This article is the first in a series of explanatory reports about diseases and conditions for which there are national and international observances. To learn more about U.S. and World Health Organization observances, visit and, respectively.

January is thyroid
awareness month

The pink ribbon is a well-known symbol for breast cancer awareness. But how many know about the blue paisley ribbon?

The American Association of Clinical Endocrinologists launched in 2012 the blue paisley ribbon as an icon for thyroid awareness to highlight the silent epidemic of thyroid disease. Thyroid disease is more common than diabetes, heart disease and cancer. It afflicts an estimated 30 million Americans yet half of them remain undiagnosed and untreated. Timely diagnosis of thyroid issues can improve general well-being and prevent incidence of fatal conditions like stroke and heart failure.

What is the thyroid gland and why is it important?

The thyroid gland is a small, butterfly-shaped gland situated in the neck below the Adam's apple. Under the feedback control of the hypothalamus and the pituitary gland, the thyroid gland metabolizes iodine to produce two key hormones, thyroxine and triiodothyronine. These hormones influence overall health since they control metabolic rate, oxygen consumption, body temperature, heart rate, cognitive function, muscle control and bone maintenance.

What happens when the gland malfunctions?

An underactive thyroid gland (hypothyroidism) produces insufficient levels of hormones causing fatigue, depression, memory loss and weight gain. In women, it causes reproductive health complications. When the thyroid gland overproduces hormones (hyperthyroidism), it leads to muscle weakness, weight loss, sleep disorders and vision problems.

What are the molecular bases for some thyroid diseases? 

Iodine deficiency and expsure to toxic halogens cause hypothyroidism by interrupting iodine uptake and metabolism. Disorders such as Hashimoto's thyroiditis and Graves' disease affect thyroid function by cell- and antibody-mediated immune processes. Thyroid nodules and cancer also disrupt thyroid function by interfering with the feedback communication between the thyroid and the pituitary gland.

What are researchers investigating now?

Terry Davies and colleagues of the Mount Sinai School of Medicine induced human embryonic stem cells to obtain thyroid cells by over-expressing two transcription factors, PAX8 and NKX2-1, and exposing the cells to activin A and thyroid-stimulating hormone. This study, which lays the ground for growing healthy thyroid tissue to replace damaged thyroid gland, was presented at the 84th annual conference of the American Thyroid Association held in October.

Other key presentations at the meeting covered the role of sex hormones in thyroid cancer and the link between the drug methimazole, which is used to treat Graves' disease, and birth defects.

Those who were following the meeting on Twitter noted recent advances in thyroid cancer diagnosis, including the use of next-generation sequencing to detect cancer in thyroid nodules by a group led by Yuri Nikiforov at the University of Pittsburgh Medical Center and a new microRNA-based assay developed by Rosetta Genomics that could prevent unneeded diagnostic surgeries.

Indumathi Sridharan Indumathi Sridharan earned her bachelor’s degree in bioinformatics in India. She holds a Ph.D. in molecular biochemistry from Illinois Institute of Technology, Chicago. She did her postdoctoral work in bionanotechnology at Northwestern University.