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.
What Is A Swollen Thyroid
Anatomically speaking, the thyroid gland, located at the front portion of the neck, is part of the endocrine body system. A swollen thyroid or medically termed as goiter is an enlargement of the thyroid gland. Furthermore, people who suffer from a swollen thyroid are occasionally battling against hypothyroidism. However, there are actually a lot of reasons which cause the thyroid gland to swell. These reasons will be explained later in the discussion on the causes for a swollen thyroid.
Symptoms Of Thyroid Goiters
Most thyroid goiters don’t cause symptoms, but they will if the goiter continues to grow. In fact, small thyroid goiters may more commonly be detected by routine examination of the patient’s neck by a doctor or by some type of screening x-ray or scan for some other reason. The symptoms occur as the goiter becomes big enough that it presses on other structures in the neck.
Larger thyroid goiters most commonly produce symptoms of
- A mass or lump in the neck.
- Uncomfortable pressure sensation on the breathing tube
- A sense of feeling like you need to swallow something or difficulty swallowing
- Excess production of the thyroid hormone, thyroxine which include:
- Unexplained weight loss
- Rapid or irregular heart rate
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Questions To Ask Your Doctor
- What is the cause of my hyperthyroidism?
- Do I have Graves disease?
- What types of food and medicine contain high levels of iodine?
- What is the best treatment?
- Will I need to take medicine? If so, for how long and what are the side effects?
- Will I need surgery? If so, what are the benefits and risks?
- Are there any lifestyle changes I can make to relieve my symptoms?
- Am I at risk for related health problems?
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.
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Hyperthyroidism Diagnosis And Treatment
A blood test measures levels of thyroid hormone and thyroid-stimulating hormone in your blood. The pituitary gland releases TSH to stimulate the thyroid to produce its hormones. High thyroxine and low TSH levels indicate that your thyroid gland is overactive.
Your doctor might also give you radioactive iodine by mouth or as an injection, and then measure how much of it your thyroid gland takes up. Your thyroid takes in iodine to produce its hormones. Taking in a lot of radioactive iodine is a sign that your thyroid is overactive. The low level of radioactivity resolves quickly and isnt dangerous for most people.
Treatments for hyperthyroidism destroy the thyroid gland or block it from producing its hormones.
- Antithyroid drugs such as methimazole prevent the thyroid from producing its hormones.
- A large dose of radioactive iodine damages the thyroid gland. You take it as a pill by mouth. As your thyroid gland takes in iodine, it also pulls in the radioactive iodine, which damages the gland.
- Surgery can be performed to remove your thyroid gland.
If you have radioactive iodine treatment or surgery that destroys your thyroid gland, you will develop hypothyroidism and need to take thyroid hormone daily.
What Is A Goiter
A goiter is an unusually enlarged thyroid gland. It may happen only for a short time and may go away on its own without treatment. Or it could be a symptom of another thyroid disease that requires treatment. goiter is more common in women than in men and especially in women before menopause.
Some common causes of goiter include:
Usually, the only symptom of a goiter is a swelling in your neck. It may be large enough that you can see it or feel the lump with your hand. A very large goiter can also cause a tight feeling in your throat, coughing, or problems swallowing or breathing.
Your doctor will do to see if it is caused by another thyroid disease.
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Look For Enlargements As You Swallow
As you swallow, look for any enlargements, lumps, protrusions, or anything that is off center. It is a good idea to repeat the process again, swallowing another mouthful of water, and observing the structures in your neck a few times.
Thyroid nodules are bumps that usually appear round. You may feel a thyroid nodule rolling beneath your fingertips or see it move with your thyroid gland when you swallow. A goiter may be seen on one side of the thyroid, and occasionally on both.
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Feeling Chilly Or Overheated
Blood pressure is directly linked to circulation. Low circulation will result in feelings of being chilled. You might find that you are reaching for a sweater when others are feeling just fine. If you are always cold or notice that your hands and feet become particularly chilled when uncovered, you may be experiencing a symptom of hypothyroidism.
Hyperthyroidism might present in the opposite way. This could cause you to feel hot flashes or experience excessive sweating.
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What Are The Treatments For Thyroid Goiter
- If the ultrasound with or without biopsy suggests that the patient has benign small thyroid goiter and there are little to no symptoms, the doctor may suggest simply watching the patient and the goiter. The duration of observation is however somewhat arbitrary. Observation usually implies repeating thyroid blood tests, ultrasound, and physical examination in approximately one year. If the thyroid goiter should increase in size or establish symptoms, another intervention may be indicated. Small thyroid goiters that don’t change over a period of years may never require any treatment whatsoever.
Whats The Treatment For A Thyroid Nodule
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.
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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.
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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.
Is Your Thyroid Medication Actually Working
As a thyroid patient, you need to be aware of a very important fact:
But, just because thyroid medication can’t make up for the real thing doesn’t mean you have to feel poorly.
Quite the opposite, actually.
It’s absolutely possible, and it should be your goal, to restore your thyroid function to what it felt like BEFORE you had thyroid problems.
This is easier said than done, though, and that’s exactly what we are going to talk about today.
Whether or not your thyroid medication is actually working and how it impacts how you are feeling.
Many thyroid patients are often frustrated to find out that even after they start taking thyroid medication, they don’t feel as well as they would like.
As a thyroid patient, you probably imagine that you will feel back to 100% of your normal self a few days after you start taking your medication.
After all, isn’t thyroid medication supposed to take over for your thyroid gland?
Well, yes, but also no.
There’s a high probability that your thyroid medication isn’t working as well as you probably think and there are a few reasons for this.
In this article we will discuss:
- How to know if your thyroid medication is working
- Signs and symptoms which indicate your thyroid medication is too low
- Reasons why your thyroid medication may not be working
- And more
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Heavy Or Irregular Periods
Both irregular and heavy menstrual bleeding are linked to hypothyroidism.
One study showed that about 40% of women with low thyroid hormone experienced increasing menstrual irregularity or heavy bleeding in the last year, compared to 26% of women with normal thyroid levels .
In another study, 30% of women with hypothyroidism had irregular and heavy periods. These women had been diagnosed with hypothyroidism after other symptoms had caused them to get tested .
Thyroid hormone interacts with other hormones that control the menstrual cycle, and abnormal levels of it can disrupt their signals. Also, thyroid hormone directly affects the ovaries and uterus.
There are several problems besides hypothyroidism that can cause heavy or irregular periods. If you have irregular or heavy periods that disrupt your lifestyle, consider talking with a gynecologist before worrying about your thyroid.
Summary: Heavy periods or irregular cycles that are worse than usual could be caused by a medical condition, including hypothyroidism. Its best to talk to a gynecologist about them.
How Are Thyroid Nodules Treated
Treatment depends on the type of nodule or nodules that you have. Treatments include:
- Watchful waiting. If your nodule is not cancerous, your doctor may decide to just watch your condition. You will get regular physical exams, blood tests, and perhaps thyroid ultrasound tests. If your nodule does not change, you may not need further treatment.
- Surgery. Surgery may be necessary to take out nodules that may be cancerous or large nodules that cause problems breathing or swallowing.
- Radioiodine. This type of treatment is helpful if you have nodules that make too much thyroid hormone. Radioiodine causes nodules to shrink and make smaller amounts of thyroid hormone.
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Ways Your Thyroid Is Messing With Your Body
Is your hair thinning a bit?
You’re likely well aware that your body works like a machineif one part is off, then, well, the whole damn thing can start having issues.
The best example of this is your thyroid, the small gland in your neck that controls your metabolism and regulates your bodily functions .
Most of the time, you don’t notice your thyroid gland is working at all . But when it starts misfiring, like not releasing enough thyroid hormone or releasing too much , all hell can break loose. Even more annoying: That hell can break loose anywhere in your body: your eyes, your skin, your hands, you name it.
That’s because symptoms of thyroid disease can mirror the symptoms of a ton of other issues. “Symptoms vary from person to person and can come on suddenly or very gradually, so they’re hard to detect,” as Valentina Rodriguez, M.D., an endocrinologist at NYU Langone Health previously told Women’s Health in Do I Need A Thyroid Check?.
That’s why it’s super important to stay on top ofand quickly act onany of the symptoms below.
Who Is At Risk For Hyperthyroidism
You are at higher risk for hyperthyroidism if you
- Are a woman
- Are older than age 60
- Have been pregnant or had a baby within the past 6 months
- Have had thyroid surgery or a thyroid problem, such as goiter
- Have a family history of thyroid disease
- Have pernicious anemia, in which the body cannot make enough healthy red blood cells because it does not have enough vitamin B12
- Have type 1 diabetes or primary adrenal insufficiency, a hormonal disorder
- Get too much iodine, from eating large amounts of foods containing iodine or using iodine-containing medicines or supplements
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How Is Thyroiditis Treated
How thyroiditis is treated depends on the type, symptoms, and phase of thyroiditis.
- Thyrotoxic phase: Usually temporary, it will eventually either recover and go to the euthyroid phase, or go to the hypothyroid phase. This hypothyroid phase could be temporary or permanent. It may not be necessary to treat symptoms in subacute, painless, or post-partum thyroiditis. During the thyrotoxic phase, treatment is symptomatic. Antithyroid medications are rarely needed.
- Palpitations/anxiety/tremors/heat intolerance/increased sweating: These symptoms are treated with beta blockers.
- Thyroidal pain: The pain can usually be managed with anti-inflammatory medications such as aspirin or ibuprofen. If the pain is severe enough, steroid therapy may be required .
- In other forms, treating the infection will be necessary to eliminate acute thyroiditis. Drug-induced thyroiditis generally lasts as long as the drugs are taken.
- Hypothyroid phase: If necessary, thyroid hormone replacement therapy is used to treat hypothyroidism. This type of therapy usually continues for 6 to 12 months. Hashimoto’s thyroiditis usually causes permanent hypothyroidism and requires continued treatment.
How Is Goiter Diagnosed
Several tests can be used to diagnose and evaluate goiter, including the following:
- Physical exam: Your doctor may be able to tell if the thyroid gland has grown by feeling the neck area for nodules and signs of tenderness.
- Hormone test: This blood test measures thyroid hormone levels, which tell if the thyroid is working properly.
- Antibody test: This blood test looks for certain antibodies that are produced in some forms of goiter. An antibody is a protein made by white blood cells. Antibodies help defend against invaders that cause disease or infection in the body.
- Ultrasound of the thyroid: Ultrasound is a procedure that sends high-frequency sound waves through body tissues. The echoes are recorded and transformed into video or photos. Ultrasound of the thyroid reveals the gland’s size and finds nodules.
- Thyroid scan: This imaging test provides information on the size and function of the gland. In this test, a small amount of radioactive material is injected into a vein to produce an image of the thyroid on a computer screen. This test is not ordered very often, since it is only useful in certain circumstances.
- CT scan or MRI of the thyroid: If the goiter is very large or spreads into the chest, a CT scan or MRI is used to measure the size and spread of the goiter.
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Your Hair Is Thinning
According to the American Academy of Dermatology , your dermatologist might be the first doctor to notice signs of thyroid disease since many signs and symptoms show up on your skin, hair, and nails.
Both conditionshypothyroidism and hyperthyroidismcan cause your hair to thin. Your eyebrows are hit especially hard: Eyebrows that thin along the outer edges can be a sign of hypothyroidism, Eve Feinberg, M.D., assistant professor of reproductive endocrinology and infertility at Northwestern University School of Medicine previously told Women’s Health.
You may also find less hair on your legs, arms, and other areas, or that your hair has become coarse, dully, dry, and breaks easily, per the AAD.
Causes Of An Enlarged Thyroid
Knowing that your thyroid is enlarged is not a diagnosis by itself.
It’s more helpful to think of an enlarged thyroid gland as an observation or as a description of what is happening.
This is because there are actually many different conditions which result in thyroid gland enlargement.
These conditions range from infections, inflammation of the gland, nutrient deficiencies, cancer and even autoimmune disease.
An important part of treating an enlarged thyroid gland is correctly identifying and diagnosing what is happening.
This important step can be done through blood testing and imaging .
The range of medical conditions which can cause thyroid gland enlargement include:
- Thyroid nodules and thyroid cysts
- Thyroiditis caused by inflammation, infection or autoimmune disease
- Hashimoto’s thyroiditis
- Iodine deficiency
These diseases can be differentiated based on how they present , how they affect the size of your thyroid gland , how they look on ultrasound imaging and how they affect thyroid hormone production.
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