More and more people are faced with thyroid diseases and diabetes. Endocrinologist Zulkhiya Ismagilova told Chelny News about the prevention of these ailments
– How serious is the situation with iodine deficiency in Tatarstan?
– Tatarstan is considered an endemic area for iodine deficiency, as it is lacking in soil and water. Therefore, its shortage is very common among Tatarstan residents. In the USSR, salt was iodized, which was a good prevention of iodine deficiency. Consumption of 4-5 grams of iodized salt per day is just enough to cover the iodine deficiency.
– Is salt really considered effective?
– Yes, it covers the lack of iodine. During Soviet times, when salt was iodized, the prevalence of goiter decreased. You can find this kind of salt in stores, but you have to look for it. And it is important to observe some points: buy iodized salt fresh according to the expiration date, store it in a closed package, pour it into a jar with a lid, and add it at the end of cooking. And if you balance your diet with seafood, eat walnuts and seaweed, it will be even better. Iodine is especially necessary for adolescents and pregnant women to prevent iodine deficiency. If we talk about iodine preparations, then potassium iodide is needed for children under 5 years old – 50 mcg per day, 6-12 years old – 100-120 mcg per day, adolescents and adults – 150 mcg per day, pregnant and lactating women – 200-250 mcg per day day.
– Who is contraindicated to take potassium iodide for prophylaxis?
– It is undesirable in the presence of large nodular formations, since the node may be activated, which will excessively produce thyroid hormones. Also, for thyrotoxicosis and diffuse toxic goiter, we do not prescribe iodine.
– Is there any point in smearing pure iodine on the body?
– No, it will not enter the body through the skin. When they say that the iodine network quickly disappears, this does not mean that the iodine is absorbed and enters the bloodstream.
– Should I worry about the presence of nodes in the thyroid gland?
– Nodes occur frequently; if they exist, we monitor them. If the ultrasound shows suspicious signs, we send the material for a biopsy to see what cells the node consists of. If the result is normal, then we continue to monitor them. There are no drugs that resolve or reduce thyroid nodules. The main reason for the appearance of nodes is iodine deficiency. Oncology occupies approximately only three percent of all nodal formations.
– What is the probability that the thyroid nodules will resolve on their own?
– The formed node does not dissolve. Some patients say that their node has disappeared, but this means that it was not a true node, but a pseudonode; as a rule, formed nodes do not resolve.
– Is thyroid cancer considered not as scary as cancer of other organs?
– Yes. It is difficult to die from thyroid cancer; it is treatable. It all depends on the type of cancer, but most often it is follicular, papillary cancer, which is treatable.
– What is the reason for the increase in autoimmune diseases, including those of the thyroid gland?
– In an autoimmune disease, the immune system destroys healthy thyroid cells, mistaking them for foreign ones. Triggers of autoimmune diseases are stress and viruses. But there must still be a genetic factor, certain genetic damage that predisposes to autoimmune diseases.
– Is it possible to reduce antibodies in autoimmune diseases to normal?
– The level of antibodies is regulated by the immune system, and we cannot get involved in this process; there are no drugs that reduce the level of antibodies. The only thing is that you can reduce the trigger points that affect these antibodies. Reduce viral load, reduce stress, eat an environmentally friendly and balanced diet.
– It is rarely talked about that viruses can cause autoimmune diseases…
– Adverse environmental factors, including viruses, are a trigger for autoimmune diseases. For example, there was a lot of autoimmune hypothyroidism after Covid.
– In what cases is the function of the thyroid gland completely lost?
– The main cause of hypothyroidism, that is, decreased functioning of the thyroid gland, is precisely autoimmune thyroiditis, which leads to damage to the cells of the thyroid gland, which leads to disruption of these cells and a lack of production of thyroid hormones. The cells become non-functional and hormone replacement therapy is needed.
– How does the thyroid gland affect weight?
– People who come with obesity try to find the cause of obesity in hormones and waste time on this. Instead of adjusting your diet. Because it is an excess of calories and an unbalanced diet that leads to obesity. Hypothyroidism itself and reduced thyroid function do not lead to obesity. Many times people came to me whose thyroid gland did not work at all, but they did not gain much weight, literally 2 kg, and that was due to edema. That is, hypothyroidism itself does not lead to obesity. Just like the hormones that are taken for hypothyroidism, and patients often think that they are getting fat because of them. This is wrong. Excess weight is related to diet.
– Why are there more and more diabetics every year?
– It has to do with lifestyle. The number of overweight people is growing, which is due to excess nutrition and a sedentary lifestyle. There is now a lot of food, it is affordable, people overeat, most have a car, and they don’t feel like moving again. Excess weight always increases the risk of developing type 2 diabetes. If you are obese
1 degree, then the risk of developing diabetes mellitus increases three times, if obesity is 2 degrees, then five times, if obesity is 3 degrees, then ten times. The first type of diabetes is an autoimmune disease when the immune system damages the pancreas’s own cells and its own insulin is no longer produced.
– Can the incidence of diabetes mellitus already be called an epidemic?
– Yes, the number of diagnosed diabetes is growing every year.
– Nowadays there is a lot of talk about insulin resistance. Is it true that many could avoid diabetes if they paid attention to the insulin resistance index?
– Yes. Insulin resistance is the reduced sensitivity of cells to insulin, and insulin is a hormone that lowers blood sugar levels. Among doctors, insulin resistance has always been talked about, but now information has begun to appear on social networks. Weight gain is always associated with an excess of calories in the diet due to excess fats and carbohydrates. As fat mass increases, insulin resistance increases. But it also happens to thin people, especially those who have polycystic ovary syndrome.
– Sweets aren’t the cause of diabetes, are they?
– It is not a direct cause. Sweets can worsen insulin resistance if consumed in excess. Insulin surges cause frequent meals with an abundance of simple carbohydrates and saturated fats, an excess of calories and weight gain.
– Diabetes mellitus can lead to amputation of limbs. How to avoid this?
– To prevent this, good compensation for diabetes is needed, that is, the main task of diabetics is to keep their sugar levels within the target values recommended by the treating endocrinologist, and not cause glucose spikes. Blood vessels are most damaged when sugar levels jump from low to high.
– Is there still a shortage of endocrinologists in the city?
– There are enough of them in Chelny now. Every clinic and hospital has an endocrinologist. Some clinics even have two or three specialists.
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2023-11-09 06:00:00
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