What Are The Symptoms Of Hyperthyroidism
The symptoms of hyperthyroidism can vary from person to person and may include:
- Nervousness or irritability
- Imaging tests, such as a thyroid scan, ultrasound, or radioactive iodine uptake test. A radioactive iodine uptake test measures how much radioactive iodine your thyroid takes up from your blood after you swallow a small amount of it.
How Are Thyroid Nodules Treated
Treatment depends on the type of thyroid nodule. Treatment options include:
- No treatment/”watchful waiting.” If the nodules are not cancerous, you and your doctor may decide that you dont need to be treated at this time. You will see your doctor on a regular basis so he or she can watch for any changes in the nodules.
- Radioactive iodine. Your doctor may use radioactive iodine to treat hyperfunctioning thyroid nodules and goiters with several nodules. The radioactive iodine is absorbed into the thyroid gland, causing the nodules to shrink. Pregnant women and women trying to become pregnant should not have this treatment.
- Surgery. Surgery to take out the nodules is the best treatment for nodules that are cancerous, cause “obstructive symptoms” , and are suspicious .
How Is A Thyroid Goiter Diagnosed
- Blood tests are done to check the level of thyroid hormones in your body. A blood test may also show if you have an autoimmune disease that caused your goiter.
- An ultrasound uses sound waves to show pictures of your thyroid on a screen.
- A fine-needle biopsy is done to get a tissue sample from your thyroid gland for testing.
- A thyroid scan is done to take pictures of your thyroid gland. A radioactive dye is given through a vein to help your healthcare provider see your thyroid better. Tell the healthcare provider if you have ever had an allergic reaction to any dye.
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Thyroid Lymphoma As A Cause Of Dysphagia And Dyspnea In A Patient Without Palpable Nodules Or Goiter
Jarrod D. Frizzell
1Department of Internal Medicine, University of New Mexico School of Medicine, MSC10-5550, 1 University of New Mexico, Albuquerque, NM 87131, USA
2Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of Kentucky College of Medicine, Kentucky Clinic L543, 740 South Limestone St, Lexington, KY 40536, USA
Tumors originating in the neck are well-known causes of progressive dysphagia and dyspnea , and thyroid lymphoma is an uncommon example. Physical examination provides an important first step in the evaluation of such complaints, as tumors large enough to produce such symptoms are typically considered to be palpable, if not able to be seen grossly. In this case presentation, the authors describe a nonsubsternal thyroid lymphoma measuring cm at its largest diameter, producing dysphagia and leading to respiratory emergency, that was entirely nonpalpable to physical exam even after confirmation of its presence by computed tomography.
2. Case Presentation
Esophagogastroduodenoscopy was performed approximately six weeks following initial presentation. Note was made of difficultly passing the endoscope into the esophagus secondary to hypopharyngeal edema. Endoscopy was terminated prematurely due to respiratory distress and decreasing oxygen saturation.
What Are Thyroid Nodules
A thyroid nodule is an unusual growth of thyroid cells in the thyroid gland.
The thyroid is part of the endocrine system, which is made up of glands that secrete various hormones into the bloodstream. The thyroid is a butterfly-shaped organ that is located on the front of the neck, just under the Adam’s apple . The thyroid gland, which is made up of the right and left lobes connected to the isthmus , produces and releases thyroid hormones. Thyroid hormones control functions such as body temperature, digestion and heart functions.
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A Quick Review Of The Thyroid Gland
The thyroid is a butterfly-shaped gland about two inches long located in the base of your neck. This gland plays a huge role in your body, as its responsible for releasing hormones that control metabolism the way your body uses energy. Hormones secreted by the thyroid regulate a host of body functions including your heart rate, breathing, body temperature, nervous system function, and much more.
When something is amiss with your thyroid, it can throw virtually every body system out of whack. Thankfully, nodules on your thyroid are often harmless, causing no change in how the gland functions. When they do cause problems, effective treatments are available.
What Is A Thyroid Nodule
The thyroid is a small gland located at the base of your throat that regulates body functions such as heart rate, metabolism, and the rate at which your body burns calories. A thyroid nodule is a lump in the thyroid gland in your neck. More than 90% of all thyroid nodules are benign . Some are actually cysts filled with fluid.
Thyroid nodules are more common in women than in men. They also tend to run in families.
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Treatment For Thyroid Nodules
Thyroid nodules may develop due to a variety of conditions such as iodine deficiency, excess tissue growth, thyroid cysts, goiter , Hashimotos disease and cancer. Heredity is also a factor if thyroid nodules run in your family, you are more likely to have them.
Treatment depends on the size of the thyroid nodule and whether or not its cancerous. If a biopsy proves its benign and it isnt causing any outward trouble, your doctor may suggest taking a wait-and-see approach. Unless it grows larger, treatment can be avoided.
Other times, it may be beneficial to remove benign nodules. This is usually accomplished through surgery or thyroid hormone suppression therapy. If nodules are causing hyperthyroidism, youll likely receive radioactive iodine or anti-thyroid medication. Surgery is the option of choice for malignant thyroid nodules.
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What To Do If You Notice Signs Of Thyroid Cancer
If you experience signs of thyroid cancer, its important to consult with your doctor to get an accurate diagnosis.
First, your doctor may conduct a physical examination, manually palpating your neck and throat to check for abnormal growths or areas of swelling, including the thyroid and lymph nodes. Your doctor may also gather your personal and family medical history, ask about your symptoms and risk factors, including any inherited genetic mutations.
A blood test called a tumor marker test may be recommended to check for high levels of certain hormones, such as:
- Thyroid-stimulating hormone
If cancer is suspected, one or more of the following diagnostic tests may be ordered:
Ultrasound. An ultrasound over the neck region may be done to locate any nodules that are present on your thyroid and determine whether theyre made up of solid or liquid material.
Magnetic resonance imaging scan: Using magnets, an MRI scan creates highly detailed images of the thyroid and surrounding areas.
Computed tomography scan or positron emission tomography scan: A CT scan uses contrast dye that helps your doctor pinpoint the size and location of your cancer, and whether it has metastasized to surrounding tissues. A PET scan is similar but uses an injection of radioactive sugar instead of contrast dye .
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Thyroid Nodule Symptom # : A Cough That Just Wont Go Away Frequent Coughing And A Need To Keep Clearing Your Throat
- What to do about it?
Thyroid nodules that cause the patient to cough should always be evaluated with an ultrasound scan. Occasionally a CAT scan is required because it is better at looking at big thyroid goiters than ultrasound is . Sometimes it just cant be known for sure if the thyroid nodule is actually causing the coughing. Often these patients undergo a laryngoscopy . If the thyroid nodule is causing the coughing, or there is a high likelihood it is the cause, then surgery is indicated. Of course, it is now very important for you to chose your surgeon wisely. The nerves to the vocal cords are occasionally damaged by a surgeon removing a thyroid and this will cause severe hoarseness and a loss of voice for months or even forever. We have an entire page dedicated to helping you chose a surgeon wisely!
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Breathe Easy By Supporting Your Thyroid
If you are suffering from breathing issues such as air hunger, asthma or even sleep apnea, they may be caused by thyroid dysfunction. If you are already being treated for a thyroid condition, speak with a physician about optimizing your treatment. If not, consider having your thyroid tested .
Keep in mind that thyroid testing standards frequently overlook thyroid deficiency. TSH testing alone is not adequate to identify thyroid dysfunction. It is best to pursue a comprehensive thyroid test that includes TSH, Free T4, Free T3, T3 uptake and thyroid antibodies to uncover any possible thyroid-related contributors to breathing difficulties.
Appropriately supporting the thyroid may be the best method for restoring respiration.
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Surprising Symptoms Of Thyroid Disease
Thyroid disease in Portland is common its believed that around 20 million people throughout the United States have a thyroid disorder of some sort a number equivalent to 12 percent of the population. Despite its prevalence, there is a widespread lack of knowledge about what its like to have thyroid disease. Youll probably find some of the symptoms surprising.
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Thyroid Nodule Symptom # : A Feeling Like Things Get Stuck In Your Throat Sometimes When Eating
- What to do about it?
A thyroid nodule that causes any symptom of swallowing will need to be removed with surgery. The vast majority of these are simply large, benign goiters and only very few are cancerous. But like almost all thyroid nodules that cause symptoms, surgery will be necessary for this group. Many of these goiters wonât need a biopsy because it can be hard to get all the way to the back of the neck with a needle. Almost all of these will need a CAT scan to give the surgeon a better understanding of how big the goiter is and where it goes.
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How Do I Know If I Have Thyroid Nodules
Most thyroid nodules do not produce any symptoms. However, if you have several nodules, or large nodules, you may be able to see them. Although rare, nodules can press against other structures in the neck and cause symptoms, including:
Hyperfunctioning thyroid nodules can lead to overproduction of thyroid hormones, also known as hyperthyroidism. Symptoms of hyperthyroidism include:
Thyroid Enlargement And Difficulty Swallowing
Thyroid enlargement can cause difficulty swallowing, or dysphagia, as a result of the thyroid gland directly compressing the swallowing organs. The thyroid gland, which is usually about the size of a quarter, can become enlarged as a symptom of various thyroid disorders, as well as other medical conditions. While not all patients with enlarged thyroid glands experience compressive symptoms, studies have shown that up to 33% of those with benign goiters do report difficulty swallowing and shortness of breath.
Conditions associated with enlarged thyroid include:
Thyroid cancer and other medical conditions can also contribute to or cause thyroid enlargement.
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How Common Are Thyroid Nodules
Thyroid nodules are very common, especially in the U.S. In fact, experts estimate that about half of Americans will have one by the time theyre 60 years old. Some are solid, and some are fluid-filled cysts. Others are mixed.
Because many thyroid nodules dont have symptoms, people may not even know theyre there. In other cases, the nodules can get big enough to cause problems. But even larger thyroid nodules are treatable, sometimes even without surgery.
Causes Of Thyroid Nodules
Thyroid nodules, masses in the thyroid gland, can be the result of benign cell overgrowth or actual discrete tumors comprised of thyroid cells that can be benign or cancerous. Thyroid nodules can sometimes contain fluid, which usually collects due to bleeding from the fragile blood vessels in thyroid tumors, so called cystic degeneration. This event sometimes causes the sudden onset of pain and swelling in the front of the neck, which typically subsides over several days.
Fortunately, more than 90% of thyroid nodules are not cancers, but malignancy should be considered in every affected person. Often patients with small thyroid nodules, less than 1 cm in diameter, and no risk factors for thyroid cancer can simply be reexamined or imaged by sonography to be sure the nodule is not enlarging. For larger nodules, additional studies are usually indicated, as described below.
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How Thyroid Dysfunction Can Cause Breathing Problems
The thyroid is most known for its influence over the metabolism and subsequently energy level, weight regulation and mental focus. However, many are not aware that thyroid dysfunction and suboptimal hormone levels can affect other aspects of health.
Because every tissue in the body has thyroid receptors, thyroid hormones can impact a wide array of bodily functions. A lesser known symptom of hypothyroidism is labored breathing and poor respiration. People may also know this as air hunger or dyspnea.
Understanding how the thyroid influences respiratory ability and what breathing difficulties are associated with thyroid dysfunction may improve diagnosis and treatment of existing or future breathing issues.
How Do Thyroid Disorders Affect Swallowing
If you have a thyroid disorder, you may feel as if you have a lump in your throat when you swallow. In some cases, the thyroid gland is situated at the base of your neck, and when it becomes enlarged, it can press into your windpipe.
Thyroid enlargement is referred to as a goiter. Fortunately, thyroid disorders are easy to diagnose. Treatment is available to restore your thyroid hormone levels and help you feel better.
Our top-quality team of head and neck surgeons at Southern ENT routinely diagnoses problems swallowing. True swallowing disorders have many causes, inicluding Parkinsons disease and esophageal cancer. But issues with the thyroid commonly cause trouble swallowing.
If you have any issues swallowing, see an ENT doctor for an examination.
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Thyroid Nodule Symptom # : A Lump In The Neck That You Can Feel
- What to do about it?
Thyroid nodules that the patient can feel under the skin, which is confirmed by a doctor should almost always be examined by an ultrasound test. Depending on the characteristics of the nodule , the nodule may need a needle biopsy. We have an entire section of this website on thyroid needle biopsies.
Treatment Of Nodules That Are Overproducing Thyroid Hormone
Nodules that produce too much T3 and T4 may be treated in several ways: radioactive iodine, alcohol ablation, or surgery to remove the nodule and thus cure the excess hormone production.
Radioactive iodine is given as a pill and causes the thyroid gland to shrink and make less thyroid hormone. Radioactive iodine is only absorbed by the thyroid gland, so it does not harm other cells within your body.
Alcohol ablation involves injecting alcohol into the thyroid nodule using a very small needle. The treatment causes the nodules to shrink and make less thyroid hormone.
Are Thyroid Nodules Cancer
The vast majority more than 95% of thyroid nodules are benign . If concern arises about the possibility of cancer, the doctor may simply recommend monitoring the nodule over time to see if it grows.
Ultrasound can help evaluate a thyroid nodule and determine the need for biopsy. A thyroid fine needle aspiration biopsy can collect samples of cells from the nodule, which, under a microscope, can provide your doctor with more information about the behavior of the nodule.
But What If Its Thyroid Cancer
A cancer diagnosis is always worrisome, but even if a nodule turns out to be thyroid cancer, you still have plenty of reasons to be hopeful.
Thyroid cancer is one of the most treatable kinds of cancer. Surgery to remove the gland typically addresses the problem, and recurrences or spread of the cancer cells are both uncommon. People who undergo thyroid gland surgery may need to take thyroid hormone afterward to keep their body chemistry in balance.
Whether its benign or not, a bothersome thyroid nodule can often be successfully managed. Choosing an experienced specialist can mean more options to help personalize your treatment and achieve better results.
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Living With Thyroid Nodules
Most people who have thyroid nodules lead a normal life. You might need to check in with your doctor more often, but there usually are no complications.
If you do have complications, they can include problems swallowing or breathing. You may also sustain significant weight gain or weight loss. Work with your doctor to treat these symptoms.
If your thyroid nodules are a symptom of thyroid cancer, you may need surgery. During the surgery, the doctor will remove most, if not all, of your thyroid. Following the surgery, youll take daily thyroid replacement hormones for the rest of your life.
What Causes Multiple Nodules In The Thyroid Gland
This often is associated with hypothyroidism. Multinodular goiter. The term goiter is used to describe any enlargement of the thyroid gland, which can be caused by iodine deficiency or a thyroid disorder. A multinodular goiter contains multiple distinct nodules within the goiter, but its cause is less clear. Thyroid cancer.
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What Causes A Thyroid Nodule To Form
Sometimes the thyroid begins to grow , causing one or more nodules to form. Why this happens is not known. Cancer is the biggest concern when nodules form. Fortunately, cancer is very rare it is found in less than 5 percent of all nodules. Nodules develop more often in people who have a family history of nodules, and in people who dont get enough iodine. Iodine is needed to make thyroid hormone.
There are different types of thyroid nodules:
- Colloid nodules: These are one or more overgrowths of normal thyroid tissue. These growths are benign . They may grow large, but they do not spread beyond the thyroid gland.
- Thyroid cysts: These are growths that are filled with fluid or partly solid and partly filled with fluid.
- Inflammatory nodules: These nodules develop as a result of chronic inflammation of the thyroid gland. These growths may or may not cause pain.
- Multinodular goiter: Sometimes an enlarged thyroid is made up of many nodules .
- Hyperfunctioning thyroid nodules: These nodules autonomously produce thyroid hormone without regard for normal feedback control mechanisms, which may lead to the development of hyperthyroidism. Hyperthyroidism can affect the heart and cause such problems as sudden cardiac arrest, high blood pressure, arrhythmias , osteoporosis and other health problems.
- Thyroid cancer: Less than 5 percent of thyroid nodules are cancerous.