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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 (72.10.124.101 (talk · contribs)) 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: [1] (→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

General Tojo (talk · contribs) 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)

References

--209.66.201.13 (talk) 14:25, 29 July 2008 (UTC)michelle--209.66.201.13 (talk) 14:25, 29 July 2008 (UTC)

This article is in dire need of references. Could you state your sources ? Books would be very welcome for an article like this.

Much of it is collated from web pages. I thought I should expand the article a bit. There must be good book sources, but I hate my physiology textbook so much I would never use it as a reference :-) JFW | T@lk 22:07, 1 November 2005 (UTC)

Thanks for this article. I suggest mentioning that the effects of changes in metablism impact on all parts of the body including activity/energy level, weight, thought process, skin/hair growth, feeling hot/cold etc. etc. etc. In terms of treatment, worth repeating that levothyronine should replace natural production of t4 and t3 because the "free" element is regulated in the blood and liver.

For references for the lay user: British Medical Association book Coping with Thyroid Illness.

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)

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)

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Review

doi:10.1172/JCI60047 - mechanisms of thyroid hormone action. JFW | T@lk 14:01, 5 September 2012 (UTC)

Fibromyalgia

Could fibromyalgia be a symptom of a thyroid problem? [2] 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. PMID 12888300. 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)

 Done 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#Anatomy, 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)

 Done Iztwoz (talk) 19:44, 21 May 2014 (UTC)

New images?

#1.

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)
 Done 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#Nerve.--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)

GA Review

GA toolbox
Reviewing
This review is transcluded from Talk:Thyroid/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: Jclemens (talk · contribs) 06:30, 5 January 2017 (UTC)


Rate Attribute Review Comment
1. Well-written:
1a. the prose is clear, concise, and understandable to an appropriately broad audience; spelling and grammar are correct. Issues identified below addressed.
1b. it complies with the Manual of Style guidelines for lead sections, layout, words to watch, fiction, and list incorporation. At GA level already, a few nitpicks identified.
2. Verifiable with no original research:
2a. it contains a list of all references (sources of information), presented in accordance with the layout style guideline. One CN tag remains, but overall the article is in good shape. Fixed.
2b. reliable sources are cited inline. All content that could reasonably be challenged, except for plot summaries and that which summarizes cited content elsewhere in the article, must be cited no later than the end of the paragraph (or line if the content is not in prose). No issues identified.
2c. it contains no original research. None seen
2d. it contains no copyright violations or plagiarism. Nothing identified with Earwig's tool.
3. Broad in its coverage:
3a. it addresses the main aspects of the topic. Fine.
3b. it stays focused on the topic without going into unnecessary detail (see summary style). Fine.
4. Neutral: it represents viewpoints fairly and without editorial bias, giving due weight to each. Fine.
5. Stable: it does not change significantly from day to day because of an ongoing edit war or content dispute. No issues noted.
6. Illustrated, if possible, by media such as images, video, or audio:
6a. media are tagged with their copyright statuses, and valid non-free use rationales are provided for non-free content. Some are a bit complex, but everything appears to be in order.
6b. media are relevant to the topic, and have suitable captions. The one listed as a dog with a goiter actually appears to be a goat. Fixed.
7. Overall assessment. Passing per improvements. Strong work!

Comments

Thanks for your review Jclemens. I will try and respond to your comments within a week. I have corrected the caption as above... an issue that has "dog"ged the article since I put it there (all "kid"ding aside, I have fixed the caption :) ) --Tom (LT) (talk) 07:42, 6 January 2017 (UTC)

Thanks for my partial review are accepted, but I don't really expect to fully finish a first read-through for the next 24 hours. I appreciate you getting to work on what I found initially. Images, edit warring, and copyvio are the easy bits. Getting the scientific bits understandable and fun to read is the much higher hurdle, and I find collaborating with content experts the more rewarding part of the review process. Cheers, Jclemens (talk) 18:42, 6 January 2017 (UTC)

First read through, from the top...

Review first go 'round if needed
Lead
  • "and consists of"? Certainly correct, but would "which consists of" be better?
  • Neck is linked twice in the first two sentences. Not sure we even need once, but definitely not twice.
  • "The hormones also have many other effects including those on development." How about "Thyroid hormones also affect development and have other functions" or something like that? "those on development" seems awkward.
  • Not sure we need syntherized/biosynthesis or hormone linked either.
  • The second paragraph in the lead might reference the feedback mechanisms mentioned in the 'regulation' paragraph below. It's currently a one-sentence paragraph, and the entire lead can go longer without being too long.
  • diseases/thyroid diseases has the same issue as a couple of the prior lead links does: it looks like an overlink of something sufficiently simple that we don't normally link it, but it's really a more subtle and appropriate link. Let's think through how piped links in the lead should best be used. It would be possible to reword the sentence and NOT pipe it so it's obviously NOT an overlink... but I'm not entirely sure that would be necessary or even better. Let's discuss options?
  • The lead needs to be longer by a bit, so what can be added? A bit about how T4 turns into T3 might not hurt, but that's possibly my medical provider bias showing. A sentence each on calcitonin and goiter would certainly be appropriate. The article doesn't at all cover treatment for thyroid diseases, otherwise surgery and ablation might merit a mention. Jclemens (talk) 20:05, 7 January 2017 (UTC)
Structure
  • "a narrow connecting thyroid isthmus" How about "a narrow thyroid isthmus connecting the halves" to be a bit more obvious to readers who may not immediately remember what an isthmus is? (it's not always isthmus season...)
  • Specify which dimension (length, width, depth?) for the isthmus, please.
  • Does it make sense to also list the gland's weight as "slightly less than an ounce" via the convert function or just in text? Ditto with the length measurements--do we want them in inches, too, given this is for a lay audience of whom many will be American?
  • You might want to make it more clear that there are typically four parathyroid glands, two per side.
  • "and where present Zuckerkandl's tubercle" Hadn't heard of this variance before, may want to clarify it as such "and, in some people, the extension known as..."
  • "they consist of a rim that has a rich blood flow, nerve and lymphatic supply," Is supply the right way to characterize lymphatic presence? I would have thought 'drainage' would be more apt.
  • What is the mix of T3 and T4 as secreted by the follicular cells? I always thought T4 was predominant. Jclemens (talk) 20:23, 7 January 2017 (UTC)
Development
  • "By 18–20 weeks, and the production of thyroxine" pretty sure the ", and" are extra.
  • "The fetus needs to be self-sufficient in thyroid hormones in order to guard against neurodevelopmental disorders that would arise from maternal hypothyroidism.[20] The presence of sufficient iodine is essential for healthy neurodevelopment.[21] Preterm neonates are at risk of these disorders as their thyroid glands are insufficiently developed to meet their postnatal needs.[22]" The middle sentence in here seems to break up the flow between the first and third. Would it be reasonable to reorder things? Alternatively, a bit more specificity to 'these disorders' might work. What do you think?
Function
  • Explain to the layman what T3 and T4 being bound vs. free means, please. It's basically buffering them so the available supply isn't all used up at once, right?
    • I wouldn't want to speculate what nature intended for buffering, but the effects of the buffering are here: "After secretion, only a very small proportion of the thyroid hormones travel freely in the blood. Most are bound to thyroxine-binding globulin (about 70%), transthyretin (10%), and albumin (15%).[29] Only the 0.03% of T4 and 0.3% of T3 traveling freely has hormonal activity" --Tom (LT) (talk) 21:01, 9 January 2017 (UTC)
  • The last paragraph of the hormone production section is confusing. Are MIT and DIT essentially T1 and T2? It sorta reads that way, but not entirely. I'd like to see this expanded and clarified. I note here we finally see the relative prevalence of T4 noted.
  • "TRH is secreted at an increased rate in situations such as cold exposure (to stimulate thermogenesis) which is prominent in case of infants." Did we just say babies get cold a lot? I think what we're trying to say is that such thermogenesis is more important in infants than in adults, but I'm not sure that's really what was written.
  • "TSH production is blunted by dopamine and somatostatin which act as local regulators at the level of the pituitary, in response to rising levels of glucocorticoids and sex hormones (estrogen and testosterone), and excessively high blood iodide concentration." I got thrown by the dopamine/somatostatin explanation in the middle of the list. Maybe this should be expanded and separated out a bit more? Jclemens (talk) 20:39, 7 January 2017 (UTC)
Clinical significance
  • Do we need some introductory text to tie the subsections together?
  • "Excessive production of the thyroid hormone" which one? Drop the 'the', add an 's' to hormone, or...?
  • "which is most commonly a result of Graves' disease, a toxic multinodular goitre, a solitary thyroid adenoma, and inflammation." pretty sure that needs to be OR inflammation.
  • Hormone therapy links to a disambiguation article. Thyroid_hormones#replacement seems like a much more apt target.
  • The treatment of hyperthyroidism may well merit more discussion, but what is here seems to be spot on to me.
  • "An underactive thyroid gland results in hypothyroidism." Technically, it's a mismatch between the body's current thyroid hormone needs and what's being produced in the thyroid, right?
  • Might hair loss be a better symptom descriptor than baldness, which is of course late stage hair loss?
  • "Hypothyroid disorders may occur as a result of autoimmune disease such as Hashimoto's thyroiditis; iodine deficiency; as a result of medical treatments such as surgical removal or radioablation of the thyroid, amiodarone and lithium; as a result of congenital thyroid abnormalities; or as a result of diseases such as amyloidosis or sarcoidosis or because of transient inflammation of the thyroid.[49]" OK, that's 1) far too complex a list for a single sentence, and 2) I'm pretty sure the punctuation needs to be taken out back and shot.
  • The article talks about thyroid hormone replacement both after ablation for hyperthyroid, and for hypothyroid. Might it make sense to pull it out into its own section? Again, my medical provider bias is showing.
    •  Not done that's a good point, and in many other anatomical articles I would do that; however because it is a relatively simple concept I can break my normal rule (about one fact in one spot only) and mention it in both sections. I don't think a section about thyroid hormone replacement would (1) be long enough and (2) justify a subsection on the main thyroid article --Tom (LT) (talk) 02:31, 10 January 2017 (UTC)
  • "an ultrasound is often used to investigate the nodule, and provide information such as whether the nodule is fluid-filled or a solid mass, and whether the appearance is suggestive of a benign or malignant cancer." Are those separate things, or does one follow from the other? In other words, can you see "fluid/solid" and "benign/malignant" separately, or does the latter flow from the former?
    • Sorry, I'm not sure what you mean here. These are all pieces of information that can be provided by an ultrasound. An ultrasonographer or interpreting physician may use a pathway to interpret results as you suggest.--Tom (LT) (talk) 02:31, 10 January 2017 (UTC)
  • "Investigations of a malignant nodule, or when hyperthyroidism is present, is discussed in the "Cancer" section below." I don't see this construction in Wikipedia articles very often. Not opposed to it, but what do you think?
    • Gah, my spelling is not great on these edit summaries. I wasn't quite sure what to write, and like you had some hesitations, as I didn't want to cover that information twice. What do you think now? --Tom (LT) (talk) 02:31, 10 January 2017 (UTC)
  • "Goiters may be associated with causes or hyperthyoidism, hypothyroidism, relating to the underlying cause." What?
  • Why is there a 'disease' section after we've spent the last few sections talking about... diseases? Should it be up top where I highlighted the lack of introductory text for the clinical significance section?
    •  Comment: I have separated the initial sections into a 'symptoms' and 'diseases' subsections. What do you think here? It was a matter of some discussion between me and another editor, Iztwoz. It's my opinion that what I have grouped are symptoms (ie, something a patient notices or causes them distress) that represent an underlying condition, which is why I have separated them, but Iztwoz has pointed out to readers there may be some confusion as technically hyper/hypothyroidism are syndromes (ie collections of symptoms). A third opinion may be useful here - what do you think? --Tom (LT) (talk) 02:31, 10 January 2017 (UTC)
  • "There are two types of thyroiditis where initially hyperthyroidism presents which is followed by a period of hypothyroidism; (the overproduction of T3 and T4 followed by the underproduction of T3 and T4). These are Hashimoto's thyroiditis and postpartum thyroiditis." I think two sentences are right; I think the parenthetical ending of the first sentence here should actually be a standalone sentence.
  • "an autoimmune disorder whereby the body's own immune system reacts with the thyroid tissues in an attempt to destroy it." It? If it's trying to destroy the body (it's not) that would be OK, otherwise I'm pretty sure tissues are plural, hence "... to destroy them."
  • Gland is overlinked.
  • "hyper-to-hypothyroid" "hyper- to hypo-thyroid"?
  • Not sure "swings" belongs in quotes. Seems scare quotesish.
  • Note the citation needed tag here--can you make that go away or rephrase the challenged statement?
  • "There are other disorders that cause inflammation of the thyroid," but it just said there were two not but a few paragraphs ago. How about combine this with that section to clarify that the two main types, Hashimoto and postpartum, will get attention but these other, minor causes will just be linked without further comment?
  • The relationship between inflammation and hyperthyroidism should be discussed somewhere.
  • "Malignant thyroid cancers are most often carcinomas, although cancer can occur in any tissue that the thyroid consists of, including C-cells, lymphomas." What?
  • The cancer section doesn't transition well between surgery, radioiodine ablation, and replacement. Again, there's probably a call for a separate section on these.
  • The 'congenital' section seems largely redundant to portions of the development section, above. Consider condensing and combining.
    •  Done moved disease-related information from development section to here. Separating them into two sections helps keep the content clear and is easier to read and convey information to readers. --Tom (LT) (talk) 02:31, 10 January 2017 (UTC)
  • The paragraph on iodine tablets for nuclear accident mitigation is cool... but I'm not sure the placement is right. I think the entire section on iodine deficiency and excess could stand to be upleveled and expanded.
  • Graves' Disease section seems partially overlapping with/redundant to the hyperthyroid sections.
    •  Not done a common condition, I believe this deserves its own section, and as one of the presenting symptoms of Grave's is hyperthyroidism, this requires some duplication.--Tom (LT) (talk) 03:53, 11 January 2017 (UTC)
  • "Physicians who specialise in the treatment of thyroid disorders are known generally as endocrinologists, thyroid specialists or thyroidologists. Thyroid surgeons may play a role in the surgical management of thyroid disease and general practitioners may play a role in monitoring for and identifying symptoms related to thyroid disease." Endocrinologists are the general class of specialists within internal medicine, and thyroid specialists a sub-specialty within endocrinology, correct? I'd also expect that otolaryngologists should be mentioned as surgeons. General practitioners seems very commonwealth oriented--we have primary care providers here in the U.S. At any rate, a worldwide view of medical providers could be readily improved.
  • "The character of the thyroid, swellings, nodules, and their consistency may all be able to be felt." "... may all be palpable."?
  • Does the whole examination section somewhat run afoul of WP:NOT#HOWTO?
    •  Comment: I don't agree here. Examination is an important part of any anatomical structure in terms of how it relates to medicine. An overview of what would be done in a standard exam is encyclopedic, and I have tried to write this in a way that conveys that... without trying to be too structured about it or write it in terms of the perspective of a medical professional (which is quite difficult). Let me know if you think something in particular should be changed here. --Tom (LT) (talk) 02:31, 10 January 2017 (UTC)
  • Blood tests is overlinked.
  • What is the point of the table in the blood tests section?
  • Blood tests section again gives some specific guidance for usage, which will vary by country in which these tests are performed. It might discuss the American practice of checking TSH, with a "reflex" to Free T4--that is, if the TSH is normal, nothing further is checked, but if the TSH is abnormal then FT4 is immediately checked by the lab and reported back to the ordering clinician together.
    •  Comment: It is my understanding that (worldwide) high T3 and T4 are generally considered to be hyperthyroidism, and likewise low T3 and low T3 hypothyroidism. --Tom (LT) (talk) 09:56, 16 January 2017 (UTC)
  • Imaging and biopsy sections appear redundant to content already covered above.
  • Can I just say that the 'Clinical Significance' section as currently constituted is too long and really needs to be appropriately broken up? Jclemens (talk) 21:28, 7 January 2017 (UTC)
    •  Comment: Ok, let me know what you think now. Unfortunately I think "symptoms", "disease" and "tests/exam" need to be in the same section as they are logically linked. That said I've made a few changes to structure (eg re-including 'symptoms' and removing headings from 'tests') - let me know what you think. --Tom (LT) (talk) 09:56, 16 January 2017 (UTC)
History
  • Renaissance is probably overlinked.
  • As a scientific article, should BC or BCE dating be used? WP:BCE suggests the format not be disturbed, but I've not seen BC used in any recent medical historical literature.
  • "In 1110 a Persian scientist was the first to describe symptoms associated with Grave's disease, describing protruding eyes and goitre,[82] although Robert Graves himself only described it in 1834.[81]" 1) Awkward wording and 2) the source names the Persian scientist, so we probably should too. Oh, also, one sentence paragraph.
    •  Done removed - another sources mentions an earlier reference. It is hard because sources differ quite markedly in their mentions of different discoveries. --Tom (LT) (talk) 06:13, 13 January 2017 (UTC)
  • "There are several findings that evidence a great interest for thyroid disorders just in the Medieval Medical School of Salerno (12th century)." So what? Even if important, that's very wordy.
  • "Rogerius Salernitanus, the Salernitan surgeon and author of "Post mundi fabricam" (around 1180) was considered at that time the surgical text par excellence all over Europe." I think a "which was" is needed in the middle there. 'par excellence' is probably puffery and could be toned down; ditto with magnum opus in the next sentence. This paragraph feels like someone dropped in in out of his or her dissertation.
  • "A Chinese physician Wang Hei recommended that the treatment of goitre should be dried minced thyroid.[80] Paracelsus, some fifty years later, attributed goitre to mineral impurities in the water." Fifty years later than what? Citation needed for the second sentence, by the way.
  • "In 1500 Leonardo da Vinci first recognised and drew the thyroid.[80] In 1543 Andreas Vesalius gave the first description and illustration of the gland.[80]" They cannot BOTH have been first.
  • Overall, the history section feels like a bunch of tidbits strung together, rather than a holistic overview.
  • Overall comment - I have tried to list discoveries chronologically in order to give some idea of how knowledge of the thyroid has progressed. It is however hard to place this in the overall context of anatomical discoveries given (1) I feel that would be speculation on my part to link it to a general trend and (2) discoveries vary geographically by some margin. If you think it merits inclusion I may provide some context (eg transition from Graecoroman -> Arabic-Persian -> Renaissance --Tom (LT) (talk) 06:13, 13 January 2017 (UTC)
Other animals
Additional images
  • Integrate these into the appropriate sections--these are good images. If you don't want to, I'd delete them as we have a commons link at the bottom of the article.
    •  Done removed these images. I have chosen to remove them because I think the position of the parathyroids is tangential to the primary topic, and I don't think another image of blood vessels (this time veins) really benefits the article that much. --Tom (LT) (talk) 00:18, 14 January 2017 (UTC)
Etc
  • Unless you end up populating this, delete the blank Notes section.
  • References mostly look good, but I see an access-date issue with #80 displayed.
  • Anything else you want for See Also? Parathyroid, maybe?
  • In the Endocrine System navbox, thyroid gland is a redirect to Thyroid, so this article doesn't appear in black.

OK, that's the first read through. Have fun digesting that! Jclemens (talk) 21:50, 7 January 2017 (UTC)

Right, thanks :). Will get to this over the next 1-2 weeks and update above as I do things. Have separated above into subtitles so I can respond more easily.--Tom (LT) (talk) 00:25, 8 January 2017 (UTC)
No rush. Identifying problems is much easier than fixing them, and I appreciate that you've stepped up to try and get a VA to GA, and will do my best to help you make it something truly worthy of the designation. Jclemens (talk) 01:24, 8 January 2017 (UTC)
Appreciate it. Getting there! Still  Doing... - will let you know when I'm done.--Tom (LT) (talk) 02:33, 10 January 2017 (UTC)
Understood and I see your progress so far. I've got the page watchlisted and will be checking in about daily. Jclemens (talk) 05:29, 11 January 2017 (UTC)
@Jclemens:  Done - have responded to your first tranche. Look forward to your responses. If you wouldn't mind using {{collapse top}} and {{collapse bottom}} to group resolved issue it will make it easier for me to address what remains :). --Tom (LT) (talk) 09:58, 16 January 2017 (UTC)
Ok, got it. May take me a bit to re-review in as much detail, but certainly by Saturday U.S. time. Jclemens (talk) 03:32, 17 January 2017 (UTC)

January 14th

Things are looking good. I Wikignomed a few typos and reference errors for you--Keep up the good work! Jclemens (talk) 18:33, 14 January 2017 (UTC)

Second Pass

Since everything has gotten gone through with a fine toothed comb, and I don't vehemently disagree with any of the 'not done's above, I'm collapsing everything above per request and going to go through it all again. Here goes... Jclemens (talk) 19:40, 21 January 2017 (UTC)

  • Goiter or goitre? Pick one and stick with it (except for direct quotes, reference titles, etc. of course)

... and I'm not going to let that hold you back from GA, knowing that you'll address this as you have all the other matters. This is certainly GA quality work, British English notwithstanding. ;-) Cheers, Jclemens (talk) 19:59, 21 January 2017 (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

This page is about the gland. For the medication, see thyroid hormones.

Removed hatnote inserted by Doc James. [3] I did this because:

  • 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.)

Looking forward to perspectives of other users. --Tom (LT) (talk) 09:52, 28 February 2019 (UTC)

Desiccated thyroid is often called just thyroid Tom (LT)[4]
Also called "thyroid tablets, usp"[5] 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)

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 IiKkEe, 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)

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