Thyroid adenoma - a benign tumor that must be removed surgically. This is necessary because the tumor may compress surrounding tissue, producing hormones and cause hyperthyroidism and finally degenerate into a malignant tumor.

Basic principles of treatment of thyroid adenoma

Thyroid adenoma - a benign tumor, so the only way to treat it can be surgical removal. But adenomas can be different: functioning (hyperthyroid - that is released into the blood thyroid hormone) and non-functioning (euthyroid).

Hyperthyroid thyroid adenoma called toxic. Just can not remove them, you must first suppress the hormonal activity of the tumor and restore the normal condition of internal organs. Therefore, in this case, before the operation is carried out medication.

If during the operation removed a significant part of the thyroid gland and reduces its function is assigned to a lifetime replacement therapy drugs - synthetic analogues of thyroid hormones.

Drug preoperative treatment

Such treatment is carried out before the operation, including when the patient has symptoms of hyperthyroidism expressed Hyperthyroidism: increased secretion of thyroid hormone . As is known, the high content of thyroid hormones have a negative effect on the internal organs and especially on the cardiovascular system.

To suppress the production of thyroid hormones administered antithyroid preparations - Mercazolilum and tiamazol as tablets for oral administration. The mechanism of action of these drugs is that they block the action of enzymes involved in the synthesis of thyroid hormones Thyroid hormones: mechanism of action and physiological effects . The operation is carried out only after the establishment of normal blood level of thyroid hormones and pituitary thyroid stimulating hormone.

At the same time appointed, and symptomatic treatment, the purpose of which is the restoration of the internal organs affected by prolonged exposure to high doses of thyroid hormones. For example, in cardiovascular disease are appointed by cardiac glycosides, potassium supplements, diuretics. Required appointed sedatives and sleeping drugs.

To neutralize the vegetative-vascular manifestations prescribe beta-blockers (eg, propranolol), suppressing a stimulating effect of thyroid hormones on the sympathetic nervous system.

Surgical treatment of thyroid adenoma

The nature of surgery on the thyroid gland depends on the type of adenoma. So, if there is a suspicion of its degeneration into a malignant tumor (usually follicular adenomas, which are very difficult to differentiate from follicular carcinomas - malignant tumors), and complete (total) removal of the thyroid, followed by a lifetime appointment of hormone replacement therapy.

If you doubt there is a benign tumor, the node is removed or half of the thyroid gland (hemithyroidectomy). In the future, the sick observe and, if necessary (if a recurrence of the disease, as it happens) do have a total resection of the thyroid gland.

Most often in adenoma of the thyroid gland is performed subtotal resection - are removed at least two-thirds of breast tissue. Usually after such surgery, relapses occur rarely.

After surgery, complications are possible. So, it is very easy to damage the parathyroid glands, which leads to disturbances of mineral metabolism: decrease in blood calcium. It shows weakness of the limbs, cramps and numbness in hands and feet. It can also be nerve damage, such as damage to the laryngeal nerve will result in hoarseness or loss of voice.

After surgery on the thyroid gland The thyroid gland - is responsible for your hormones   you need constant supervision of the endocrinologist, a periodic survey of thyroid hormone levels in the blood. It is necessary for early detection of recurrence of the disease, or hypothyroidism.

Radioiodine therapy of thyroid adenoma

Elderly patients who are contraindicated for surgery, functioning thyroid adenoma Thyroid adenoma - a benign tumor   treated using radioactive iodine (a single oral solution or tablets, iodine 131). Radioactive iodine enters the adenoma cells and destroys it, in the place that grows connective tissue.

So you can treat only functioning adenoma, and if it does not work and does not absorb iodine, this method is not suitable.

Thyroid adenoma respond well to treatment.

Galina Romanenko

Metformin - a drug that reduces the level of sugar in the blood Blood sugar Blood sugar - a very important indicator   - One of the main indicators of human health And used to treat type II diabetes. Unlike some other similar drugs, metformin does not increase the production of insulin, thereby reducing the level of blood sugar. It increases the sensitivity of liver, muscle, adipose, and other tissues to insulin - which also leads to a reduction in blood sugar levels.

Dosage regimen

Adults: usually begin with metformin 500 mg twice a day or 850 mg once a day. Increase the dose of 500 mg weekly or 850 mg every two weeks - depending on the variation of the blood sugar level of the patient. The maximum dose of metformin is 2550 mg per day - the preparation is divided into three equal doses and is usually taken in the morning, afternoon, and evening.

Kids: patients aged 10 to 16 years are beginning to take 500 mg of metformin daily. Then, the dose is increased to 500 mg per week; the maximum dose for children - 2000 mg per day.

Contraindications

Contraindications to the use of metformin are:

• Pregnancy;
• The period of breast-feeding;
• Liver disease;
• Ketoacidosis;
• The various states, causing breathing problems;
• Alcoholism;
• Allergies to components of the preparation.

Side effects

Metformin may cause the following side effects:

• Muscle pain;
• Muscle weakness;
• Headache;
• Nausea, vomiting, diarrhea, flatulence, pain in the stomach.

When the following side effects of metformin as soon as possible, contact your doctor:

• Numbness of the limbs;
• Heavy breathing;
• Dizziness, nausea, severe fatigue;
• Severe pain in the stomach;
• Reduced heart rate;
• Irregular heartbeat;
• Shortness of breath;
• Swelling.

Drug Interactions

As a general rule, it should not take metformin concurrently with the following medications:

• Furosemide;
• Nifedipine;
• Cimetidine (Tagamet) or ranitidine Ranitidine - help in the prevention of relapse of peptic ulcer   (Zantac);
• Amiloride or triamterene;
• Digoxin;
• Procainamide;
• Quinidine;
• Trimethoprim;
• Vancomycin;
• Isoniazid;
• Diuretics (diuretics;
• Steroids (prednisone etc.);
• Various drugs to treat heart disease and hypertension;
• Niacin;
• Phenothiazines;
• Preparations for the treatment of thyroid diseases Thyroid disease - women at risk   (Synthroid and others);
• Birth control pills and other hormonal agents;
• Anticonvulsants;
• Diet pills;
• Medications to treat asthma, colds or allergies.

If the cancellation of any of these medications is not possible, it is necessary to adjust the dose and carefully monitor changes in the patient's condition during the course of treatment.