Metabolism : is a series of complex processes by which the human body converts food, water, and oxygen into tissue, energy, and waste products. It is a continuous process and goes on in every cell of the body. It comprises the breaking down of substances into simpler parts, and their shuffling and recombination into countless new substances that compose the body. For example, the carbohydrates are broken down by enzymes and acids and converted into pure sugar or glucose.
The constructive chemical and physical process by which food materials are adapted for the use of the body is known as anabolism; and the destructive process by which energy is produced with the breaking down of tissues into waste products is called catabolism. The two processes together are called metabolism.
There are clinical situatuions where thyroid hormones in the circulation are within normal range, but gland is enlarged ex: diffuse goitre, multinodular goitre, single thyroid nodule. single thyroid nodule. Single thyroid nodule deserves attention for its association with malignancy. FNAC by and experienced cytologist is of great help to rule out malignany. Once suspected, a differentiated carcinoma of thyroid calls for total thyroidectomy, followed by radio-iodine ablation, so that no thyroid tissue remains in the thyroid bed. This will facilitate to diagnose recurence of tumour by estimation thyroglobulin in circulation during the follow-up period. Fortunately most of the thyroid disorders including differentiated carcinoma of thyroid, are curable if managed properly.
Auto-immunity plays a major role in the aetiopathogenesis of thyroid disorders whether it is hypothyroidism or hyperthyroidism. However, iodine deficiency is still recognised as the commonest environmental factor keeping a large population at risk across the globe in spite of global effort to overcome the iodine deficiency. No continent is totally free of iodine deficiency. Iodine deficiency disorders include still birth, congenital malformation, deaf-mutism, cretinism, goitre and hypothyroidism in scholl going children and in adults. Physicians of India have a great task to overcome the illiteracy and misconception of the people towards iodised salt intake, and facilitate the governments effort for compulsory use of iodised salt by all.
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