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A gland located beneath the larynx (voice box) that makes thyroid hormone and calcitonin. The thyroid helps regulate growth and metabolism. Also called thyroid gland.

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The thyroid gland is a vital hormone gland: It plays a major role in the metabolism, growth and development of the human body. It helps to regulate many body functions by constantly releasing a steady amount of thyroid hormones into the bloodstream. If the body needs more energy in certain situations – for instance, if it is growing or cold, or during pregnancy – the thyroid gland produces more hormones.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 19, 2018

Vandetanib (trade name: Caprelsa) has been approved in Germany since February 2012 for the treatment of advanced medullary thyroid cancer in adults.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: May 4, 2017

The thyroid is a butterfly‐shaped gland at the front of the oesophagus/throat that produces thyroid hormone. Thyroid hormone helps the body to make energy, keeps body temperature regulated and assists other organs in their functions. Hypothyroidism (a deficiency of thyroid hormone) is a relatively common illness that can cause fatigue, constipation, muscle cramps and weakness, hair loss, dry skin, intolerance to cold, depression and weight gain. Medication is with levothyroxine. Selenium is a trace element that changes the expression of selenoproteins. These act as antioxidants and appear to decrease thyroid inflammation in autoimmune thyroiditis. Pregnant women with subclinical hypothyroidism have abnormal thyroid hormone levels but no symptoms. They are at a increased risk of miscarriage, pre‐eclampsia and preterm birth with impaired neuropsychological development in the child.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: May 31, 2013

An overactive thyroid can be treated with medication, surgery or radioactive iodine. The most suitable treatment option will mainly depend on the cause of the disease. If the thyroid gland makes too many hormones and releases them into the bloodstream, it can lead to things like weight loss, nervous restlessness and a rapid heartbeat. An overactive thyroid (hyperthyroidism) can have various underlying causes. The most common of these is called Graves’ disease. It also often develops if cells in the thyroid gland start making too many hormones "autonomously" – in other words, without being instructed to by the pituitary gland, which is normally the case. These autonomous cells are either found in nodules or spread throughout the whole gland. Mild hyperthyroidism may get better on its own, without treatment. In most cases, though, the symptoms get worse without treatment. Taking medication is sometimes enough to keep the symptoms under control. But they usually only go away completely in the long term if treated with surgery or radioactive iodine (radioiodine therapy).

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 19, 2018

The thyroid gland regulates a lot of functions in the body. It is said to be overactive if it produces too many thyroid hormones. This can lead to symptoms such as weight loss, sweating, nervous restlessness and a rapid heartbeat. An overactive thyroid increases the risk of cardiovascular disease.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 19, 2018

Subclinical (latent) hypothyroidism means that the thyroid gland is still producing enough thyroid hormones. But some blood values may suggest the early stages of a hormone deficiency. Experts don't agree on whether subclinical hypothyroidism should be treated. It's not clear in which cases treatment would have advantages. If you already have noticeable (“overt” or “manifest”) hypothyroidism, the thyroid is no longer producing enough thyroid hormones. Thyroxine is the most important of the thyroid hormones. It helps regulate many of the body’s functions to balance your metabolism. Too little thyroxine can cause a number of different health problems. The symptoms range from cold hands to physical weakness, difficulty concentrating and depression. Hypothyroidism can be treated easily by taking a tablet containing the thyroid hormone once a day. These tablets act to replace the thyroxine that is not being produced. This usually makes the symptoms disappear completely. Because it doesn't cause any symptoms, subclinical hypothyroidism isn't noticeable. The TSH (thyroid-stimulating hormone) value is too high, but the thyroid is still producing enough hormones. This hormone is produced in the pituitary gland and acts as a trigger for the thyroid to start producing the thyroid hormones. TSH levels that are just a little too high may be the first sign of the early stages of hypothyroidism: The pituitary gland responds to lower levels of thyroid hormones by increasing TSH production to activate the thyroid. It is estimated that about 5 out of 100 people have subclinical hypothyroidism. Slightly elevated TSH levels are usually detected by accident during a routine examination. But taken on their own they don't pose any health risk. It's also possible that TSH levels are high only temporarily, for example after intense physical activity. Experts don't fully agree on how to decide when subclinical hypothyroidism should be treated.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: August 10, 2017

The thyroid gland is a vitally important endocrine (hormone) gland that is mainly involved in the body’s energy metabolism. It is located at the front of the neck, below the voice box, and is butterfly-shaped. The thyroid gland produces the thyroid hormones triiodothyronine (T3) and thyroxine (T4), among other things.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 30, 2018

If you constantly feel unmotivated, have a low pulse and are constipated, you may wonder what the cause is. There are many possible reasons for these sorts of symptoms, but they are all typical of an underactive thyroid. A blood test can help you find out for sure.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: August 10, 2017

Subclinical hypothyroidism is a condition where some laboratory findings point at a thyroid gland not working properly. Patients with subclinical hypothyroidism may have vague, non‐specific symptoms of actual hypothyroidism (for example dry skin, cold skin or feeling colder, constipation, slower thinking, poor memory) but these thyroid‐related symptoms are not specific, that is why the diagnosis is based on test results. The fundamental question regarding people with subclinical hypothyroidism is whether they should be treated with thyroid hormones. To answer this question twelve studies of six to 14 months duration involving 350 people were analysed. Thyroid hormone therapy for subclinical hypothyroidism did not result in improved survival or decreased cardiovascular morbidity (for example less heart attacks or strokes). Data on health‐related quality of life and symptoms did not demonstrate significant differences between placebo and thyroid hormone therapy. Some evidence indicated that thyroid hormone had some effects on blood lipids and technical measurements of heart function. Adverse effects were inadequately addressed in most of the included studies and have to be urgently investigated in future studies, especially in older patients.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 18, 2007

The main method for the treatment of differentiated thyroid carcinomas (a cancer of the thyroid gland) is total or near‐total thyroidectomy (surgical removal of the thyroid) followed by radioactive iodine therapy (iodine‐131) and treatment with thyroid hormones (mainly thyroxin). The metastatic disease of this thyroid carcinoma or spread of the tumour includes local recurrence and distant metastases. Metastatic disease is a factor that worsens prognosis of patients with differentiated thyroid carcinoma. After surgery or as the primary treatment, located metastases should, if possible, be removed by an experienced surgeon. For unremovable metastases which can gather radioiodine, iodine‐131 therapy is an accepted procedure.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: January 21, 2009

Congenital hypothyroidism is a condition that affects infants from birth and results from a missing or abnormally developed thyroid gland, abnormal production of thyroid hormones or a failure of the pituitary gland to stimulate thyroid hormone production. It affects approximately 1 in 3000 to 4000 newborn infants and early diagnosis and treatment is very important to achieve a good outcome.Treatment of congenital hypothyroidism consists of a daily dose of thyroid hormone (thyroxine). However, the initial dose of thyroxine required to improve outcomes for infants with this condition is unclear and has been the subject of several studies. Some studies have suggested that when infants with congenital hypothyroidism are treated with a higher dose of thyroxine compared with the standard dose, this results in earlier normalisation of the their thyroid hormones and leads to better developmental outcome and intelligence.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: January 20, 2009

To assess the effects of Chinese herbal medicines in the treatment of benign thyroid nodules in adults.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: March 4, 2014

Thyroid cancer is the most common malignancy of the endocrine system consisting of several subtypes like papillary carcinoma (accounting for 80% of cases) and follicular carcinoma (accounting for 11% of cases). These are collectively referred to as 'differentiated thyroid cancer'. Treatment with radioactive iodine after surgery (ablation of the thyroid gland or 'thyroidectomy') is important for the detection of metastatic disease and for the destruction of the remaining thyroid tissue with microscopic cancer. After radioactive iodine treatment, adverse effects may happen in the salivary glands and cause salivary gland swelling and pain, usually involving the parotid. The symptoms may develop immediately after a therapeutic dose of radioactive iodine or months later and progress in intensity with time. Secondary complications reported include dry mouth ('xerostomia') and taste alterations.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: October 6, 2009

After the removal of the thyroid gland (thyroidectomy) thyroid hormones have to be substituted to attain a normal way of life. Thyroid hormone withdrawal for four to six weeks has been used for more than 50 years for the treatment of metastatic differentiated thyroid cancer after thyroidectomy because residual cancer cells may then be better destroyed by radiation therapy using radioiodine. Another therapeutic approach to prepare for radiation uses injections of technologically created (recombinant) human thyroid‐stimulating hormone (thyrotropin, TSH) to avoid the symptoms of a malfunctioning thyroid gland (hypothyroidism), which are caused by thyroid hormone withdrawal. This technique has been approved for use in the diagnosis of recurrent and metastatic differentiated thyroid cancer and in the preparation of patients for elimination of normal thyroid remnants after thyroid surgery, but not for treatment of known locally recurrent or metastatic disease.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: November 10, 2010

Nodules (lumps) within the thyroid gland are common and usually benign. They are more frequent in women, the elderly and in iodine‐deficient areas. Thyroid nodules are often observed as an incidental finding in the course of ultrasonography of the thyroid, nodules of more than 1 cm in size are usually detected by palpation of the thyroid gland during a physical examination. Thyroid nodules may occur as a single nodule or as multiple nodules and may contain fluid (cyst). About 5 in 100 palpable thyroid nodules have a risk of becoming malignant (thyroid cancer). Thyroid nodules are often treated with thyroid hormones in order to reduce the size of the nodule. If thyroid nodules cause problems such as pressure symptoms or cosmetic complaints, surgery may be performed. Other therapies try to destroy the thyroid nodule by means of minimally invasive procedures (techniques which are less invasive than open surgery) and are usually performed on an outpatient basis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: June 18, 2014

The aim of this review was to compare different surgical techniques for treatment of Graves' disease. We wanted to address whether surgically removing the whole thyroid (total thyroidectomy) gland is better than removing most of the gland (subtotal thyroidectomy) at controlling increased activity of the thyroid (hyperthyroidism) and eye symptoms associated with Graves' disease.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: November 25, 2015

The thyroid is a large gland in the neck that produces hormones that help to regulate the chemical processes in the body that maintain life, including growth and energy use. If a woman has an overactive thyroid (hyperthyroidism), or an underactive thyroid (hypothyroidism) in pregnancy which is not managed, there is a possibility of poor outcomes for the mother and her baby. The mother may be more likely to develop high blood pressure and protein in the urine (pre‐eclampsia), give birth before 37 weeks of gestation (preterm birth), and her baby may develop disabilities (such as cerebral palsy, blindness, deafness and other developmental delays including intellectual impairment). Managing thyroid dysfunction in pregnancy (e.g. thyroxine for hypothyroidism, or antithyroid medication for hyperthyroidism) may improve outcomes for mothers and their babies. There are different methods of screening for thyroid dysfunction, including case finding, which means screening only pregnant women who are thought to be at high risk of thyroid dysfunction, or universal screening, which involves screening all pregnant women. Although universal screening may help to diagnose more women with hyperthyroidism or hypothyroidism than case finding, it could also lead to more women having medications and may be costly. It is not currently clear what the effects are of these different methods of screening for thyroid dysfunction for the mother and her baby, and health services.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: September 21, 2015

BACKGROUND: Advanced laryngeal and hypopharyngeal squamous cell carcinomas carry an inherent risk of invading thyroid parenchyma leading to the incorporation of a hemithyroidectomy or total thyroidectomy as part of a total laryngectomy. In some centres, thyroid gland removal occurs routinely during surgery for T3 and T4 laryngopharyngeal carcinoma. However, the incidence of invasion is low, and therefore, thyroid-sparing surgery must be considered for select cases.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

The pituitary gland regulates various body functions and plays an important role in balancing hormone levels in the body. It is a protrusion at the base of the brain and about the size of a pea or cherry. The gland lies well protected in a small bony cavity of the skull, level with the eyes, and roughly in the middle of the head.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 19, 2018

We conducted this systematic review to support the U.S. Preventive Services Task Force in updating its recommendation on screening for thyroid cancer. Our review addresses the following Key Questions (KQs): 1) Compared with not screening, does screening adults for thyroid cancer lead to a reduced risk of thyroid-specific mortality or morbidity, reduced all-cause mortality, and/or improved quality of life? 2) What are the test performance characteristics of screening tests for detecting malignant thyroid nodules in adults? 3) What are the harms of screening for thyroid cancer in adults? 4) Does treatment of screen-detected thyroid cancer reduce thyroid-specific mortality or morbidity, reduce all-cause mortality, and/or improve quality of life? 5) What are the harms of treating screen-detected thyroid cancer?

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: May 2017

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