The thyroid plays a central role in the regulation of energy metabolism, thermogenesis, cardiovascular function, bone health and the modulation of neuropsychic pathways. When there are changes in the functioning of the gland, different symptoms can appear — and many of them are confused with stress, anxiety or tiredness from routine.

Hypothyroidism, hyperthyroidism and nodular disease are among the most prevalent endocrinopathies in outpatient practice, with a significant impact on cardiovascular, bone and reproductive outcomes, as well as quality of life.

Signs of thyroid problems appear silently

Complaints such as chronic fatigue, difficulty losing weight, hair loss, mood changes and thermal intolerance, often attributed to stress or lifestyle habits, are part of the clinical spectrum of manifest or subclinical thyroid dysfunction, as described in international guidelines.

According to Adriano Cury, endocrinologist at Alta Diagnósticos, premium at Dasa, one of the main challenges is that signs tend to appear silently and with little specificity, delaying diagnosis. “In many cases, patients associate symptoms only with stress or their busy lifestyle, which can cause them to delay seeking medical evaluation”, he explains.

Differences between hypothyroidism and hyperthyroidism

Hypothyroidism occurs when the thyroid produces insufficient hormones, slowing down the metabolism. In addition to tiredness and weight gain, the condition can cause changes in cholesterol and increase cardiovascular risk. Most cases are related to Hashimoto’s thyroiditis, an autoimmune disease.

Hyperthyroidism, on the other hand, occurs when there is excessive production of hormones, causing the body to accelerate. Anxiety, palpitations, irritability, insomnia and unexplained weight loss are among the most common symptoms. In some cases, the disease can also promote cardiac arrhythmias and loss of bone mass, especially in women after menopause.

Thyroid nodules are common

Thyroid nodules also deserve attention. Although extremely common and, in most cases, benign, some cases require more detailed investigation to rule out Cancer of thyroid.

Data from the Global Cancer Observatory and recent estimates from the National Cancer Institute (INCA) show that thyroid cancer is among the most common endocrine tumors today, with an increase in cases mainly related to the diagnosis of small asymptomatic tumors.

“Therefore, the evaluation of nodules must include clinical history, physical examination and cervical ultrasound with standardized risk stratification criteria, in addition to the judicious use of fine needle aspiration (FNA). In some specific cases, molecular tests may also be indicated”, says Adriano Cury.

Diagnosis thyroid problems

When there are symptoms related to thyroid problems, the investigation usually begins with laboratory tests, mainly TSH and free T4. Depending on the clinical picture, the doctor may also order T3 and antithyroid antibodies. Cervical ultrasound is mainly indicated for the evaluation of nodules and structural changes in the gland.

Below, see guidelines for thyroid health to put into practice:

• Observe body signals: Persistent changes in weight, energy, mood, or sleep deserve attention;
• Do check-ups regularly: people with a family history, autoimmune diseases or frequent symptoms should maintain medical monitoring;
• Avoid self-medication: inappropriate use of hormones and supplements can harm thyroid function;
• Maintain healthy habits: a balanced diet and stress control help with hormonal balance;
• Seek expert assessment: the presence of nodules or persistent symptoms must be investigated to avoid future complications.

In recent years, artificial intelligence tools applied to ultrasound have also started to assist in the assessment of nodules thyroids. Even so, experts reinforce that individualized clinical analysis remains essential for an accurate diagnosis and adequate treatment.

By Mariana Durante