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How Do You Check If Your Thyroid Is Enlarged

Whats The Treatment For A Thyroid Nodule

Thyroid exam: How to check your thyroid with Dr. Christianson

Even a benign growth on your thyroid gland can cause symptoms. If a thyroid nodule is causing voice or swallowing problems, your doctor may recommend treating it with surgery to remove all or part of the thyroid gland.

If the doctor recommends removal of your thyroid , you may not even have to worry about a scar on your neck. Some patients are good candidates for a scarless thyroid procedure, where the surgeon reaches the thyroid through an incision made on the inside of your lower lip.

A newer alternative that the doctor can use to treat benign nodules in an office setting is called radiofrequency ablation . Radiofrequency ablation uses a probe to access the benign nodule under ultrasound guidance, and then treats it with electrical current and heat that shrinks the nodule. Its simple: Most people treated with RFA are back to their normal activities the next day with no problems.

The Johns Hopkins Thyroid and Parathyroid Center

Our thyroid experts in the head and neck endocrine surgery team diagnose and treat patients with a variety of thyroid and parathyroid conditions. Learn about what we offer at our center.

Benefits And Limitation Of The Self

An at-home self-exam known as the “neck check” can help you find thyroid lumps or enlargements on your own thyroid gland. These growths may point to any number of thyroid conditions from nodules and goiters to thyroid cancer.

Lumps in the neck can be caused by thyroid disease, and they can also be caused by a variety of other conditions, such as lymph node enlargement, lymphoma, an infectious abscess, or a traumatic injury.

In general, a neck check is not considered the most accurate or reliable way to identify thyroid disease. You can have serious thyroid disease if you have a completely normal neck check. On the other hand, a major growth can often be a sign of an easily treatable condition, such as an iodine deficiency.

In the end, there are limitations as to what a neck check can tell you. A 2017 report from the U.S. Preventive Services Task Force concluded that neck palpation was able to detect thyroid nodules in only 11.6% of cases. Ultrasound, an imaging procedure using sound waves, was five times more accurate in detecting abnormal growths.

T3 Resin Uptake Results

A T3 resin uptake, also known as a T3RU, is a blood test that measures the binding capacity of a hormone called thyroxin-binding globulin . If your T3 level is elevated, your TBG binding capacity should be low.

Abnormally low levels of TBG often indicate a problem with the kidneys or with the body not getting enough protein. Abnormally high levels of TBG suggest high levels of estrogen in the body. High estrogen levels may be caused by pregnancy, eating estrogen-rich foods, obesity, or hormone replacement therapy.

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Who Should Be Tested

If you think you have symptoms of a thyroid problem, ask your doctor if you should be tested. People with symptoms or risk factors may need tests more often. Hypothyroidism more frequently affects women over age 60. Hyperthyroidism is also more common in women. A family history raises your risk of either disorder.

When To See A Gp

How To Do A Thyroid Neck Check

See a GP if you have symptoms of an overactive thyroid.

They’ll ask about your symptoms and if they think you might have a thyroid problem, they can arrange for a blood test to check how well your thyroid is working.

If the blood test shows that you have an overactive thyroid, you may be referred for further tests to identify the cause.

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Our Approach To Thyroid Nodules And Goiter

UCSF offers comprehensive consultations and treatments for thyroid conditions, including goiter and thyroid nodules. Many goiters and thyroid nodules are harmless, so we often can take a watch-and-wait approach. However, treatment may be necessary for goiters or nodules that are causing bothersome symptoms or health concerns, such as the production of too much or too little thyroid hormone. Additionally, some cases are caused by thyroid cancer, although this is rare.

Treatment options include thyroid hormone medication, radioactive iodine therapy and surgery. For patients considering surgery, UCSF offers less invasive approaches that leave either no scar or a small scar hidden under the chin.

What Causes Thyroids To Swell

An enlarged thyroid can have various causes. In many cases, the bodys immune system attacks the thyroid, causing it to stop functioning properly and produce too much or too little thyroid hormone . A swollen thyroid, or goiter, can also be caused by an infection, a drug interaction, nodules in the gland, inflammation, iodine deficiency or as a reaction after pregnancy.

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Who Is More Likely To Develop Hyperthyroidism

Women are 2 to 10 times more likely than men to develop hyperthyroidism.2 You are more likely to have hyperthyroidism if you

  • eat large amounts of food containing iodine, such as kelp, or use medicines that contain iodine, such as amiodarone, a heart medicine
  • are older than age 60, especially if you are a woman
  • were pregnant within the past 6 months
  • Imaging And Evaluating Your Thyroid

    How To Do A Thyroid Neck Check Self-Exam

    One of the best ways to look at your thyroid gland is by imaging it or looking at it via ultrasound .

    Ultrasound is a nearly painless procedure which allows radiologists to look at the size, shape, texture and other characteristics of your thyroid gland.

    Because the thyroid gland is near to the surface of your skin it can easily be assessed with this type of imaging.

    The good news about ultrasound testing is that it is NOT associated with radiation exposure and is therefore considered to be very safe .

    Doctors are often taught that the only way to hurt someone with an ultrasound is by throwing the machine at them.

    Ultrasound is very important if you have an enlarged thyroid because it can further help to diagnose what exactly you are dealing with.

    For instance:

    If you have a single large thyroid nodule, ultrasound can pick up that nodule and give information regarding the size, shape, and consistency of the nodule.

    This information can help to determine if the nodule is benign ) or potentially cancerous and also help determine if you need a biopsy.

    Other conditions which cause thyroid enlargement may be consistent and make your thyroid look “irregularly inconsistent” throughout the entire gland.

    Conditions which cause this type of pattern tend to result in inflammation of the entire gland or may be caused by nutrient deficiencies such as iodine deficiency.

    In addition to ultrasound testing, there are other ways to check your thyroid gland such as uptake tests or CT scans .

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    Radioactive Iodine Uptake Test

    A radioactive iodine uptake test, also called a thyroid uptake test, can help check thyroid function and find the cause of hyperthyroidism. The thyroid takes up iodine from the blood to make thyroid hormones, which is why this is called an uptake test. Your health care professional may ask you to avoid foods high in iodine, such as kelp, or medicines containing iodine for a week before the test.

    For this test, you will swallow a small amount of radioactive iodine in liquid or capsule form. During the test, you will sit in a chair while a technician places a device called a gamma probe in front of your neck, near your thyroid gland. The probe measures how much radioactive iodine your thyroid takes up from your blood. Measurements are often taken 4 to 6 hours after you swallow the radioactive iodine and again at 24 hours. The test takes only a few minutes.

    If your thyroid collects a large amount of radioactive iodine, you may have Graves disease, or one or more nodules that make too much thyroid hormone. You may have this test at the same time as a thyroid scan.

    Even though the test uses a small amount of radiation and is thought to be safe, you should not have this test if you are pregnant or breastfeeding.

    Thyroiditis Causes And Types

    Many things can make your thyroid swell. You may have gotten an infection from a virus or bacteria. You may be taking a drug like lithium or interferon. Or you may have problems with your immune system.

    One form of thyroiditis shows up after childbirth. Pregnancy has a major impact on the thyroid in general.

    These are the most common causes:

    • Hashimotos disease. This is the most common type of thyroiditis. Your immune system attacks your thyroid and slowly weakens the gland until it canât make enough thyroid hormones.
    • Subacute thyroiditis. This type is often triggered by an infection. Thereâs usually a pattern of how the thyroid functions. First, the thyroid and neck area are painful. Then, the thyroid makes too much hormone, called hyperthyroidism. Then, your thyroid works normally, followed by a time where the thyroid produces too little thyroid hormone. This is called hypothyroidism. After about 12 to 18 months, thyroid function returns to normal.
    • Postpartum thyroiditis. This type begins within a year after childbirth, particularly in women with a history of thyroid issues. With treatment, the thyroid usually recovers within 18 months.
    • Silent thyroiditis. As the name suggests, there are no symptoms with this type. Itâs similar to postpartum thyroiditis, and recovery usually takes up to 18 months. It starts with a phase of too much hormone production, followed by a longer period of the thyroid making too little.

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    How Is Postpartum Thyroiditis Treated

    Treatment for postpartum thyroiditis depends on the phase of the disease and what symptoms you have. For example, if you get symptoms of hyperthyroidism in the first phase, your treatment may include medicines to slow down the heart rate.

    In most women who have postpartum thyroiditis, the thyroid returns to normal within 12 to 18 months after symptoms start. But if you have a history of postpartum thyroiditis, your risk is higher for developing permanent hypothyroidism within 5 to 10 years.

    What Other Health Problems Could I Have Because Of Hyperthyroidism

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    If hyperthyroidism isnt treated, it can cause some serious health problems, including

    • an irregular heartbeat that can lead to blood clots, stroke, heart failure, and other heart-related problems
    • an eye disease called Graves ophthalmopathy that can cause double vision, light sensitivity, and eye pain, and rarely can lead to vision loss
    • thinning bones and osteoporosis

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    Weak Nails And Thinning Hair

    Your hair and nails are constantly growing. One important function of the thyroid gland is sending hormone signals to trigger hair and nail growth. With hyperthyroidism, the extra hormones tell your body to increase the growth of your hair follicles and nails in a shorter period of time. While it would seem that your nails growing fast would be a positive side effect of thyroid dysfunction, that isnt the case. This forced growth is too fast. As a result, your body has to stretch its natural resources, which can lead to thin and brittle hair and nails.

    How Are Thyroid Diseases Diagnosed

    It can be hard to tell if you have a thyroid disease. The symptoms are the same as many other health problems. Your doctor may start by asking about your health history and if any of your family members has had thyroid disease. Your doctor may also give you a physical exam and check your neck for thyroid nodules.

    Depending on your symptoms, your doctor may also do other tests, such as:

    • Blood tests. Testing the level of thyroid stimulating hormone in your blood can help your doctor figure out if your thyroid is overactive or underactive. TSH tells your thyroid to make thyroid hormones. Depending on the results, your doctor might do another blood test to check levels of one or both thyroid hormones in your blood.
    • Radioactive iodine uptake test. For this test, you swallow a liquid or capsule that holds a small dose of radioactive iodine . The radioiodine collects in your thyroid because your thyroid uses iodine to make thyroid hormone.

    High levels of radioiodine mean that your thyroid makes too much of the thyroid hormone. Low levels mean that your thyroid does not make enough thyroid hormone.

  • Thyroid ultrasound. The thyroid ultrasound uses sound waves to make a picture of the thyroid on a computer screen. This test can help your doctor tell what type of nodule you have and how large it is. You may need more thyroid ultrasounds over time to see if your nodule is growing or shrinking.
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    Other Causes Of Hypothyroidism

    In some cases, hypothyroidism results from a problem with the pituitary gland, which is at the base of the brain. This gland produces thyroid-stimulating hormone , which tells the thyroid to do its job. If your pituitary gland does not produce enough TSH, levels of thyroid hormones will fall. Other causes of hypothyroidism include temporary inflammation of the thyroid or medications that affect thyroid function.

    Symptoms Of An Enlarged Thyroid

    How to Do a Self Thyroid Exam

    A goiter may be small, moderate or at times, it may be so large compressing the trachea and esophagus. Typically, a goiter is painless, but if it grows large, it causes other uncomfortable and unpleasant symptoms. Symptoms resulting from the goiter primarily include:

    • Problems associated with swallowing and experiencing a sensation like food is getting stuck in your upper throat after when eating.
    • Shortness of breath including waking up feeling like you cannot breathe.
    • Hoarseness and stridor. Stridor is a wheezing sound that results from the turbulent air flow in and out of the obstructed trachea.

    When hyperthyroidism or hypothyroidism is the reason behind your enlarged thyroid, other symptoms associated with thyroid disorders such as fatigue or sweating a lot can accompany those discussed above.

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    Side Effects And Aftercare

    A blood draw is a routine, minimally invasive procedure. During the days immediately after the blood draw, you may notice slight bruising or soreness at the area where the needle was inserted. An ice pack or an over-the-counter pain reliever can help ease your discomfort.

    If you experience a great deal of pain, or if the area around the puncture becomes red and swollen, follow up with your doctor immediately. These could be signs of an infection.

    What Is A Thyroid Nodule

    A thyroid nodule is simply a lump or mass in the thyroid gland. Thyroid nodules are relatively common 6% of adult women and 2% of adult men in the U.S. have a thyroid nodule that can be felt on examination. Moreover, close inspection of the thyroid by sonographic imaging shows that as many as one-third of women and one-fifth of men have small nodules in their glands.

    The thyroid may contain just one nodule or several of them . Thyroid nodules can be solid if they are comprised of thyroid or other cells or an accumulation of stored thyroid hormone called colloid. When nodules contain fluid, they are called cystic nodules. These can be completely fluid filled , or partly solid and partly fluid, .

    Thyroid nodules vary greatly in size. Many are large enough to see and feel . Some multinodular goiters can become enormous, bulging out of the neck and over the collar bones or extending down into the chest behind the breastbone, a condition called substernal goiter. At the other end of the spectrum, the majority of thyroid nodules are too small to see or feel at all, and are called nonpalpable nodules.

    Such small nodules are found when a person has a medical imaging procedure performed for some other reason, such as a sonogram of the carotid arteries a CAT or MRI scan of their neck, head, or chest or a PET scan. These very small, incidentally detected thyroid nodules are called thyroid incidentalomas.

    Multinodular Goiter

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    How Is A Thyroid Nodule Diagnosed

    You may not know you have a nodule until your doctor finds it during a general physical exam. They may be able to feel the nodule.

    If they suspect you have a thyroid nodule, they will probably refer you to an endocrinologist. This type of doctor specializes in all aspects of the endocrine system, including the thyroid.

    Your endocrinologist will want to learn if you:

    • underwent radiation treatment on your head or neck as an infant or child
    • have a family history of thyroid nodules
    • have a history of other thyroid problems

    They will use one or more of the following tests to diagnose and assess your nodule:

    • thyroid ultrasound, to examine the structure of the nodule
    • thyroid scan, to learn if the nodule is hot, warm, or cold
    • fine needle aspiration, to collect a sample of the nodule for testing in a laboratory
    • blood tests, to check your levels of thyroid hormones and thyroid stimulating hormone

    What Imaging Tests Do Doctors Use To Diagnose And Find The Cause Of Thyroid Disease

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    Your health care professional may order one or more imaging tests to diagnose and find the cause of thyroid disease. A trained technician usually does these tests in your doctors office, outpatient center, or hospital. A radiologist, a doctor who specializes in medical imaging, reviews the images and sends a report for your health care professional to discuss with you.

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