The thyroid, or thyroid gland, is an endocrine gland in vertebrates. In humans it is in the neck and consists of two connected lobes. The lower two thirds of the lobes are connected by a thin band of tissue called the thyroid isthmus. The thyroid is located at the front of the neck, below the Adam's apple. Microscopically, the functional unit of the thyroid gland is the spherical thyroid follicle, lined with follicular cells (thyrocytes), and occasional parafollicular cells that surround a lumen containing colloid. The thyroid gland secretes three hormones: the two thyroid hormones – triiodothyronine (T3) and thyroxine (T4) – and a peptide hormone, calcitonin. The thyroid hormones influence the metabolic rate and protein synthesis, and in children, growth and development. Calcitonin plays a role in calcium homeostasis.[1] Secretion of the two thyroid hormones is regulated by thyroid-stimulating hormone (TSH), which is secreted from the anterior pituitary gland. TSH is regulated by thyrotropin-releasing hormone (TRH), which is produced by the hypothalamus.[2]
The thyroid gland develops in the floor of the pharynx at the base of the tongue at 3–4 weeks gestation; it then descends in front of the pharyngeal gut, and ultimately over the next few weeks, it migrates to the base of the neck. During migration, the thyroid remains connected to the tongue by a narrow canal, the thyroglossal duct. At the end of the fifth week the thyroglossal duct degenerates, and over the following two weeks the detached thyroid migrates to its final position.
Euthyroid is the term used to describe a state of normal thyroid function in the body. Thyroid disorders include hyperthyroidism, hypothyroidism, thyroid inflammation (thyroiditis), thyroid enlargement (goitre), thyroid nodules, and thyroid cancer. Hyperthyroidism is characterized by excessive secretion of thyroid hormones: the most common cause is the autoimmune disorder Graves' disease. Hypothyroidism is characterized by a deficient secretion of thyroid hormones: the most common cause is iodine deficiency. In iodine-deficient regions, hypothyroidism secondary to iodine deficiency is the leading cause of preventable intellectual disability in children.[3] In iodine-sufficient regions, the most common cause of hypothyroidism is the autoimmune disorder Hashimoto's thyroiditis.
The presence of the thyroid and its various diseases have been noted and treated for centuries, although the gland itself has only been described and named since the Renaissance.[4] Knowledge of the thyroid, its biochemistry, and its disorders developed throughout the late nineteenth and twentieth centuries. Many modern treatments and investigative modalities evolved throughout the mid-twentieth century, including refinement of surgical techniques for thyroid removal (thyroidectomy) for the treatment of goitre; the use of radioactive iodine and thiouracil for the treatment of Graves' disease; and fine needle aspiration for diagnosis of thyroid nodules.[4]
The thyroid gland is a butterfly-shaped organ composed of two lobes, left and right, connected by a narrow tissue band, called an "isthmus".[5] It weighs 25 grams in adults, with each lobe being about 5 cm long, 3 cm wide, and 2 cm thick and the isthmus about 1.25 cm in height and width.[5] The gland is usually larger in women than in men, and increases in size during pregnancy.[5][6]