Diagnosing And Treating Thyroid Disorders
Hypothyroidism and hyperthyroidism are generally easy to diagnose using a simple blood test to measure the amount of thyroid hormones in the blood.
There are several different treatment options for patients suffering from either condition, including hormone replacement therapy for hypothyroidism or drugs to limit thyroid function for hyperthyroidism. Hyperthyroidism also can be permanently corrected by surgically removing all, or part, of the gland.
While both conditions can usually be treated successfully, its rarely a one-size-fits-all equation.
Hyperthyroidism tends to be easier to treat because you can simply remove the gland, Nakhle said. However, after doing so, the patient will need to use drugs to replace the thyroid hormones, which are the same drugs used for people with hypothyroidism. The hormone replacement drugs are successful about 90 percent of the time, but occasionally there are patients who dont respond well to any of the options.
Overview Of The Thyroid Gland
, MD, MS, David Geffen School of Medicine at UCLA
The thyroid is a small gland, measuring about 2 inches across, that lies just under the skin below the Adams apple in the neck. The two halves of the gland are connected in the middle , giving the thyroid gland the shape of a bow tie. Normally, the thyroid gland cannot be seen and can barely be felt. If it becomes enlarged, doctors can feel it easily, and a prominent bulge may appear below or to the sides of the Adams apple.
The thyroid gland secretes thyroid hormones, which control the speed at which the bodys chemical functions proceed . Thyroid hormones influence the metabolic rate in two ways:
Thyroid hormones affect many vital body functions, such as the heart rate, the rate at which calories are burned, skin maintenance, growth, heat production, fertility, and digestion.
When To See A Gp
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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What Is It Like For A Patient To Have A Thyroid Ultrasound
A thyroid scan is a simple outpatient procedure. You lie flat on the table, with your head and neck extended. Doctors apply a gel, which allows the sound waves from the ultrasound probe to get through the skin.
If a biopsy is needed, doctors use ultrasound to scan the area again, ensuring that they know exactly where to place the needle. Doctors numb the skin and insert a fine needle right into the nodule to retrieve cells.
Usually three needle passes are performed. After that, they perform one more scan to make sure the needle hasnt caused any complications, and it rarely does. We put on a Band-Aid and the patient goes home or right back to work, Dr, Kent says. The whole thing takes about a half-hour to an hour.
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.
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Circulatory And Cardiovascular Systems
Hypothyroidism slows your heart rate and weakens your heartbeat, making your heart less efficient at pumping blood out to your body. This can make you short of breath when you exercise. By narrowing your arteries, this condition can also raise blood pressure.
Hypothyroidism can lead to high cholesterol. Together, high blood pressure and high cholesterol can increase your risk for heart disease.
What Are The Best Supplements For Thyroid Health
Different thyroid supplements are recommended for different types of thyroid conditions. Be sure to work with your doctor, and only include supplements that are indicated for your particular situation.
Before you reach for supplements to support your thyroid health, keep the big picture in mind: a healthy thyroid begins with a healthy gut, so make sure to include thyroid support supplements only after youve addressed your gut health.
Heres an overview of thyroid supplements that may be helpful:
For more information on supplements for Hyperthyroidism, see Natural Management of Graves Disease.
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What Are Thyroid Nodules
A thyroid is a swelling in one section of the thyroid gland. The nodule may be solid or filled with fluid or blood. You may have just one thyroid nodule or many.
Thyroid nodules are common and affect four times as many women as men. Researchers do not know why nodules form in otherwise normal thyroids.
Graves Disease Diagnosis And Treatment
A simple physical exam can reveal an enlarged thyroid, enlarged bulging eyes, and signs of increased metabolism, including rapid pulse and high blood pressure. Your doctor will also order blood tests to check for high levels of T4 and low levels of TSH, both of which are signs of Graves disease. A radioactive iodine uptake test might also be administered to measure how quickly your thyroid takes up iodine. A high uptake of iodine is consistent with Graves disease.
Theres no treatment to stop the immune system from attacking the thyroid gland and causing it to overproduce hormones. However, the symptoms of Graves disease can be controlled in several ways, often with a combination of treatments:
- beta-blockers to control rapid heart rate, anxiety, and sweating
- antithyroid medications to prevent your thyroid from producing excessive amounts of hormone
- radioactive iodine to destroy all or part of your thyroid
- surgery to remove your thyroid gland, a permanent option if you cant tolerate antithyroid drugs or radioactive iodine
Successful hyperthyroidism treatment usually results in hypothyroidism. Youll have to take hormone-replacement medication from that point forward. Graves disease can lead to heart problems and brittle bones if its left untreated.
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Where Is My Thyroid Gland
The thyroid gland is located at the front of the neck just below the Adam’s apple . It is butterfly-shaped and consists of two lobes located either side of the windpipe . A normal thyroid gland is not usually outwardly visible or able to be felt if finger pressure is applied to the neck.
Diagram showing the location of the thyroid gland in the neck. It has two lobes and sits in front of the windpipe . The voice box sits just above the thyroid.
Supporting A Healthy Thyroid
Now that you have a basic overview of thyroid function, you may be wondering if there are ways to support your thyroid health in addition to medication. This is important because sometimes it can take a while before medication can correct hormone imbalance. In this case, the next best thing you can do is adjust your lifestyle habits.Managing stress: Because there is a relationship between your adrenal health and your thyroid health, its wise to get a hold on your stress levels. When you are chronically stressed, adrenal fatigue an overtaxing of the adrenal system may kick in, triggering your body to release hormones as a way of coping. This chronic stress can worsen thyroid issues, leading to imbalanced hormone levels. Chronically stressed? You might notice slowed metabolism and weight gain and stress may even further lower your levels of T3 and T4. It can also affect the conversion of T4 into T3.For this reason, its key to find a regular stress management ritual. This might be a daily yoga, meditation, or journaling break in which you disconnect from all distractions and stressors and simply focus on your breath and your emotional well-being. Regular nature walks also referred to as earthing or forest bathing have been proven to provide stress reduction on a physiological level as well.
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Risks Of A Thyroid Scan
Theres a small but safe amount of radiation contained in the radionuclide used in any thyroid scan. Your exposure to radiation will be minimal and within the acceptable ranges for diagnostic exams. There are no known long-term complications of having a nuclear medicine procedure.
Allergic reactions to the radionuclide material are extremely rare. The effects are mild when they occur. You may experience mild pain and redness at the injection site for a short time if you receive an injection of the radionuclide.
Even though the radiation exposure is minimal and short term, thyroid scans arent recommended for pregnant or breastfeeding women. Your doctor may recommend that you avoid becoming pregnant or fathering a child for six months after the test if youve had a metastatic scan.
The Purpose Of The Thyroid
Your thyroid is truly a workhorse. The hormones it makes fuel your metabolism, or the system in your body that converts what you eat and drink into energy. Thyroid hormones are taken by your blood to all of your bodys tissues and regulate vital organs, like your heart, brain, and muscles.
Fluctuations in your weight can often be linked to the thyroid because of its regulatory abilities. When it goes haywire, you may gain or lose weight seemingly inexplicably.
In addition to impacting your weight, your thyroid plays a significant role in young peoples growth and development, from the earliest days of life.
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What Are The Effects Of Thyroid Hormone
Thyroid hormones play an important role in the regulation of metabolism, including energy expenditure thermogenesis and protein, carbohydrate, and lipid metabolism. Thyroid dysfunction can lead to obesity or obesity-related diseases, such as metabolic syndrome, hypertension, hyperglycemia, and dyslipidemia.
Treatment For Thyroid Gland Disorders
Problems with thyroid hormone levels can be diagnosed with a simple blood test. The presence of antibodies in the blood will confirm Graves or Hashimotos disease. Underactivity is treated by taking thyroxine tablets – a form of hormone replacement. Overactivity is treated with drugs that slow the activity of the thyroid gland. If these do not work, part or all of the thyroid can be removed surgically, or some or all of the active thyroid cells can be killed with radioactive iodine.Nodules and cancers are diagnosed with a variety of different tests, including ultrasound, special x-rays and fine needle biopsies. Hot nodules will generally be removed surgically or destroyed with radioactive iodine. Cold nodules are frequently left alone and simply kept under observation. Cancer is treated by surgically removing the thyroid gland, followed by treatment with radioactive iodine to destroy any cells which may have spread.Taking iodine supplements can be dangerous for patients with Graves disease or hot nodules.
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What Happens In Your Body
Thyroid hormones have an impact on every cell and every organ. Specifically, T3 directly controls the production of various proteins made by your bodys cells. T3 does this by binding to a cells DNA.
Free T4 and free T3 circulating in your blood are available to immediately enter your bodys cells whenever they’re needed, for instance, when you’re cold or when your body is digesting food. Some of the intracellular T4 is converted to T3, and some of the T3 binds to specific T3-receptors in the nucleus of the cell. This bound T3 causes nuclear DNA to stimulate the production of specific proteins.
Among these proteins are various enzymes that, in turn, control the behavior of many important bodily functions mentioned above, such as how quickly your food is digested, your heart rate, body temperature, and how fast calories are burned.
Though thyroid hormones regulate DNA in this way in all cases, different cells in your body have different kinds of T3-nuclear receptors and in different concentrations. As such, the effect of T3 on a cell is quite variable from tissue to tissue and under various circumstances.
Desiccated Thyroid Side Effects
Get emergency medical help if you have any signs of an allergic reaction: hives difficult breathing swelling of your face, lips, tongue, or throat.
Less serious side effects may include temporary hair loss .
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
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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.
Are There Different Types Of Thyroid Removal Surgery
If your healthcare provider determines that your thyroid needs to be removed, there are a couple of ways that can be done. Your thyroid may need to be completely removed or just partially. This will depend on the severity of your condition. Also, if your thyroid is very big or has a lot of growths on it, that could prevent you from being eligible for some types of surgery.
The surgery to remove your thyroid is called a thyroidectomy. There are two main ways this surgery can be done:
- With an incision on the front of your neck.
- With an incision in your armpit.
The incision on the front of your neck is more of the traditional version of a thyroidectomy. It allows your surgeon to go straight in and remove the thyroid. In many cases, this might be your best option. You may need this approach if your thyroid is particularly big or has a lot of larger nodules.
Alternatively, there is a version of the thyroid removal surgery where your surgeon makes an incision in your armpit and then creates a tunnel to your thyroid. This tunnel is made with a special tool called an elevated retractor. It creates an opening that connects the incision in your armpit with your neck. The surgeon will use a robotic arm that will move through the tunnel to get to the thyroid. Once there, it can remove the thyroid back through the tunnel and out of the incision in your armpit.
- Are not at a healthy body weight.
- Have large thyroid nodules.
- Have a condition like thyroiditis or Gravess disease.
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What Happens If I Overdose
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include headache, sweating, diarrhea, irregular menstrual periods, confusion, weakness, swelling in your hands or feet, fast heart rate, chest pain, feeling short of breath, fainting, or feeling nervous, restless, or irritable.
What Are The Functions Of The Thyroid Hormones
- Thyroid hormones help with brain development and function
- It also helps with muscle control as well as bone health
- Regulates the metabolic rate of the body
- Also regulates the metabolism of fat, proteins and carbohydrates
- Thyroid hormones also help with protein synthesis
- Increases the bodys sensitivity to catecholamines
- Essential for the development and differentiation of cells
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Testing Your Thyroid Levels
According to the American Thyroid Association, there isnt one test for every situation in fact, there are several kinds of thyroid tests. But if you are concerned about thyroid issues, or if your hormones are imbalanced, your doctor may provide an initial TSH level blood test. This is because the TSH level can serve as a tip-off to other, more specific issues.Whats a normal TSH level? Most lab companies have a wide reference as it relates to TSH levels , Dr. Rice says. So, if your results are somewhere between 0.4-4.0, youd be in the normal range. However, there is research that suggests that the reference range for TSH should be narrowed to 0.4 to 2.5, says Dr. Rice, which means that the normal range could be even smaller than some healthcare providers might think.Generally, healthy TSH levels are an indicator the whole system is working well, but thats an oversimplification at best. A normal T3 level might be somewhere between 100 to 200 nanograms per deciliter , while a normal T4 level falls between 5.0 to 12.0 micrograms per deciliter . Free T4, which tests for the amount of T4 that is available in the body, should range between 0.8 to 1.8 nanograms per deciliter .
Before Taking This Medicine
Since thyroid hormone occurs naturally in the body, almost anyone can take thyroid. However, you may not be able to use this medication if you have a thyroid disorder called thyrotoxicosis, or an adrenal gland problem that is not controlled by treatment.
To make sure this medicine is safe for you, tell your doctor if you have:
heart disease, angina
coronary artery disease
any type of diabetes or
problems with your adrenal gland.
Desiccated thyroid is not expected to be harmful to an unborn baby, but your dose needs may be different during pregnancy. Tell your doctor if you become pregnant while taking this medicine. Small amounts of thyroid can pass into breast milk, but this is not expected to harm a nursing baby. However, do not use this medication without telling your doctor if you are breast-feeding a baby.
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