Of the metabolically active thyroid hormones, 93% is T4 and 7% is T3. T3 is four times more potent than T4 and most T4 is converted to T3 in the tissues. Iodine is necessary for adequate hormone production. Thyroid-stimulating hormone (TSH) is a circulating or serum hormone from the pituitary gland that stimulates the thyroid gland to produce T3 and T4. Hypothyroidism occurs when the thyroid gland does not produce enough T3 and T4.The most common cause of hypothyroidism worldwide is too little dietary iodine. Hashimotos thyroiditis is the most common cause of hypothyroidism in countries with sufficient dietary iodine. With the cessation of the production of thyroid hormone, the thyroid gland contains enough reserve T3 and T4 to last 2 to 3 months.The thyroid hormones T3 and T4 influence the production by virtually all cells in the body of hundreds of new intracellular proteins and enzymes. This influence includes the expression of the calcium ATPase, regulation of ion channels, oxidative phosphorylation, increased Na-K-ATPase activity, increased carbohydrate metabolism, increased free fatty acids, increased vitamin requirements, and increased overall metabolism. The absence of the thyroid hormones T3 and T4 are responsible for many bodily functions at the genetic and cellular level and an absence of these thyroid hormones as seen in myxedema coma has very serious consequences including a broad spectrum of symptoms and a high mortality rate.
Alternatively, enlarged lymph nodes may represent a primary malignancy of the lymphatic system itself, such as lymphoma (both Hodgkins and non-Hodgkins), lymphocytic leukemia, Lymphadenopathy that lasts less than two weeks or more than one year with no progressive size increase has a very low likelihood of being neoplastic.Metastatic lymph nodes are enlarged because tumor cells have detached from the primary tumor and started growing in the lymph node ("seeded"). Since cancer generally occurs more frequently in older people, this kind of lymphadenopathy is more common in older persons. Metastatic lymph nodes tend to feel hard and may be fixed to underlying tissues and may or may not be tender. Usually the lymph nodes that directly drain the area of the cancer are affected by the spread (e.g. Sometimes metastatic cervical lymph node is detected before the main cancer). In such cases, this discovery leads to a search for the primary malignancy, firstly in the nearby area with endoscopy, "blind" biopsies, and tonsillectomy on the side of the lymphadenopathy. If no tumor is found, then the rest of the body is examined, looking for lung cancer or other possible sites. If still no primary tumor is detected, the term "occult primary" is used.In lymphoma, usually there are multiple enlarged nodes which feel rubbery to palpation. Rhabdomyosarcoma
Neuroblastoma

Other causes
Surgical trauma, e.g.