{"id":2236,"date":"2026-02-27T10:10:26","date_gmt":"2026-02-27T10:10:26","guid":{"rendered":"https:\/\/www.innothyrogen.eu\/uncategorized-sr\/%d0%b1%d0%be%d0%bb%d0%b5%d1%81%d1%82%d0%b8-%d1%88%d1%82%d0%b8%d1%82%d0%b0%d1%81%d1%82%d0%b5-%d0%b6%d0%bb%d0%b5%d0%b7%d0%b4%d0%b5-%d1%81%d0%b8%d0%bc%d0%bf%d1%82%d0%be%d0%bc%d0%b8-%d1%83%d0%b7%d1%80\/"},"modified":"2026-02-27T10:18:04","modified_gmt":"2026-02-27T10:18:04","slug":"%d0%b1%d0%be%d0%bb%d0%b5%d1%81%d1%82%d0%b8-%d1%88%d1%82%d0%b8%d1%82%d0%b0%d1%81%d1%82%d0%b5-%d0%b6%d0%bb%d0%b5%d0%b7%d0%b4%d0%b5-%d1%81%d0%b8%d0%bc%d0%bf%d1%82%d0%be%d0%bc%d0%b8-%d1%83%d0%b7%d1%80","status":"publish","type":"post","link":"https:\/\/www.innothyrogen.eu\/sr\/%d0%b1%d0%bb%d0%be%d0%b3\/%d0%b1%d0%be%d0%bb%d0%b5%d1%81%d1%82%d0%b8-%d1%88%d1%82%d0%b8%d1%82%d0%b0%d1%81%d1%82%d0%b5-%d0%b6%d0%bb%d0%b5%d0%b7%d0%b4%d0%b5-%d1%81%d0%b8%d0%bc%d0%bf%d1%82%d0%be%d0%bc%d0%b8-%d1%83%d0%b7%d1%80\/","title":{"rendered":"Bolesti \u0161titaste \u017elezde: simptomi, uzroci, dijagnoza i le\u010denje"},"content":{"rendered":"\n

Kako \u0161titasta \u017elezda funkcioni\u0161e i reguli\u0161e hormone<\/strong><\/h2>\n\n

\u0160titasta \u017elezda je organ koji se nalazi u donjem prednjem delu vrata. Glavna funkcija \u0161titaste \u017elezde je proizvodnja trijodtironina (T3) i tiroksina (T4). Hormoni \u0161titaste \u017elezde su klju\u010dni regulatori bazalne potro\u0161nje energije i metabolizma, redovnog razvoja i diferencijacije \u0107elija, neurorazvojnih procesa u prvim godinama \u017eivota, linearnog rasta, sastava tela i telesne te\u017eine. Normalna funkcija \u0161titaste \u017elezde regulisana je hipotalamusnim hormonom koji osloba\u0111a tireotropin (TRH), koji stimuli\u0161e osloba\u0111anje tireostimuli\u0161u\u0107eg hormona (TSH) iz hipofize. TSH, zauzvrat, pokre\u0107e sintezu i sekreciju hormona \u0161titaste \u017elezde. Nivoi TSH i TRH rastu kada su nivoi cirkuli\u0161u\u0107ih hormona \u0161titaste \u017elezde niski, i obrnuto. Koncentracije serumskog TSH i slobodnog tiroksina (FT4) rutinski se koriste za procenu funkcije \u0161titaste \u017elezde pojedinca u svakodnevnoj klini\u010dkoj praksi. Slobodni T3 ili slobodni T4 mere aktivni hormon \u0161titaste \u017elezde koji nije vezan za protein i koji mo\u017ee uticati na telesna tkiva. Ukupni T3 ili ukupni T4 mere vezani i slobodni hormon, na koji mogu uticati nivoi proteina u krvi. Testovi koji mere slobodne hormone preciznije odra\u017eavaju funkcionisanje \u0161titaste \u017elezde. <\/p>\n\n

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\u010cesti poreme\u0107aji \u0161titaste \u017elezde: hipotireoza i hipertireoza<\/strong><\/h2>\n\n

Hipotireoza: uzroci, simptomi i le\u010denje<\/h3>\n\n

Hipotireoza<\/strong> je stanje koje karakteri\u0161e smanjena proizvodnja i sekrecija hormona \u0161titaste \u017elezde. Kod primarne hipotireoze, \u0161titasta \u017elezda ne mo\u017ee da proizvede adekvatne hormone \u0161titaste \u017elezde. Re\u0111e vi\u0111ena sekundarna hipotireoza nastaje kao posledica abnormalne funkcije hipofize. Glavni pokazatelj hipotireoidnog stanja je nizak nivo hormona \u0161titaste \u017elezde i povi\u0161en nivo TSH. Naj\u010de\u0161\u0107i uzrok hipotireoze je Ha\u0161imotov tireoiditis. Pacijenti sa hipotireozom zahtevaju do\u017eivotnu terapiju nadoknade hormona \u0161titaste \u017elezde levotiroksinom. Primarni cilj le\u010denja je obezbe\u0111ivanje odgovaraju\u0107e dnevne doze hormona \u0161titaste \u017elezde kako bi se vratila normalna funkcija \u0161titaste \u017elezde za svakog pojedina\u010dnog pacijenta. <\/p>\n\n

Ha\u0161imotov tireoiditis kao uzrok hipotireoze<\/h3>\n\n

Ha\u0161imotov tireoiditis<\/strong> je autoimuna bolest kod koje disfunkcionalni imuni sistem dovodi do hroni\u010dnog o\u0161te\u0107enja tkiva \u0161titaste \u017elezde, nakon \u010dega sledi zamena o\u0161te\u0107enih podru\u010dja o\u017eiljnim tkivom i limfocitima. Ova dijagnoza je \u010de\u0161\u0107a kod \u017eena, a njena prevalencija raste sa godinama. Bolest karakteri\u0161u pozitivna antitela protiv tireoglobulina i tireoidne peroksidaze. Metabolizam se usporava usled pada nivoa hormona. Pacijenti se naj\u010de\u0161\u0107e \u017eale na umor, lo\u0161u koncentraciju i pam\u0107enje, osetljivost na hladno\u0107u, zatvor, pove\u0107anje telesne te\u017eine, gubitak kose, lo\u0161e raspolo\u017eenje, ose\u0107aj gu\u0161enja ili stezanja u vratu i nedostatak motivacije. <\/p>\n\n

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Hipertireoza: simptomi, rizici i upravljanje<\/h3>\n\n

Hipertireoza<\/strong> je stanje prekomerne proizvodnje i sekrecije hormona \u0161titaste \u017elezde u krv. Glavni pokazatelji su povi\u0161eni nivoi hormona \u0161titaste \u017elezde i smanjen nivo TSH. Ubrzan metabolizam supstanci i nutrijenata u organizmu mo\u017ee dovesti do razvoja drugih zdravstvenih problema nakon du\u017eeg perioda hipertireoze. U ve\u0107ini slu\u010dajeva, uzrok hipertireoze je Bazedov-Grejvsova bolest, ali drugi mogu\u0107i uzroci uklju\u010duju multinodularnu toksi\u010dnu gu\u0161u, toksi\u010dni adenom i upalu \u0161titaste \u017elezde. Nele\u010dena hipertireoza mo\u017ee izazvati sr\u010dane aritmije, kongestivnu sr\u010danu insuficijenciju, osteoporozu, nepovoljne aku\u0161erske ishode i metaboli\u010dke poreme\u0107aje kao \u0161to su pove\u0107ana potro\u0161nja energije u mirovanju i glukononeogeneza. Le\u010denje treba da bude usmereno na pacijenta i individualizovano, uzimaju\u0107i u obzir godine, komorbiditete, te\u017einu hipertireoze, verovatno\u0107u remisije, planove za trudno\u0107u, dostupnu hirur\u0161ku ekspertizu i preferencije pacijenta. <\/p>\n\n

Bazedov-Grejvsova bolest i autoimuna hipertireoza<\/h3>\n\n

Bazedov-Grejvsova bolest<\/strong> je autoimuni poreme\u0107aj koji se \u010de\u0161\u0107e javlja kod mla\u0111ih \u017eena. Manifestuje se difuznim uve\u0107anjem \u0161titaste \u017elezde, koje mo\u017ee biti pra\u0107eno ispup\u010denim o\u010dima. Obele\u017eje bolesti je prisustvo antitela protiv tireoglobulina, tireoidne peroksidaze i TSH receptora. Pacijenti se naj\u010de\u0161\u0107e \u017eale na lupanje srca, ubrzano varenje, gubitak te\u017eine uprkos pove\u0107anom apetitu, ose\u0107aj vru\u0107ine i znojenje, nesanicu, promene u menstrualnom ciklusu i seksualnoj \u017eelji, nervozu i drhtanje ruku. Kod pacijenata sa Grejvsovom bole\u0161\u0107u, le\u010denje treba da se fokusira na kontrolu hipertireoze sa o\u010dekivanom eventualnom remisijom Grejvsove bolesti antitireoidnim lekovima. Antitireoidni lekovi smanjuju sintezu i sekreciju hormona \u0161titaste \u017elezde. Kod pacijenata koji ne postignu remisiju, ili kod onih \u010dija hipertireoza u\u0111e u remisiju a zatim se ponovi, treba razmotriti definitivnu terapiju radioaktivnim jodom ili tireoidektomiju. <\/p>\n\n

Multinodularna toksi\u010dna gu\u0161a i toksi\u010dni adenom<\/h3>\n\n

Multinodularna toksi\u010dna gu\u0161a<\/strong> je bolest koju karakteri\u0161u vi\u0161estruki \u010dvorovi u \u0161titastoj \u017elezdi koji lu\u010de hormone \u0161titaste \u017elezde prekomerno bez regulacije od strane hipofize. Toksi\u010dni adenom<\/strong> je vrsta benignog tumora koji na sli\u010dan na\u010din prekomerno lu\u010di hormone \u0161titaste \u017elezde. Toksi\u010dna nodularna gu\u0161a i toksi\u010dni adenom se uglavnom le\u010de radioaktivnim jodom ili tireoidektomijom. <\/p>\n\n

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Tumori \u0161titaste \u017elezde i rak \u0161titaste \u017elezde<\/h2>\n\n

Tumor je abnormalna akumulacija tkiva. Tumori mogu biti benigni ili maligni. Etiologija karcinoma \u0161titaste \u017elezde nije u potpunosti razja\u0161njena. Me\u0111utim, poznato je da je ve\u0107i rizik prisutan kod \u017eena, osoba sa porodi\u010dnom istorijom raka, onih koji su bili izlo\u017eeni radijaciji, i da se \u010de\u0161\u0107e javlja nakon tridesete godine \u017eivota. <\/p>\n\n

Benigni tumori \u0161titaste \u017elezde: folikularni adenom<\/strong><\/h3>\n\n

Folikularni adenom<\/strong> je naj\u010de\u0161\u0107i epitelni benigni tumor. Javlja se u svim starosnim grupama, ali \u010de\u0161\u0107e kod mladih odraslih. To su solitarne, sferi\u010dne formacije pre\u010dnika manjeg od 3 cm. Adenomi mogu biti funkcionalni (toksi\u010dni) ili nefunkcionalni. Funkcionalni adenomi proizvode hormone \u0161titaste \u017elezde nekontrolisano, bez aktivacije hipofize. <\/p>\n\n

Maligni tumori \u0161titaste \u017elezde: tipovi i opcije le\u010denja<\/h3>\n\n

Maligni tumori \u0161titaste \u017elezde su veoma retki i \u010dine oko 1% svih malignih tumora. Mogu biti diferencirani (papilarni i folikularni) ili nediferencirani (medularni i anaplasti\u010dni). Diferencirane tumorske \u0107elije li\u010de na normalne \u0107elije tkiva. Tumori sastavljeni od takvih \u0107elija bolje reaguju na le\u010denje. Nediferencirani tumori sastoje se od \u0107elija koje ne li\u010de na normalno tkivo, pa se pona\u0161aju agresivnije i zahtevaju agresivniji pristup le\u010denju. Maligni tumori se ne\u0161to \u010de\u0161\u0107e javljaju kod \u017eena, tipi\u010dno izme\u0111u 30. i 45. godine \u017eivota. Opcije le\u010denja odre\u0111uju se prema tipu i stadijumu raka \u0161titaste \u017elezde. Hirur\u0161ko uklanjanje \u0161titaste \u017elezde je uobi\u010dajen pristup. Sve preostale rakove \u0107elije se zatim le\u010de terapijom radioaktivnim jodom. Nakon hirur\u0161kog uklanjanja \u0161titaste \u017elezde, pacijenti moraju uzimati terapiju nadoknade hormona \u0161titaste \u017elezde do kraja \u017eivota kako bi odr\u017eali normalne fiziolo\u0161ke procese. Spolja\u0161nja zra\u010dna terapija mo\u017ee biti opcija za osobe \u010diji agresivni ili uznapredovali tumori \u0161titaste \u017elezde ne reaguju na standardnu negu. <\/p>\n\n

Papilarni karcinom \u0161titaste \u017elezde<\/h3>\n\n

Papilarni karcinom<\/strong> je naj\u010de\u0161\u0107i rak \u0161titaste \u017elezde. Ovaj tip raka ima najbolju prognozu. \u010ce\u0161\u0107e se dijagnostikuje pre 40. godine \u017eivota. Mo\u017ee ostati lokalizovan u \u017elezdi godinama, ali kod nekih pacijenata metastaze na cervikalne limfne \u010dvorove su ve\u0107 prisutne u trenutku dijagnoze. <\/p>\n\n

Folikularni karcinom \u0161titaste \u017elezde<\/h3>\n\n

Folikularni karcinom<\/strong> je drugi naj\u010de\u0161\u0107i tip raka \u0161titaste \u017elezde. Javlja se uglavnom kod osoba srednjih godina i starijih. Ovaj tip raka je agresivniji od papilarnog karcinoma \u0161titaste \u017elezde, ali tako\u0111e ima dobru prognozu za oporavak. <\/p>\n\n

Medularni karcinom \u0161titaste \u017elezde<\/h3>\n\n

Medularni karcinom<\/strong> je redak tip raka \u0161titaste \u017elezde. Javlja se u srednjem i kasnom odraslom dobu, obi\u010dno sporadi\u010dno kao solitarni \u010dvor \u0161titaste \u017elezde. Prognoza medularnog raka \u0161titaste \u017elezde obi\u010dno nije tako povoljna kao kod diferenciranih karcinoma \u0161titaste \u017elezde. <\/p>\n\n

Anaplasti\u010dni karcinom \u0161titaste \u017elezde<\/h3>\n\n

Anaplasti\u010dni karcinom<\/strong> je najre\u0111i histolo\u0161ki tip raka \u0161titaste \u017elezde, ali je izuzetno agresivan. U pore\u0111enju sa drugim tipovima karcinoma \u0161titaste \u017elezde, na\u017ealost ima najlo\u0161iju prognozu. <\/p>\n\n

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Aktuelna istra\u017eivanja i napredak u le\u010denju bolesti \u0161titaste \u017elezde<\/h2>\n\n

Po\u0161to su poreme\u0107aji \u0161titaste \u017elezde u velikoj meri posledica hekti\u010dnog na\u010dina \u017eivota, va\u017eno je uvesti neke promene u svakodnevni \u017eivot pojedinca. U le\u010denju bolesti \u0161titaste \u017elezde, pored medikamentozne terapije, nagla\u0161ava se i zna\u010daj pravilne ishrane. Ishrana treba da bude raznovrsna i uravnote\u017eena, uz \u010destak unos te\u010dnosti. Ne postoji specifi\u010dna dijetetska terapija za probleme sa \u0161titastom \u017elezdom, ali se preporu\u010duje mediteranska ishrana, jer se pokazala izuzetno korisnom za \u0161irok spektar zdravstvenih problema. Va\u017eno je naglasiti zna\u010daj konzumiranja minimalno prera\u0111ene hrane ili izbegavanja industrijski pripremljene hrane koja je obilna u prodavnicama. Selen i selenoproteini su va\u017eni u stvaranju i metabolizmu hormona \u0161titaste \u017elezde. Imaju antiinflamatorno dejstvo, mogu smanjiti titar antitela tireoidne peroksidaze, imaju pozitivan efekat na hipotireozu i rezultiraju smanjenjem potrebne doze levotiroksina. <\/p>\n\n

Pored postoje\u0107ih dijagnosti\u010dkih metoda, sprovode se dodatna istra\u017eivanja u svrhu ranijeg otkrivanja bolesti, personalizovane medicine i boljih metoda le\u010denja. Istra\u017euje se povezanost razli\u010ditih inflamatornih parametara sa poreme\u0107ajima \u0161titaste \u017elezde kako bi slu\u017eili kao dodatni dijagnosti\u010dki alati. Ispituje se i uklju\u010denost razli\u010ditih gena u bolestima \u0161titaste \u017elezde, \u0161to bi moglo biti korisno u personalizovanom pristupu pacijentima u budu\u0107nosti. Razvijeno je nekoliko me\u0111unarodnih sistema stratifikacije rizika \u010dvorova \u0161titaste \u017elezde zasnovanih na ultrazvuku sa ciljem smanjenja nepotrebnih biopsija. Istra\u017euju se manje invazivne alternative operaciji za rak \u0161titaste \u017elezde niskog rizika, kao \u0161to su aktivno pra\u0107enje i minimalno invazivne intervencije. Nove sistemske terapije su sada dostupne za pacijente sa uznapredovalim rakom \u0161titaste \u017elezde. Napredak ciljane terapije i istra\u017eivanja biomarkera kod raka \u0161titaste \u017elezde predstavlja mogu\u0107u promenu u terapijskim metodama usmerenim na preciznost i individualizaciju. <\/p>\n\n

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Autor: Marija Banovi\u0107 (Poliklinika Leptir)<\/p>\n\n

Reference<\/strong><\/p>\n\n

    \n
  1. Patil N, Rehman A, Anastasopoulou C, et al. Hypothyroidism. [Updated 2024 Feb 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK519536\/ <\/li>\n\n\n\n
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  3. Guo M, Sun Y, Wei Y, Xu J and Zhang C. (2024) Advances in targeted therapy and biomarker research in thyroid cancer. Front. Endocrinol. 15:1372553. doi: 10.3389\/fendo.2024.1372553<\/li>\n\n\n\n
  4. Br\u010di\u0107 L, Bari\u0107 A, Gra\u010dan S, Brdar D, Torlak Lovri\u0107 V, Vidan N, Zemunik T, Pola\u0161ek O, Barbali\u0107 M, Punda A, Boraska Perica V. (2016): Association of established thyroid peroxidase autoantibody (TPOAb) genetic variants with Hashimoto’s thyroiditis, Autoimmunity, DOI: 10.1080\/08916934.2016.1191475<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Kako \u0161titasta \u017elezda funkcioni\u0161e i reguli\u0161e hormone \u0160titasta \u017elezda je organ koji se nalazi u donjem prednjem delu vrata. Glavna funkcija \u0161titaste \u017elezde je proizvodnja trijodtironina (T3) i tiroksina (T4). Hormoni \u0161titaste \u017elezde su klju\u010dni regulatori bazalne potro\u0161nje energije i metabolizma, redovnog razvoja i diferencijacije \u0107elija, neurorazvojnih procesa u prvim godinama \u017eivota, linearnog rasta, sastava […]<\/p>\n","protected":false},"author":1,"featured_media":2237,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[76],"tags":[],"class_list":["post-2236","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-76"],"yoast_head":"\nBolesti \u0161titaste \u017elezde: uzroci, simptomi i le\u010denje<\/title>\n<meta name=\"description\" content=\"Saznajte vi\u0161e o bolestima \u0161titaste \u017elezde, uklju\u010duju\u0107i hipotireozu, hipertireozu, Ha\u0161imotov tireoiditis i rak \u0161titaste \u017elezde. 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