The annual appointment with the World Thyroid Week from 25 to 31 May. In Italy there are 6 million people with thyroid problems, associated with a prevalence of non-serious and treatable diseases. The considerable diffusion of these diseases in the population and the ever growing interest of people makes the issue of correct information central. For this reason, the World Thyroid Week 2022, on the recommendation of Thyroid Federation International and Cape (Committee of the associations of endocrine patients), will deal with information: “Thyroid and health: I am well informed”.
In Italy, World Week 2022 is sponsored by the Higher Institute of Health (Iss) and promoted by the main endocrinological, medical and surgical scientific societies, together with the Cape, with the unconditional contribution of Ibsa Farmaceutici Italia, Merck and Eisai. “The theme of communication is important because the impact and spread of thyroid disease in the population are considerable”, explains Marcello Bagnasco, scientific coordinator of Smt and president of the Italian thyroid association (Ait), “and this is increasingly perceived clearly from public opinion. Fortunately, this great diffusion is matched by a prevalence of pathologies that are not serious and above all well treatable, and prevention strategies are available “.
“The wide availability of news on the internet – continues the endocrinologist,” has undoubtedly, as always, positive implications, but it can also lead to the illusion of being able to all intents and purposes ‘doctors of oneself’, and above all to determine the proliferation of inaccurate or even false information, often alarmist, susceptible to relaunch and amplification. On the occasion of this annual event, we will try to answer the many questions that people with thyroid disease ask themselves and identify the most common false myths and dispel them through a ‘decalogue’. The exhortation for patients is always to turn to family doctors and specialists, and to distinguish the qualified sources from which to draw information “.
The topic of hypothyroidism therapy with dry thyroid, proposed as a ‘natural’ alternative to the use of purified thyroid hormone, deserves a separate discussion: “The dry thyroid is nothing more than a dry extract of porcine thyroid. For decades, it was used as a treatment for hypothyroidism, before the introduction of the chemically synthesized L-thyroxine, ”said Luca Chiovato, past president of AIT. “In terms of composition, it contains a mixture of the two thyroid hormones, L-Thyroxine (T4) and L-Triiodothyronine (T3), which can vary from preparation to preparation depending on the origin and diet of the animals from which the thyroid is taken. As a result, it is less manageable than L-thyroxine and its use requires more accurate monitoring. In fact, in reality, standard therapy with L-Thyroxine alone is easy and decisive in the vast majority of patients, thus debunking the usefulness of dry thyroid as a therapeutic alternative. Furthermore, dry thyroid is not a drug authorized by the Ministry of Health and its supply is often not very transparent, using galenic laboratories or products abroad ”.
On the Facebook profile of the World Thyroid Week 2022, a ‘decalogue’ is available with all the answers of the experts to the doubts on the matter. Starting with an evergreen theme: ‘thyroid and extra pounds’. Patients often blame the thyroid for overweight, ‘but this is not the case “, explains Anna Maria Colao, president of Sie, Italian Society of Endocrinology.” Patients with severe hypothyroidism may be overweight, but this is not usually found in hypothyroidism mild, much more frequent. Moreover, obese patients may present modest alterations in thyroid function tests, which must be correctly framed by the endocrinologist. In any case, the use of drugs based on thyroid hormone for slimming purposes is not adequate nor effective, and presents health risks “.
Other doubts concern the use of iodized salt in the diet. “Iodine is essential for the functioning of the thyroid gland because it is the fundamental constituent of thyroid hormones, therefore, adequate iodine nutrition allows you to prevent most thyroid diseases”, explains Antonella Olivieri, head of the National Observatory for the monitoring of iodoprophylaxis (Osnami) of the Iss. “Everyone, even people with thyroid diseases can use iodized salt (‘Little salt but iodized’, according to a successful slogan) because this food guarantees the necessary needs but does not cause an excessive iodine intake” .
“Another misconception is to think that the child has no thyroid problems”, explains Mariacarolina Salerno, president of Siedp (Italian Society of Endocrinology and Pediatric Diabetology). “The thyroid is a fundamental organ for growth, and thyroid diseases can appear already at birth. For decades, screening for hypothyroidism has been carried out at birth, which gives the possibility of diagnosis and timely treatment, guaranteeing normal psychophysical development. Other pathologies similar to those in adults can arise in childhood and in ‘ adolescence, easily identifiable and treatable by the endocrinologist pediatrician “.
“Thyroid pathologies are very common in particular in the elderly”, says Fabio Monzani, Sigg (Italian Society of Geriatrics and Gerontology), “however the symptoms can have particular characteristics and cannot be easily distinguished and classified due to the presence of other pathologies . It is always advisable to contact the specialist who will assess if, when and how to intervene with a therapy in the overall picture of the person’s health “. As regards thyroid surgery” the probability of complications in thyroid surgery – says Pietro Giorgio Calò, President Siuec (Italian Unitary Society of Endocrine Surgery) – is not correlated with the technique used. Minimally invasive interventions are preferred due to the possibility of having almost invisible signs on the neck, but these techniques are reserved for the thyroid glands and smaller nodules. Thyroid surgery is increasingly moving towards a personalized approach on each individual patient and on the characteristics of the gland and the nodule “.
“When there is difficulty in swallowing, one immediately thinks of the thyroid gland”, explains Francesco Frasca, Executive Committee Member ETA, European Thyroid Association who specifies “it must be said that only a very enlarged thyroid, and in particular large nodules can lead to a real difficulty in swallowing. More common causes should be carefully evaluated, such as reflux esophagitis or pharyngitis “.
“Another important doubt to dispel because it could jeopardize breast cancer prevention campaigns”, explains Maria Cristina Marzola, Aimn (Italian Nuclear Medicine Association). “Some people think that the radiation they are exposed to through mammograms screening, can cause thyroid damage and therefore it would always be necessary to wear a leaded collar to protect yourself. In reality – she explains – there is no danger of thyroid damage, and in particular of the onset of tumors, linked to mammography screening, a precious procedure for the early diagnosis of breast cancer. The radioactivity delivered is very low and the radiation in any case does not affect the thyroid. The use of lead collars is not only useless but harmful because it can alter the result of the mammogram “.
Finally, patients with thyroid problems often complain of anxiety and insomnia. “Anxiety, irritability, insomnia and other signs of psychological discomfort – explains Franco Grimaldi, President of Ame (Association of endocrinologists) – can be linked to thyroid malfunction, in particular hyperthyroidism, and normalize with adequate therapy of the dysfunction. Moreover, disorders related to pathological anxiety are very frequent in general, and the finding of normal thyroid function tests allows us to exclude a link with dysfunctions of the gland “.
“Patients who come to us – says Annamaria Biancifiori, president of Cape – are often confused about their own clinical condition. It is not easy for a patient to find his way around the thousands of information ‘just a click away’, information that is difficult to understand and often and willingly misleading. It is therefore very difficult for anyone who does not have knowledge in the medical-scientific field to be able to understand, many times, what they are told because unfortunately it happens that the specialist uses terms that are not always ‘simple’ and easy to understand. incessant search for answers on the internet pushes many patients to self-diagnose clinical conditions that are far from correct ”, he warns.
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