Secretion of thyroxine (T 4 ) and triiodothyronine (T 3 ) from the thyroid gland provides an overall “set point” for the activity of this hormonal axis. However, as in the case of other hormones, in particular, those from the adrenal cortex and gonads, mechanisms governing the cellular uptake and metabolism of thyroid hormones have an important influence on their plasma concentrations. These “prereceptor” processes are also critical determinants of the cellular level of T 3 available for binding to nuclear thyroid hormone receptors. The metabolic fate of thyroid hormones in peripheral tissues thus serves as an important control mechanism of thyroid hormone action.
As with many diseases, it is better to prevent the problem rather than have to treat it. Over the last 80 years, world-wide efforts have been made to eliminate iodine deficiency. Indeed, elimination of iodine deficiency has been a major goal of the World Health Organization. Iodized salt has been the mainstay of treatment for iodine deficiency worldwide, including in the United States. Injections of iodized oil are occasionally used in regions of the world where widespread iodized salt use is not possible. Iodination of water supplies also has been effective in some places.
University of Michigan endocrine surgeons perform their own thyroid ultrasounds. Their overall experience and insight into thyroid disease allows them to gather necessary information at the time of the first office visit so they can formulate a specific course of treatment for each patient. This approach supports streamlined patient care, avoidance of unnecessary visits and minimizing the time from diagnosis to treatment.
For patients needing thyroid surgery, minimally invasive approaches are offered by some of our surgeons.