Talk:Thyroid/Archive 1

list of errors found and fixed
Listing of errors found and removed after Nature review beginning 12/14/05. Please add only clear errors of fact rather than editorial or language improvement. I have only reviewed a few paragraphs so far and will look up some more things. alteripse 12:18, 15 December 2005 (UTC)
 * 1) thyroid is not largest gland, pancreas and often the testes are larger in mass and volume; (and this is not even counting the non-classical endocrine glands like the brain, heart, liver, intestines, adipose, kidneys etc)
 * 2) normal adult size is closer to 10-20 g rather than 15-40
 * 3) there are two pairs of arteries (i.e., 4 not two arteries)
 * 4) surgical damage to recurrent laryngeal nerve causes hoarseness not muteness
 * 5) iodination campaigns have not eliminated "cretinism" in developed countries, but have eliminated endemic iodine deficiency cretinism. Newborn screening programs have eliminated cretinism in developed countries.


 * Apparently there were seven inaccuracies. Where are the five other ones? Is there a list somewhere or are we expected to find them ourselves? Given that I expanded the article quite substantially a few weeks ago, this fairly low inaccuracy count is an implicit compliment :-) JFW | T@lk  12:57, 15 December 2005 (UTC)


 * I didnt see any others on a quick run through but I will go through it more carefully. I wish we knew how nitpicky the reviewer was being. The first error I listed above is a true error, though not major. The second I would call nitpicky. I wanted to ask people to list them if several of us go through this with a fine tooth comb this week to see if could find 7. Also thanks to wouterstamp for removing the copyvio text that I replaced without realizing what it was. alteripse 16:38, 15 December 2005 (UTC)

Interestingly the vandal was reverted every time capitalised nonsense was inserted, but his obvious copyvio was retained until WS caught it. JFW | T@lk  17:00, 15 December 2005 (UTC)
 * Well, strangely, that text seemed to be (re?)inserted by Alteripse: (→Diseases of the thyroid gland - replacing removal by vandal) --WS 17:32, 15 December 2005 (UTC)

Nothing strange, just a mistake in thinking it had already been in the article, as I mentioned above. I am glad you caught it. alteripse 18:11, 15 December 2005 (UTC)
 * This is exactly why we need references. There are a ton of little factoids here which sound reasonable but I cannot easily verify. InvictaHOG 23:39, 16 December 2005 (UTC)

david

Just reading through, I was surprised that Vesalius missed the thyroid. And he didn't. Also sounds like it was described even before Vesalius, but I didn't have time to get to the bottom of it. InvictaHOG 04:11, 17 December 2005 (UTC)

I'll have to go over this article thoroughly with my Thyroid textbook on my lap, when I can find the time. Cybergoth 03:15, 20 December 2005 (UTC)

Redundant paragraph
has repeatedly reinserted a paragraph that I removed. It was originally added by an anon and contains no new information that is not already covered in the article. Unless General Tojo can offer a good reason, I really think this should stay out. JFW | T@lk  16:45, 21 June 2006 (UTC)


 * I don't agree at all. All articles should begin with a summary. Many people reading Wikipedia often just want a brief summary. They don't want to have to read the whole page to find what they are looking for. It's good to include a summary. --General Tojo 17:20, 21 June 2006 (UTC)

But the paragraph you keep on reinserting is not the intro. It is an extra paragraph. Do you mean the lead section should be expanded? JFW | T@lk  17:49, 21 June 2006 (UTC)


 * Combined and better written would be better. --General Tojo 18:21, 21 June 2006 (UTC)

Happy with the new version? JFW | T@lk  21:52, 21 June 2006 (UTC)

Structure, location, function, malfunction - it's now got all it needs to have. --General Tojo 22:06, 21 June 2006 (UTC)

Embryology
I do not know the protocol for something like this but I do believe the thyroid is from the 3rd and 4th pharyngeal pouches and therefore a developmentally abnormality results in DiGeorge's syndrome. —Preceding unsigned comment added by 05:58, 17 May 2007 (talk • contribs) 69.123.55.161


 * I've reverted as embryological development is from pharyngeal arches (a pharyngeal pouch is an abnormal diverticulum). David Ruben Talk 23:42, 17 May 2007 (UTC)
 * DiGeorge's syndrome makes interesting reading, but I'm not sure that article can be used to infer that the thyroid is from arches 3 & 4. Anyone have reliable source for its embryology ? David Ruben Talk 23:48, 17 May 2007 (UTC)

I am the poster who originally decided to switch the thyroid embyrological development to the third and fourth pharyngeal pouches. The third pharyngeal pouch forms the inferior parathyroid and the thyroid while the fourth forms the superior parathroid. I got this information from the books I am using to study for the USMLEs Step 1s. What is the correct procedure in referencing and double checking sources?

It's from the first pharyngeal pouch as it derives from the foramen caecum of the tongue and descends in the thyroglossal duct. 3+4 do give rise to the larynx/pharynx, but the thyroid is not related to these embryologically. So says my embryology textbook anyway.

TU tests needs it own article
t4 TU is indirect measure of TBG. also need info about t3 uptake

this deserves its own article. —Preceding unsigned comment added by 207.151.252.81 (talk) 21:02, 19 December 2007 (UTC)

Hi sorry don't know how to change it but thyroid ima artery is listed in the table under veins. Needs updating. —Preceding unsigned comment added by 82.11.252.72 (talk) 09:48, 7 March 2008 (UTC)

Colloid ambiguity
I don't think the colloid in the thyroid is the same as the type of chemical mixture. Please check if adding more info about it. Temporal User (Talk) 04:50, 18 March 2009 (UTC)

Errors ID'd by Nature, to correct
The results of what exactly Nature suggested should be corrected is out... italicize each bullet point once you make the correction. -- user:zanimum


 * Calcitonin production is regulated by TSH.
 * The thyroid is not enlarged during menstruation but does vary in size through the menstrual cycle.
 * C cells do not fill the spaces between follicles, they are scattered through the gland, there is also connective tissue in the intra-follicular space.
 * The description of radioactive isotopes is biased. They are very useful in the diagnosis and treatment of adult thyroid dysfunction, including cancer. The increase in thyroid cancer after Chernobyl was restricted to children.
 * Thyroid is described as ....largest endocrine gland... and quite large for an endocrine gland.. which?
 * Does not contain the information that most thyroid hormone is in the form of thyroxine and this is how it is most easily transported e.g. across the blood/brain barrier. However T3 is the biologically active form of the hormone and is produced, partly directly, but also by de-iodination of thyroxine which occurs in tissues.
 * The description of thyroid disorders should include hyperthyroidism (overactivity), hypothyroidism (under activity) and the fact that these are common affecting about 2% of the population.
 * Possible to also add specific affects of T3 and T4? The summary states controls metabolic functions, but would be helpful to see specifically, which should also tie in with the thyroid disorders 207.38.194.9 (talk) 06:27, 19 May 2009 (UTC)


 * It's funny that the external reviewers did not pick up all of the errors. InvictaHOG 21:44, 22 December 2005 (UTC)

Link to mental illness?
I am right in thinking that an over-active thyroid gland can cause mania? I seem to recall this. Anybody know please?  SmokeyTheCat   •TALK•  12:40, 9 February 2010 (UTC)

"Endocinal Jubachina System"
This "Endocinal Jubachina System" was on the page for years. That's funny and kind of pathetic that out of thousands of peoples who have visted the page, nobody bothered to correct it.7mike5000 (talk) 01:45, 15 April 2010 (UTC)

Seasonal Allergies
Moved a modified version of some stuff about seasonal allergies and thyroid problems over here with citations. Not really sure where to put it in the article though, so feel free to find it a better home. Persephone12 (talk) 01:48, 19 July 2010 (UTC)

Review
10.1172/JCI60047 - mechanisms of thyroid hormone action. JFW &#124; T@lk  14:01, 5 September 2012 (UTC)

Fibromyalgia
Could fibromyalgia be a symptom of a thyroid problem? Brian Pearson (talk) 00:04, 5 July 2008 (UTC)

When looking at any disease you might want to consider what you are eating. You may have celiac disease, food sensitivity to milk or yeast. You may want to be testing if you have fibromyalgia or a thyroid disease. — Preceding unsigned comment added by Dennylou56 (talk • contribs) 23:24, 7 September 2012 (UTC)


 * That is more a question for the reference desk. The link you provided are to an unreliable source touting the theories of a practitioner with his own theories. It doesn't sound like we'll be including this. JFW | T@lk  14:01, 6 July 2008 (UTC)


 * This theory appears on medline too. Perhaps you could include it. . Mathityahu (talk) 15:24, 6 July 2008 (UTC)
 * And because it's on medline, it's reliable? I didn't even read further than the journal title.  --Dr. Friendly (talk) 22:03, 7 July 2008 (UTC)
 * I asked it as a simple question and didn't intend the link to be a source. It does seem to me that the Medline article gives the question more weight, if nothing else. Brian Pearson (talk) 01:42, 17 July 2008 (UTC)

In addition to Hypothyroidism
As a patient, relative, and staff of health and education foundations, I have some ideas you may want to write down. My father and paternal grandfather died of low BP in the LV, just as my father had diabetes I. Diabetes I can normally lead to epilepsy, as me, and diabetes I the next the generation. As I have hypothyroidism, I may have Diabetes 1.5. Others I work and live with all agree autism, epilepsy, just as neurology, psych, and liver, all relate. For they say they have known the same problems. Thank you. Benjamin Minney 23:32, 15 February 2014 (UTC) — Preceding unsigned comment added by Musketeer41 (talk • contribs)

Proposed merge with Lobes of thyroid gland
As above. Additionally, it is strange to have a separate article on 'lobes of thyroid gland', and unlikely that readers will know that it exists. This content should absolutely be displayed on the main page, as it is essential to the structure of the thyroid. This would benefit readers by centralising information and, by virtue of context, enhance the quality of information displayed. LT910001 (talk) 01:08, 19 April 2014 (UTC)
 * ✅ Iztwoz (talk) 14:11, 21 May 2014 (UTC)

Thyroid size
The article states that each lobe of the thyroid about 5cm long x 3cm wide x 2cm thick. There is no attribution for that claim. I have been unable to locate an authoritative source, but all of the information I can find suggests that a more typical size would be 4.5cm long x 2cm wide x 1.5cm thick. That may not seem like much of a difference but it reduces the volume of the thyroid by half. I was diagnosed with an enlarged thyroid and my ultrasound dimensions make the volume of my thyroid actually smaller than the reported size in this article but significantly larger than the dimensions I've suggested here. Can anyone find a source for this information and update the article? Thanks. 157.185.95.29 (talk) 15:50, 21 July 2014 (UTC)mjd
 * Using the 5cm x 3cm x 2cm length on the first page and the standard ellipsoid volume formula (l x w x t) * pi/6 the volume inferred in this article is almost 16 cm^3 per lobe. According to this source the normal volume of a thyroid gland is 7-11 cm^3 per lobe: http://www.ultrasoundpaedia.com/normal-thyroid/. So these dimensions do appear to be too large. The dimensions I suggested appear to be toward the low end of the normal range. I don't consider the source I found as fully authoritative, but it appears to be an actual guideline used in the practice. Does anyone have a better source? Thanks again... 157.185.95.29 (talk) 17:13, 21 July 2014 (UTC)mjd
 * I did find this article (Dan Med Bull. 1990 Jun;37(3):249-63) that gives the following formula for healthy thyroid size: 1.97 + 0.21*mass(kg) + 0.06*age(years) in mL or cc. Using the average weights for men (82kg) and women (69kg) in the US and an age of 40 it appears that the average size of the thyroid in the US is about 20 cc. The dimensions currently in the article indicate a full thyroid volume of well over 30 cc, so those numbers in the article can't be very accurate, but I cannot find an authoritative article that gives the dimensions. I'll keep looking, but if anyone has a source... Thanks. 157.185.95.38 (talk) 14:54, 28 July 2014 (UTC)mjd

Proposed merge with Pyramidal lobe of thyroid gland
Content could be readily merged into a 'Variation' section (per WP:MEDMOS, benefiting readers by displaying this information in a central location. If needed, content could be re-expanded at a later date. LT910001 (talk) 01:06, 19 April 2014 (UTC)
 * ✅ Iztwoz (talk) 19:44, 21 May 2014 (UTC)

New images?
I find the images in this article aren't really up to scratch and with the other work being done I think we should get a few newer ones. Soon I'll have a few high quality images, but for now I can suggest #1, which can also be split up in several parts. I'll be back with more. CFCF (talk · contribs · email) 14:45, 2 June 2014 (UTC)

Proposed merge with Lalouette's pyramid
See above. LT910001 (talk) 01:06, 19 April 2014 (UTC)
 * Isn't this the same entity as the Pyramidal lobe? Iztwoz (talk) 20:18, 21 May 2014 (UTC)


 * ✅ Iztwoz (talk) 15:54, 2 June 2014 (UTC)

Technical Tag
Added the "technical" tag in hopes that someone will go over and rewrite the article to make it more accessible to the average reader. The introductory paragraph is pretty good, but thereafter it descends into medical jargon and terminology which makes it difficult to follow. For example, the following text might be more appropriate for a medical student than for a patient facing a thyroid examination, and wondering what to expect. I believe the latter reader is more representative of our target audience:

In a healthy patient the gland is not visible yet can be palpated as a soft mass. Examination of the thyroid gland is carried out by locating the thyroid cartilage and passing the fingers up and down, examining for abnormal masses and overall thyroid size. Then, place one hand on each of the trachea and gently displace the thyroid tissue to the contralateral side of the neck for both sides while the other hand manually palpates the displaced gland tissue; having the patient flex the neck slightly to the side when being palpated may help in this examination. Next, the two lobes of the gland should be compared for size and texture using visual inspection, as well as manual or bimanual palpation. Finally, ask the patient to swallow to check for mobility of the gland; many clinicians find that having the patient swallow water helps this part of the examination. In a healthy state, the gland is mobile when swallowing occurs due its fascial encasement. Thus when the patient swallows, the gland moves superiorly, as does the whole larynx.[8] --Cmichael (talk) 03:48, 8 March 2015 (UTC)
 * Thanks for noticing this. I removed most of the text that was direct instruction. --Tilifa Ocaufa (talk) 21:12, 13 September 2015 (UTC)

"One of the largest"
A little misleading. Pancreas, kidneys, liver, gut all have endocrine components and are larger than the thyroid. Have removed this phrase. --Tom (LT) (talk) 05:22, 2 September 2016 (UTC)

Acronyms
I have added four common acronyms used throughout the article in the "acronyms" field. Not sure whether this is useful or just information clutter. Any thoughts? --Tom (LT) (talk) 05:27, 2 September 2016 (UTC)


 * How are you defining 'acronym'? and just clutter imo. --Iztwoz (talk) 07:13, 2 September 2016 (UTC)
 * I see this has disappeared. Thanks - was worth a try to see how it looked, and answer was, not great. --Tom (LT) (talk) 09:41, 6 September 2016 (UTC)

Subsections in thyroid
I've reinstated these... I think it's very useful to distinguish between symptoms and diseases of the thyroid, which are often incorrectly lumped together. Hyperthyroid and hypothyroid are symptoms, and we can talk about separate disease processes in the second section. I will make the table of contents smaller so this is less visible at the article's lead. Happy to discuss. --Tom (LT) (talk) 09:41, 6 September 2016 (UTC)
 * Well - i cannot see any reasoning for this separation. Hyperthyroid and co are just adjectives of the diseases. and the symptoms discussed are those of the diseases. ? (i like your other changes) --Iztwoz (talk) 10:46, 6 September 2016 (UTC)
 * If by "adjective" you mean "symptom"! One reason why they should be distinct here is that most of the diseases can cause both hyper, hypo, nodules, and/or goiters, yet there are specific things about each symptom and disease that differ. I hope this difference makes sense--Tom (LT) (talk) 11:39, 8 September 2016 (UTC)
 * By adjective I meant adjective as defined in my Oxford English dictionary. Hyperthyroidism (for example) is the condition and hyperthyroid the adjective. Hyperthyroidism is the condition of a dysfunctional thyroid, a functional disorder as is Hypothyroidism. All accounts state that the symptoms of hyperthyroidism are such and such. Hyperthyroidism is not defined as a symptom of Grave’s disease but is caused as a result of Grave’s disease. Likewise for Hashimoto’s thyroiditis and the sometimes development of hypothyroidism.  Each of these functional disorders has their own set of symptoms. I still don’t see the point in this separation with the sections you have placed under the heading Symptoms. The sections  just refer to and describe the disorder and mentions the symptoms and also treatment. Nodules are placed under this heading of symptoms as well, and they do not usually present any. Congenital hypothyroidism is not referred to as a symptom it is a condition that has symptoms. I don’t know what you mean by most of the diseases can cause both disorders and nodules etc. And a goitre is just an enlarged thyroid gland which does not have symptoms. --Iztwoz (talk) 06:16, 9 September 2016 (UTC) Just to add Tom (LT) that I've just added a sentence on Graves' disease where hyperthyroidism is cited as a sign of Graves'. I cannot do more as I really feel that the whole clinical significance section is in need of restructuring. --Iztwoz (talk) 11:17, 16 September 2016 (UTC)
 * Sorry for the long delay in editing. Responses:


 * Hyperthyroidism and hypothyroidisms are syndromes - collections of symptoms - that are caused by an underlying disease state. That's why I think they belong in the "symptoms" section - because these are what people notice
 * Symptoms are what a person notices - a goitre and a nodule are both symptoms of an underlying disease. You are not correct to say "a goiter... does not have symptoms". A large neck swelling is what the person affected notices.
 * So separating them separate what people notice from the underlying causes - eg many inflammatory states can cause hypo or hyperthyroidism and a goiter, but hypo/hyperthyroidism/goiters also share other causes. Lumping them under a heading relating to symptoms (goiter, nodule, hypo/hyper) is very confusing. --Tom (LT) (talk) 09:38, 20 September 2016 (UTC)
 * Tom (LT) Cannot see the justification for calling the disorders of Hyper- and hypothyroidism, symptoms. A symptom describes a subjective experience. Nobody would say to another that they were feeling hyperthyroid. ? So removed heading.--Iztwoz (talk) 07:38, 15 October 2016 (UTC)
 * Seeing as there is about to be a review, will also respond here: happy to compromise, and the reply to this was here: User talk:LT910001/Archive_5.--Tom (LT) (talk) 19:50, 1 December 2016 (UTC)
 * Hello Tom (LT) - thanks for the note. I do think that's a big improvement. I too have been a bit busy but not as productively as you and I'm getting back into things here a bit more, all best --Iztwoz (talk) 20:07, 1 December 2016 (UTC)

Hypothyroidism (existing section, second paragraph, management of)
I am new to offering comments on Wikipedia, so please bear with me.

If you check Google Scholar for thyroid, there are literally hundreds of new research papers published weekly. There is still so much to learn. My wife has hypothyroidism, and I have been following her treatment for 20+ years.

This section is incomplete and thus misleading. It says: "Hypothyroidism is managed with replacement of the hormone thyroxine." thyroxine = T4. This is certainly true for many patients, but a significant number are also treated with replacement of T3, either in synthetic form, for example brand name Cytomel, or through various natural thyroid, typically derived from dessicated pig or cow thyroid gland, for example brand names Armour Thyroid or Naturethroid. More research is calling into question the established doctrine of the american endocrinologists to treat only with T4 levothyroxine. --Jmb5 (talk) 23:20, 23 July 2017 (UTC)

Hatnote
Removed hatnote inserted by. I did this because: Looking forward to perspectives of other users. --Tom (LT) (talk) 09:52, 28 February 2019 (UTC)
 * Article is very clear about what it is about, readers will discover this via the picture and reading the text
 * Readers looking for the medication very unlikely to search just for "thyroid" without supplying some more information (hatnote may be better placed on Thyroid hormone article)
 * Hatnote better placed in thyroid hormone article or even a relevant section if consensus emerges for it to be placed
 * For the reason above, this is not standard on our anatomy articles (eg we do not supply a hatnote for Pancreas to Digestive enzymes etc.)
 * Desiccated thyroid is often called just thyroid
 * Also called "thyroid tablets, usp" Doc James  (talk · contribs · email) 09:56, 28 February 2019 (UTC)
 * Have posted at WP:MED and WP:ANATOMY to get some additional perspectives. Am not convinced by your thinking above. I have never heard patient's describe medications as just 'thyroid' - yes I have heard 'thyroid tablets' and 'heart medications' but that's why people use the second term ('tablets', 'medications') and not just state something confusing like 'I take thyroid' or 'I take heart' (which I assume most people would take to mean an meaty bits of an animal organ are literally being eaten). I think readers are cluey enough to work this out and so still don't support this hatnote. Am not a big fan of the excessive use of hatnotes as they make articles harder to read and I feel deter reading. Anyhow will see what other editors think. --Tom (LT) (talk) 06:33, 1 March 2019 (UTC)
 * The stuff is actually made out of thyroid. Maybe we can just put it as a "see also". Agree it is a less common use and not set on a hatnote as I agree those can be overused. Doc James  (talk · contribs · email) 08:35, 1 March 2019 (UTC)
 * agree w/ Doc James suggestion--Ozzie10aaaa (talk) 11:16, 1 March 2019 (UTC)
 * Good idea, would support this. --Tom (LT) (talk) 22:49, 1 March 2019 (UTC)


 * A hatnote definitely makes sense, but it shouldn't read "the medication", but rather "the hormones" or "the product of the thyroid". Thyroid hormones may be perceived by the general public as drugs, but they are primarily hormones. Carl Fredrik  talk 08:45, 2 March 2019 (UTC)


 * I oppose the hatnote. I am fine with the "See also" section. Axl ¤ [Talk] 13:38, 2 March 2019 (UTC)

Lead edits
I have rephrased para 2 of the Lead for clarity and accuracy, and plan several more edits to this article. I welcome review of and comments on my edits, especially by those who have made major contributions to this article, such as Tom (LT) (talk), and Iztwoz (talk). Regards, IiKkEe (talk) 12:21, 30 November 2019 (UTC)
 * Thanks for many of your edits, as I noted on your talk page some do improve the article and I can see you clearly have the goal of improving readability :). Some comments:
 * I have removed many unnecessary subheadings, which have left subsections of single paragraphs or resulted in arbitrary subsections. --Tom (LT) (talk) 07:22, 2 December 2019 (UTC)
 * Per WP:NOT a catalogue; and also probably (WP:BRD), as I do admit this is somewhat subjective. I have reverted your changes to the clinical significance subsection. My goal in structuring the section is to help readers understand the difference between symptoms of thyroid disease (which are generally just those four) vs. the diseases underlying them. I encourage you to edit something like Diseases of the thyroid gland if you want to create a comprehensive list or summary article of all diseases in a list format. In general these broad overview type articles are written in summary style and redirect readers to associated articles rather than covering more content here.
 * I want to express my appreciation for some edits, eg your edit to the lead, the caption (putting colours, which it is true some readers may not immediately grasp) and some reordering sentences into logical formats :)

Happy to discuss further! There are many anatomy articles in need of attention, hope to see you around the traps with content addition related edits too :). (see WP:ANAT500 for our top 500 and their quality assesments) --Tom (LT) (talk) 07:22, 2 December 2019 (UTC)

Tom (LT) Again, apologies for the 4 month delay in responding, I have been away from WP until a few days ago. Thank you for your patience and civility. What you call stylistic changes I call organizational changes. I like subsection headings, I think they are an improvement. They tell the reader what the subject of the ensuing paragraph(s) will be. If any other editor thinks the article is better without them, I never object to having them reverted. I move on. In the 6 years I have been editing, the majority of my ~15,000 edits of ~500 articles have been modifications of Leads for clarity and completeness; many others have been organizational changes; the fewest have been content corrections or additions. All I ask is that you and others review and leave unaltered the edits you agree with (I always appreciate others clicking on "Thank") and revert those you don't agree with. Specifically, thank you for expressing your appreciation for my edits of the Thyroid article Lead and image caption. Let's keep co-editing! Regards, IiKkEe (talk) 02:48, 6 April 2020 (UTC)