nervous system.

thymosin

This hormone is a polypeptide protein synthesized in the epithelial cells of the organ stroma and performs the following functions:

• regulation of development musculoskeletal system by controlling calcium metabolism;
• regulation of carbohydrate metabolism;
• increased synthesis of pituitary hormones - gonadotropins;
• an increase in the synthesis of T-lymphocytes before puberty;
• regulation of antitumor defense.

With its insufficient activity or secretion, T-cell failure develops in the human body - up to the absolute absence of cells. Clinically, this is manifested by a sharp decrease in protection against infections, the dominance of severe and atypical forms infectious diseases.

thymopoietin

Thymopoietin is a 49 amino acid peptide hormone. It is involved in the differentiation and maturation of T cells in the cortex and medulla and determines in which of several types of T lymphocytes a particular cell matures.

Another function of the hormone is to block neuromuscular transmission. It also has the property of immunomodulation - this is the ability of the hormone, if necessary, to suppress or enhance the synthesis and activity of T-cells.

Timulin

The protein hormone thymulin influences the final stages of T-cell differentiation. It stimulates cell maturation and recognition of foreign agents.

From common influences on the body, there is an increase in antiviral and antibacterial protection by increasing the production of interferons and enhancing phagocytosis. Thymulin also accelerates tissue regeneration. The determination of thymulin is decisive in evaluating the effectiveness of the treatment of thymus diseases.

Other hormones

In its own way chemical structure insulin-like growth factor-1 is similar to insulin. Regulates the mechanisms of differentiation, development and growth of cells, participates in glucose metabolism. In muscle cells, the hormone has growth-stimulating activity, is able to shift metabolism and promote increased fat burning.

Thymus humoral factor is responsible in the body for stimulating the reproduction of lymphocytes.

Thymus gland diseases

Diseases of the thymus practically do not occur in adults, most often the pathology is recorded in children under the age of one year. The most common and most studied diseases of the thymus are:

• MEDAC syndrome;
• DiGeorge syndrome;
• myasthenia gravis;
• various tumors.

Inflammation of the thymic stroma is rare.

Tumors of the thymus gland include the following:

• thymomas and hyperplasia - benign neoplasms in which the gland is enlarged in size;
• hypoplasia, or underdevelopment of the organ;
• T-cell lymphoma;
• pre-T-lymphoblastic tumors with transformation into leukemia or cancer;
• neuroendocrine tumors.

Thymus diseases have a variety of clinical manifestations, but some symptoms are common to all:

• respiratory failure;
• heaviness of the eyelids;
• chronic fatigue;
• muscle weakness and rarely muscle pain;
• decreased resistance to infections.

Most of the diseases of the thymus are dangerous for the life of the child, therefore, if a pathology of the thymus is suspected, urgent consultations of an immunologist and a hematologist are necessary.

The doctor's examination plan includes:

• general and biochemical analyzes blood;
• determination of the activity of thymus hormones;
• immunogram;
• Ultrasound of the gland.

What is a colloidal thyroid nodule?

Colloidal nodule of the thyroid gland, what is it? This is a pathology characterized by the appearance benign neoplasms. Their presence is not dangerous to human life, but plays an important role in the diagnosis of diseases. endocrine system. Colloidal nodes in the thyroid gland are found in most patients of endocrinologists, but most often they are benign. A colloid is a viscous mass that fills the follicle of the gland, so it is not considered atypical for this body. Such a substance is formed in the tissues responsible for the production of thyroid hormones. Microscopic analysis reveals that the node consists of glandular cells, blood and colloid. It does not contain foreign inclusions, which means it is safe for health.

Reasons for the development of the disease

The role of the thyroid gland in the human body cannot be overestimated. The organ, which is relatively small, must produce many hormones that are distributed throughout the body. Chronic and infectious diseases, stress, unfavorable environmental conditions make the gland work at an accelerated pace, which leads to organic and functional disorders. Some parts of the body begin to produce hormones unevenly, which is accompanied by vasodilation and an increase in tissue density. This is how colloidal nodes of the thyroid gland are formed.

The main reasons for the appearance of colloid nodes in the thyroid gland are: unfavorable environmental conditions, stress, high physical exercise, chronic diseases, iodine deficiency in the body, malnutrition, puberty, pregnancy. Iodine deficiency is the most common cause of nodular changes. All residents of our country are deficient in this element, with the exception of people living in the Crimea and the Far East. Iodine is considered the most important substance, without which the thyroid gland cannot produce hormones.

Clinical picture

In the early stages of node development, no symptoms appear. More often the reason for going to the doctor is a significant increase in the size of the gland. In this case, symptoms of the mechanical impact of the node on the surrounding tissues appear: pressure in the area of ​​​​the organ, difficulty in swallowing and breathing, sore throat, cough. On the late stages the disease changes the timbre and volume of the voice. Constant pressure large vessels and nerve endings can affect the central nervous system: headaches, dizziness, tinnitus appear. Pain in the neck area occur when rapid increase node in size, accession of hemorrhages or inflammatory processes.

Depending on the prevalence of the pathological process, the thyroid gland can increase both on one and on both sides. If the size of the node exceeds 1 cm, a person can detect it on their own. Depending on the degree of dysfunction of the thyroid gland, the clinical picture of the disease may vary. Symptoms of hypothyroidism appear when the colloidal mass begins to replace healthy gland cells. General weakness appears, intellectual abilities decrease, appetite is lost. The patient's body swells, metabolic processes in the body slow down, weight begins to grow, the skin becomes dry.

When the thyroid gland begins to produce an increased amount of hormones, a person experiences symptoms of hyperthyroidism. This condition manifests itself in the form of irritability, fatigue, aggression. Appetite increases, but the person loses weight, digestive processes are disturbed, which manifests itself in the form of diarrhea. Body temperature may rise and tachycardia develop. If the process of hormone production is not disturbed, the only sign of the disease will be the compaction of the thyroid gland and its increase in size. Growing nodes compress large vessels and nerve endings, which leads to a feeling of a lump in the throat, problems with breathing and swallowing.

Diagnosis and treatment of the disease

It is possible to determine the nature of the nodes in the thyroid gland only after complete examination. It begins with palpation of the cervical region, which reveals pathological changes. Additional diagnostic methods include: biopsy, ultrasound of the thyroid gland, CT or MRI, blood test for hormones, radioisotope scanning. Based on results diagnostic procedures the endocrinologist reveals the presence of organic and functional changes in the thyroid gland. A biopsy is prescribed in the presence of large colloid nodes. Despite the fact that in most cases nodal changes are benign, it is necessary to study the structure of the largest of them.

With an asymptomatic course of the pathological process, treatment may not begin immediately. Neoplasm is recommended to be observed for several years. The doctor may prescribe iodine preparations to restore thyroid function. The patient may wish to get rid of the colloid node surgically, but doctors do not recommend such operations. After resection, the thyroid tissue begins to grow faster.

Surgical intervention should be performed in the presence of absolute indications: squeezing by a knot of large vessels and nerve endings, the production of an increased amount of hormones. Radical operations are also used in the malignant nature of the course of the pathological process. Depending on the size of the tumor and the presence of metastases, the thyroid gland can be partially or completely removed.

In other cases, the treatment of colloid nodes begins with the elimination of the cause of their occurrence. For example, if toxic goiter contributed to the accumulation of colloidal mass, it is necessary to regulate the production of thyroid hormones and restore the functions of all organs and systems. If the cause of the appearance of nodal changes is not clarified, symptomatic therapy is carried out aimed at eliminating discomfort associated with the mechanical impact of the colloid node on the surrounding tissue.

There are several ways conservative treatment: drug therapy aimed at eliminating dysfunction of the thyroid gland; minimally invasive surgical interventions- laser treatment or sclerosis of colloid nodes. Before prescribing a particular drug, a blood test for hormones should be performed to assess functionality organ. It is necessary to interview the patient about the presence of allergic reactions to drugs. In most cases, derivatives of thyroxine and thyroidin are prescribed.

Properly chosen treatment regimen helps to avoid the development dangerous complications. Colloidal nodes are a fairly common phenomenon; there are no specific preventive measures. A person should carefully monitor their health, regularly visit an endocrinologist, eat right and take iodine preparations. It is necessary to avoid exposure to radiation and visiting places with unfavorable environmental conditions. This will help maintain the health of the thyroid gland, normalize the structure of its tissues, and improve the general condition of the body.

Hormonal functions of the thyroid gland and their disorders

Location

Associating deviations from the norm in their condition with the pathology of the thyroid gland, patients are wondering where the thyroid gland is located, since the diagnosis begins with this - with palpation.

The gland is located under the larynx, at the level of the fifth or sixth cervical vertebra. It covers the top of the trachea with its lobes, and the isthmus of the gland falls directly into the middle of the trachea.

The shape of the gland resembles a butterfly with wings tapering upwards. The location does not depend on gender, in a third of cases there may be an insignificant additional part of the gland in the form of a pyramid, which does not affect its functioning, if present from birth.

In terms of mass, the thyroid gland reaches 25 grams, and in length no more than 4 cm. The average width is 1.5 cm, the same thickness. The volume is measured in milliliters and is up to 25 ml for men and up to 18 ml for women.

Functions

The thyroid gland is an organ internal secretion responsible for the production of hormones. The functions of the thyroid gland are hormonal regulation through the production of a certain type of hormones. Thyroid hormones include iodine in their composition, since another function of the gland is the storage and biosynthesis of iodine into a more active organic function.

Gland hormones

Patients who are referred for laboratory diagnosis of thyroid diseases mistakenly believe that they are examining thyroid hormones TSH, AT-TPO, T3, T4, calcitonin. It is important to distinguish which hormones are produced by the thyroid gland, and which are other organs of internal secretion, without which the thyroid gland simply will not work.

• TSH is a thyroid-stimulating hormone that is produced by the pituitary gland, not the thyroid gland. But it regulates the work of the thyroid gland, activates the capture of iodine from the blood plasma by the thyroid gland.
• Ab-TPO is an antibody to thyroperoxidase, a non-hormonal substance produced by the immune system as a result of pathological processes and autoimmune diseases.

Directly thyroid hormones and their functions:

• Thyroxine - T4 or tetraiodothyronine. Represents thyroid hormones, is responsible for lipid metabolism, lowering the concentration of triglycerides and cholesterol in the blood, supports bone metabolism.
• Triiodothyronine - T3, the main thyroid hormone, since thyroxine also tends to be converted to triiodothyronine by attaching another iodine molecule. Responsible for the synthesis of vitamin A, lowering the concentration of cholesterol, activating metabolism, accelerating peptide metabolism, normalizing cardiac activity.
• Thyrocalcitonin is not a specific hormone, since it can also be produced by the thymus and parathyroid gland. Responsible for the accumulation and distribution of calcium in bone tissue essentially reinforcing it.

Based on this, the only thing the thyroid gland is responsible for is the synthesis and secretion of thyroid hormones. But the hormones produced by it perform a number of functions.

secretion process

The work of the thyroid gland does not even begin in the gland itself. The process of production and secretion, first of all, begins with the "commands" of the brain about the lack of thyroid hormones, and the thyroid gland implements them. The secretion algorithm can be described in the following steps:

• First, the pituitary and hypothalamus receive a signal from the receptors that the blood levels of thyroxine and triiodothyronine are low.
• The pituitary gland produces TSH, which activates the uptake of iodine by thyroid cells.
• Iron, capturing the inorganic form of iodine obtained from food, begins its biosynthesis into a more active, organic form.
• Synthesis occurs in the follicles that make up the body of the thyroid gland, and which are filled with a colloidal fluid containing thyroglobulin and peroxidase for synthesis.
• The resulting organic form of iodine is attached to thyroglobulin and released into the blood. Depending on the number of attached iodine molecules, thyroxin is formed - four iodine molecules, or triiodothyronine - three molecules.
• In the blood, T4 or T3 is released separately from globulin, and it is again captured by gland cells for use in further synthesis.
• The pituitary receptors receive a signal about a sufficient amount of hormones, the production of TSH becomes less active.

Accordingly, having detected signs of thyroid disease, the doctor prescribes a study not only of the concentration of thyroid hormones, but also of the hormones that regulate it, as well as antibodies to an important component of the colloid - peroxidase.

gland activity

At the moment, medicine divides all pathologies of the thyroid gland into three conditions:

• Hyperthyroidism is a dysfunction of the thyroid gland, in which secretion activity increases and an excess amount of thyroid hormones enters the blood, metabolic processes in the body increase. Thyrotoxicosis is also included in the disease.
• Hypothyroidism is a dysfunction of the thyroid gland, in which an insufficient amount of hormones is produced, as a result of which metabolic processes slow down due to lack of energy.
• Euthyroidism - diseases of the gland, as an organ, which do not have any hormonal manifestations, but are accompanied by pathology of the organ itself. Among the diseases, this includes hyperplasia, goiter, nodular formations.

Diseases of the thyroid gland in women and men are diagnosed through the TSH index, a decrease or increase in which indicates the reactivity or hypoactivity of the gland.

Diseases

In women, symptoms of thyroid disease appear more often, since hormonal fluctuations are reflected in the menstrual cycle, which makes the patient seek medical help. Men are more likely to attribute typical thyroid symptoms to fatigue and overexertion.

The main and most common diseases:

• Hypothyroidism;
• Nodular, diffuse or mixed goiter;
• Malignant tumors of the gland.

Each of these diseases is characterized by a special clinical picture and stages of development.

Hypothyroidism

This is a syndrome of chronic decrease in the secretion of T3 and T4, which helps to slow down metabolic processes organism. At the same time, the symptoms of thyroid disease may not make themselves felt for a long time, progress slowly, and disguise themselves as other diseases.

Hypothyroidism can be:

• Primary - with pathological changes in the thyroid gland;
• Secondary - with changes in the pituitary gland;
• Tertiary - with changes in the hypothalamus.

The causes of the disease are:

• Thyroiditis, which occurs after inflammation of the thyroid gland;
• iodine deficiency syndrome;
• Rehabilitation after radiation therapy;
• Postoperative period of removal of tumors, goiters.

Hypofunctional thyroid disease symptoms are as follows:

• Slow heart rate, heart rate;
• dizziness;
• pale skin;
• Chills, trembling;
• Hair loss, including eyebrows;
• Swelling of the face, legs, hands;
• Voice changes, its roughness;
• constipation;
• An increase in the size of the liver;
• Weight gain despite decreased appetite;
• Loss of strength, emotional inertia.

Treatment of hypothyroidism is usually carried out with hormonal drugs that compensate for the lack of thyroid hormones in the body. But it should be understood that such treatment is advisable in a chronic case, which is diagnosed most often. If the disease is detected in the early stages, there is a chance to stimulate the work of the body by eliminating the root causes and temporarily taking another class of hormones.

This disease is called the lady's disease, since there are nine women for ten patients diagnosed with hyperthyroidism. Excessive production of hormones leads to an acceleration of metabolic processes, excitation of cardiac activity, disturbances in the work of the central nervous system and ANS. Pronounced signs of the disease and the advanced form is called thyrotoxicosis.

Reasons for the development of pathology:

• Graves', Plummer's syndrome - goiters of an autoimmune or viral nature;
• Malignant tumors in the thyroid gland or pituitary gland;
• Possible development due to long-term treatment arrhythmic drugs.

Often, the disease overtakes women after the onset of menopause due to hormonal imbalance, not being a consequence of tumors or goiters.

In this case, the main signs of thyroid gland in women:

• accelerated heartbeat;
• Atrial fibrillation;
• Humidity, hotness of the skin;
• Trembling of the fingers;
• Tremor can reach amplitudes, as in Parkinson's disease;
• Increased body temperature, fever;
• increased sweating;
• Diarrhea with increased appetite;
• Decrease in body weight;
• An increase in the size of the liver;
• Irritability, irascibility, insomnia, anxiety.

Treatment involves taking thyreostatics - drugs that reduce the activity of the secretion of thyroid hormones. Thyreostatics include drugs Thiamazole, Diiodothyrosine, as well as drugs that prevent the absorption of iodine.

In addition, a special diet is prescribed, in which alcohol, coffee, chocolate, hot spices and spices that can excite the central nervous system are excluded. Additionally, adrenergic blockers are prescribed to protect the heart muscle from harmful effects.

The disease has vivid symptoms - already from the second stage of goiter, the gland increases, which means that the entire neck area above the collarbone, where the thyroid gland is located, acquires distorted outlines.

Goiter can be nodular, diffuse and diffuse-nodular. The causes of the disease are sufficiently differentiated - it may be a lack of iodine, on its own developing syndrome and excess hormones.

Symptoms depend on the degree of goiter, of which there are five in medicine:

• In the first degree, the isthmus of the gland increases, which can be felt when swallowing;
• The second degree is characterized by an increase in both the isthmus and the lateral lobes of the gland, which are visible when swallowing and are well felt on palpation;
• At the third stage, the gland covers the entire wall of the neck, distorting its outlines, visible to the naked eye;
• The fourth degree is characterized by a clearly visible goiter, even visually, by a change in the shape of the neck;
• The fifth degree is indicated by a huge goiter, which compresses the trachea, blood vessels and nerve endings of the neck, causes coughing, difficulty breathing, swallowing, tinnitus, memory and sleep disorders.

characteristic, but nonspecific symptom This disease of the thyroid gland in women is a strong protrusion of the eyes, amenorrhea up to six months or more, which is often confused with early menopause.

Treatment consists of hormonal therapy in the early stages, in the later stages surgery is proposed to remove part of the organ.

In addition, treatment depends on the type of goiter, as Graves' syndrome, euthyroid goiter, Plummer's syndrome and Hashimoto's syndrome are subdivided. Precise definition possible only with complex diagnostics.

Malignant formations

Develop against the background chronic diseases thyroid glands that did not respond to treatment. The growth of cells in the gland can be provoked and unauthorized.

The prognosis is positive, since in most cases it is diagnosed on early stage and treatable. Vigilance requires only possible relapses.

Symptoms:

• Pain in the neck;
• Seals, the growth dynamics of which is noticeable even within two weeks;
• Hoarse voice;
• breathing difficulties;
• bad swallowing;
• Sweating, weight loss, weakness, poor appetite;
• Cough of non-infectious nature.

At timely diagnosis sufficient drug therapy. In later stages, surgical removal is indicated.

Diagnostics

Diagnosis of any disease of the thyroid gland begins with the collection of anamnesis. Then an ultrasound is prescribed for:

• Timely detection of nodes, cysts, tumors of the thyroid gland;
• Determining the size of an organ;
• Diagnosis of deviations from the norm in size and volume.

Laboratory diagnostics involves the analysis of:

• AT-TPO;
• T3 - general and free;
• T4 - general and free;
• Tumor markers for suspected tumor;
• General analysis of blood and urine.

In some cases, a biopsy of the tissues of the organ may be prescribed to clarify the diagnosis, if laboratory diagnostics was not enough. It is not recommended to independently interpret the results of tests and make a diagnosis, since the norm of thyroid hormones is different for each gender, age, disease, and the impact of chronic diseases. Self-treatment of autoimmune and even more so oncological diseases may result in a threat to health and life.

How safe is thyroid cancer surgery?

Treatment of thyroid hyperplasia

What does the appearance of a cough with a thyroid gland mean?

Flow features autoimmune thyroiditis

How to recognize and treat thyroid cysts

Reasons for the development of adenoma in the thyroid gland

I talked about why it is useful to spend regular examination thyroid with ultrasound. After that, a lot of letters came to the mail with questions about what the norms of the thyroid gland should be.

Therefore, I decided to write a separate article so that everyone can get acquainted with the information.

The thyroid gland is an organ located in the neck, in front, under the larynx. It has the shape of a butterfly and consists of two symmetrical lobes and an isthmus. Since the gland is located directly under the skin, deviations in its structure or structure can be detected even during the initial examination by an endocrinologist by palpation.

The thyroid gland of normal size in most cases is not palpable, except in cases where excessive thinness or the anatomical structure of the patient's neck allows this.

However, with a noticeable increase in the size of the gland during palpation, it is easy to determine:

• the shape of the organ, the size and symmetry of its lobes, the total volume;
• mobility and localization of the gland;
• density and consistency of gland tissue;
• the presence of nodes and volumetric formations.

Unfortunately, the manipulation does not allow to detect formations while maintaining or reducing the normal size of the organ, therefore, the main method for reliable diagnosis of the state of the thyroid gland is ultrasound.

On ultrasound, the thyroid gland is defined as a rounded organ, vaguely resembling a butterfly in shape, with symmetrical lobes and a homogeneous structure.

• The volume of the gland: in women - from 15 to 20 cm3, in men - from 18 to 25 cm3.
• Dimensions of the lobes of the gland: length - 2.5-6 cm, width - 1.0-1.8 cm, thickness - 1.5-2.0 cm.
• Isthmus thickness: 4 to 8 mm.
• Parathyroid glands with a diameter of 2–8 mm, from 2 to 8 units.

In different medical sources, the boundaries of normal indicators of the size of the lobes and the volume of the organ differ. Studies among the population have shown that the average values ​​of the norm are relative - for example, the population of regions with a constant iodine deficiency is characterized by a general change in the size of the thyroid gland upwards, and this is not a pathology.

Often there is asymmetry of the body - right lobe usually more than the left, but it also happens vice versa - as an individual feature of the organism. There were cases when in healthy people one of the lobes was underdeveloped or completely absent.

The difference in the volume of the thyroid gland in men and women is not associated with gender, but with the difference in physical and physiological indicators organism.

Normal thyroid size

Although throughout menstrual cycle in women, and there are some fluctuations in the data of ultrasound of the thyroid gland, nevertheless, when conducting an examination, specialists take into account, first of all, the age and weight of the patient. In adults, the normal size of the thyroid gland can vary within:

• weight up to 40 kg - up to 12.3 cm3;
• 41–50 kg - up to 15.5 cm3;
• 51–60 kg - up to 18.7 cm3;
• 61–70 kg - up to 22 cm3;
• 71–80 kg - up to 25 cm3;
• 81–90 kg - up to 28.4 cm3;
• 91–100 kg - up to 32 cm3;
• 101–110 kg - up to 35 cm3.

As the data of the list show, the concept of the norm in a healthy person is very relative and often goes beyond the average indicators. In addition, it is allowed to exceed these norms by 1 cm3 or more, provided that the function of the thyroid gland is not impaired.

There are cases of individual underdevelopment (hypoplasia) of the organ with the preservation of its full functionality.

In about 1/6 of the population, the thyroid gland has a pyramidal lobe - an additional structural unit with a base in the middle of the isthmus - which is also one of the variants of the individual norm. Specialists of diagnostic rooms periodically observe the absence of an isthmus between the lobes of the organ in some patients.

To identify pathological changes, a comprehensive analysis of the data of ultrasound examination of the thyroid gland is necessary:

• The contours of the gland - a healthy organ has clear, even contours, the change of which indicates the development of the inflammatory process.
• Structure - homogeneous glandular tissue is an indicator of the norm and has a characteristic granularity. With the development of immune inflammatory diseases - autoimmune thyroiditis, diffuse toxic goiter - the structure becomes heterogeneous. Sometimes the heterogeneous structure of the glandular tissue is also found in healthy older people. age groups with increased production of antibodies to certain enzymes of thyroid cells.
• Echogenicity is a certain value of the general acoustic response characteristic of the tissue under study. Echogenicity should be normal, i.e. meet the standards for that body. If echogenicity is reduced, the doctor may suspect the development of an inflammatory process. An increase in echogenicity may indicate acute inflammation or the development of pathological changes.
• Foci of changes are areas characterized by a decrease (hypoechogenicity), absence (anechoicity) or an increase (hyperechogenicity) of the acoustic response of ultrasound. Such formations should not normally be, although the presence of small, up to 4 mm, anechoic areas is allowed - single enlarged follicles of the glandular tissue. Pathological foci, identified in the structure of the tissue, are nodes of the thyroid gland. Nodes can be single or multiple. Solitary small nodules (1-3 mm) are usually not treatable and often disappear on their own over time. Formations larger than 3 mm, as a rule, require clarification of the diagnosis.
• The state of the lymph nodes - the latter should have clear, even contours, no cysts and a normal size (not enlarged).

What does a thyroid ultrasound show?

colloid nodes- formations, which are overgrown follicles. These are benign lesions that almost never degenerate into malignant tumors.

Adenoma- a benign tumor surgical removal. The presence of a fibrous capsule allows it to be differentiated from other pathologies. It develops with age, mainly in women.

Cyst- fluid-filled formation. Usually observable.

thyroid cancer- a dangerous single node that does not have clear boundaries and a shell. It is characterized by rapid growth, is subject to immediate removal along with the lymph nodes.

When a neoplasm is detected, the patient undergoes additional research- Dopplerography or elastography, to assess changes in the intensity of blood flow in the vessels of an organ, and the cellular and tissue structure of existing formations. If necessary, a needle biopsy is performed for histological analysis under ultrasound supervision.

Diffuse toxic goiter- a disease manifested by an increase in the volume of the gland and the heterogeneity of its structure due to the formation of multiple nodes.

Inflammatory diseases (thyroiditis)- distinguish between acute and subacute thyroiditis of infectious and viral origin, arising as complications after tonsillitis, bronchitis, pneumonia, SARS; fibrous thyroiditis - inflammation of the tissue as a result of the abundant growth of its fibrous component; autoimmune chronic thyroiditis- a feature of the body to perceive thyroid cells as foreign, as a result of which an inflammatory process occurs.

Goiter of the thyroid gland- an increase in volume due to tissue growth. Euthyroid goiter does not affect the function of the organ, hypo- and hyperthyroid goiters are associated with corresponding dysfunctions. Perhaps the development of endemic goiter among the population of areas with a low content of iodine in the environment, as well as some hypertrophy of the thyroid gland during pregnancy.

Hypoplasia of the thyroid gland- congenital underdevelopment of the organ due to endocrine disorders during pregnancy of the mother or insufficient intake of iodine in the body.

Thyroid atrophy- a decrease in its size as a result of the gradual replacement of the glandular tissue with connective tissue, combined with the development of hypothyroidism, requiring constant replacement therapy.

Thus, when making an accurate diagnosis by an endocrinologist, the results of ultrasound examination (ultrasound) are analyzed in combination with other indicators of the patient's health. The set of complaints individual symptoms, general well-being, blood tests and data functional diagnostics allows the doctor to determine the individual boundaries of the norm and pathology and choose the best means of treating the patient.

Dear readers, if you have any questions, then ask them in the comments, I will try to answer them in detail.

Overweight and thyroid connected by an unbreakable thread. In this article, you will learn how the work of the thyroid gland affects weight fluctuations. Many of us are ready to justify our excess weight with thyroid disease. Is it always like this? In what case is the thyroid gland to blame for excess weight, and in which is its mistress? Let's understand these important issues like "who's to blame?" and "what to do?" right in this article.

I get asked a lot of questions about excess weight and fight against it. Many mistakenly believe that this endocrine pathology, and most often it is associated with impaired thyroid function. Yes, indeed, in some diseases of this organ, changes in body weight can be observed both upward and downward. But true endocrine obesity is very rare, mostly overeating and low physical mobility.

All diseases of the thyroid gland conditionally according to the level of work can be divided into 3 groups:

1. with enhanced function
2. with reduced function
3. with unchanged function

Let's remember what function it performs. It regulates the basic exchange. Her hormones accelerate all metabolic processes: the breakdown of fats, proteins and the absorption of carbohydrates. Thyroid hormones are needed to obtain energy from any resource. And energy is needed for the work of all cells of the body. It's like fuel for a steam locomotive.

The most important resource for humans in terms of energy is carbohydrates. If there are not enough carbohydrates in the food consumed, fats begin to be consumed. Most diets are based on this principle, where the main restriction is the ban on easily digestible carbohydrates. When fats are already used up from fat depots, muscles go to consumption.

A similar picture was observed in concentration camps, when a person looked like a skeleton covered with skin. Although even now there are young ladies “obsessed” with thinness who are no better than the sufferer from the concentration camp. The only difference is that the young lady goes for it consciously.

From everything we can conclude that for a certain group of thyroid diseases there will be a certain situation with weight.

When are overweight and thyroid related?

When the work of the thyroid gland is excessively increased, which is typical for such a disease as diffuse toxic, the main metabolism is accelerated and under the influence of an excess of thyroid hormones, all resources go to waste. At the same time, a person can eat a lot, but not gain weight.

If the work of the thyroid gland is reduced, which happens with hypothyroidism, then small amount hormones cannot provide good speed main exchange. And everything that enters the human body is deposited in fat depots. Plus, there is fluid retention in the body, which also contributes to weight gain. Read the article and everything will become clear to you.

In a situation with a normal, preserved, functioning of the thyroid gland, everything is clear. The speed of the main exchange is optimal, resources are spent exactly as much as necessary. Therefore, in this case, if there is still weight gain, then the reason is not at all in the thyroid gland. This may be a violation of the work of other endocrine glands, or a banal overeating and insufficient physical activity.

Now let's figure out what to do when there are problems with weight. And by problems, I also mean a rapid weight loss with thyrotoxicosis (increased work of the thyroid gland). What kind of disease it is and what other signs it has, you will learn from the article.

In principle, in both cases, the problem is solved with the normalization of the thyroid gland. When the level of thyroid hormones becomes normal, weight problems will gradually disappear.

The difficulty of normalizing the level of thyroid hormones in thyrotoxicosis is that this very thyrotoxicosis can be observed with various diseases with different approaches to treatment. Therefore, here it is necessary first to accurately determine the diagnosis that causes thyrotoxicosis. Further treatment is carried out according to the disease.

Hypothyroidism, unlike thyrotoxicosis, is treated in the same way, regardless of the cause that caused it. Normalization of the level of hormones is achieved by the substitution intake of synthetic analogs of thyroid hormones. These include drugs such as L-thyroxine, eutiroks, etc.

After the start of taking these drugs, the main metabolism is leveled, excess fluid leaves. The excess weight starts to decrease. - the answer is in the article.

There are cases when hypothyroidism is not pronounced, then it is called subclinical (there are no symptoms, but laboratory indicators changed). With subclinical hypothyroidism, there may not be excess weight gain, but sometimes the prescription of the above-mentioned drugs is required. In this case, they ask me: “Won’t I gain weight from these hormones?”.

My answer is always "No". And then at the consultation, I explain why for a long, long time. From thyroid hormones it is impossible to gain weight in principle, if the dose is chosen correctly. Weight can increase with a lack of hormones or decrease with their excess.

In endocrinology, if hormones are prescribed (not only of the thyroid gland), then with a substitution purpose, that is, in physiological doses - those that would be produced by the gland itself.

But, for example, in rheumatology hormones are used in large doses especially to suppress pathological process, and this is associated with the appearance of side effects, including weight gain.

And finally, in the article I talk about the effect of this particular drug on body weight. Highly recommend.

The thyroid gland (glandula thyroidea), being the largest endocrine gland in the human body, produces and accumulates iodine-containing hormones. Under their influence are all metabolic reactions and many processes that determine the supply and consumption of energy in the body.

Organ structure

The shape resembles a horseshoe with a concavity facing inward. If it is supplemented by a pyramidal lobe, then it is similar in shape to a trident pointing upwards. From external influence gland is protected by skin, subcutaneous tissue, muscles and fascia of the neck (fascia cervicalis).

The fascia of the neck forms a connective tissue capsule (capsula thyroidea), which loosely closes with a fibrous capsule (capsula fibrosa) and fixes the gland to nearby muscles. The outer surface of the capsule is closely fused with the larynx and trachea, with the pharynx and esophagus - the connection is loose. Above it (lateral lobes) limits the thyroid cartilage, below - 5-6 tracheal rings.