Thyroid hormone in health and disease

    1. J A Franklyn
    1. Division of Medical Sciences, IBR Building, 2nd floor, The Medical School, University of Birmingham, Birmingham B15 2TT, UK
    1. (Requests for offprints should be addressed to K Boelaert; Email: k.boelaert{at}bham.ac.uk)

    Abstract

    Thyroid disease is common, affecting around 2% of women and 0.2% of men in the UK. Our understanding of the effects of thyroid hormones under physiological circumstances, as well as in pathological conditions, has increased dramatically during the last two centuries and it has become clear that overt thyroid dysfunction is associated with significant morbidity and mortality. Both hypo-and hyperthyroidism and their treatments have been linked with increased risk from cardiovascular disease and the adverse effects of thyrotoxicosis in terms of osteoporosis risk are well established. Although the evidence suggests that successful treatment of overt thyroid dysfunction significantly improves overall survival, the issue of treating mild or subclinical hyper- and hypothyroidism remains controversial. Furthermore, the now well-established effects of thyroid hormones on neurodevelopment have sparked a whole new debate regarding the need to screen pregnant women for thyroid function abnormalities. This review describes the current evidence of the effects of thyroid hormone on the cardiovascular, skeletal and neurological systems, as well as the influence of thyroid diseases and their treatments on the development of malignancy. Furthermore we will describe some recent developments in our understanding of the relationship between thyroid status and health.

    • Received in final form 26 April 2005
    • Accepted 17 May 2005
    • Accepted 23 May 2005
    • Made available online as an Accepted Preprint 23 May 2005
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