Knowing Thyroids
 Understanding Your Thyroid Gland  Common Thyroid Problems  Treatment
What is your thyroid gland?
The thyroid gland is a small, butterfly-shaped gland located at the base of your neck that
regulates your body’s energy levels. Problems with your thyroid gland can affect you in many
ways. These problems are treatable, and you and your doctor can discuss the best option to
treat your thyroid problem.
The thyroid gland controls the rate at which your organs work. This is called metabolism. A
healthy thyroid will keep your metabolism at a steady pace and keep your body working
right. The thyroid gland controls your metabolism by producing the thyroid hormone, a chemical that carries messages
from the thyroid to the rest of the body via the bloodstream. This hormone will tell your organs how quickly to work.
Your thyroid gland makes the thyroid hormone from iodine, which is absorbed from the food you eat. When more thyroid
hormone is made, the cells work more quickly. And when less thyroid hormone is made, the cells work more slowly. The
pituitary gland determines the amount of the thyroid hormone produced by monitoring its levels in the bloodstream. The
pituitary gland produces more thyroid stimulating hormone (TSH) when it senses there is not enough thyroid hormone.
TSH tells the thyroid to produce more hormones. The pituitary glands produces TSH more slowly when it senses there is
enough thyroid hormone in the bloodstream.
Common Thyroid Problems
Thyroid problems are very common and affect a large number of people. A thyroid problem may indicate your thyroid
gland is underactive and does not produce enough hormone, or that it is overactive and produces too much hormone.
Your thyroid gland may grow larger and this enlarged gland is called a goiter. It may also form lumps called nodules,
which may be cancerous.
Hypothyroidism: An Underactive Thyroid
Hypothyroidism occurs when the thyroid gland is not working hard enough and produces too little hormone. This
causes your body to run more slowly and have less energy. The most common cause is Hashimoto’s
thyroiditis. Hashimoto’s thyroiditis occurs when the body’s immune system mistakes the thyroid gland for
something it needs to attack. Hypothyroidism may also occur if there is not enough iodine for the thyroid to
produce the hormone, removal of the thyroid gland or problems with the pituitary gland. Common symptoms
include:
 Easily getting cold
 Muscle pain
 Gaining weight
 Dry and brittle skin, hair and nails
 Constipation
 Slowed thinking
 Decrease in energy level
 Feeling down and depressed
 Longer or heavier menstrual periods
Hyperthyroidism: An Overactive Thyroid
Hyperthyroidism occurs when your thyroid gland works too hard and produces too much hormone. This causes
your body to run faster. The common cause is Grave’s disease. This occurs when the body’s immune system
overstimulates the thyroid. This disease sometimes causes the eyes to look like they are bulging
(exophthalmos). Less commonly, the cells of a nodule in your neck may produce more hormone than the rest of
the gland causing hyperthyroidism. Common symptoms include:
 Weight loss
 Shaking, nervousness, jitters, irritability
 Easily getting hot
 Muscle weakness, fatigue
 A rapid, irregular heartbeat
 Hair loss
 More frequent bowel movements
 Shorter or lighter menstrual periods
Thyroid Nodules
The thyroid gland may develop small lumps, called nodules. Despite forming nodules,
your thyroid gland will often continue to function at a normal pace. There are no known
direct causes of thyroid nodules, but they are more common in people who have
experience therapeutic radiation to the head or neck for problems such as acne or
swollen tonsils. You may not notice any symptoms but you may be able to feel the nodule
in your neck. For the most part, nodules are harmless, but occasionally they are
cancerous.
Goiters
A goiter is an enlarged thyroid gland. Thus may cause visible
swelling on one or both sides of your neck. Hypothyroidism may
cause a goiter because the thyroid may enlarge in order to produce
more hormone. Hyperthyroidism may cause a goiter because thyroid
cells may multiply too fast and cause the thyroid to grow.
Development of multiple nodules may cause the thyroid to grow as
well.
Problems with the thyroid gland are easily treatable, and most forms of thyroid cancer can be stopped. You and your
doctor can discuss your best treatment options, and this may include medications, thyroid hormone pills, surgery and
other procedures.
What test will I need?
In order to determine your best treatment plan, your doctor will perform an evaluation. This will include a patient history
and exam. Your doctor will ask questions about your symptoms and medical history to rule out alternative causes. Be sure
to clearly describe your symptoms. Because thyroid problems can be hereditary, your doctor may also ask if other family
members have had thyroid problems. During your physical exam, your doctor will look at your neck and thyroid gland to
check for growth, nodules or other changes. He or she may check your blood pressure, weight, and pulse rate and
examine your eyes and skin as well.
In addition, test and procedures may be performed to determine what thyroid problem you have and it cause. A blood
test can tell if your thyroid is underworking or overworking by measuring the amount of thyroid hormone and TSH in your
blood. A radioiodine uptake test measures how well your thyroid absorbs iodine. You will ingest a small amount of mildly
radioactive iodine. Hours later and the next day, a machine will measure the amount of radioactive iodine in your thyroid.
A thyroid scan and an ultrasound exam will create images of the thyroid gland which helps your doctor access nodules.
If you doctor finds nodules, he or she may order a fine-needle aspiration biopsy to determine whether the nodule is
cancerous. Using ultrasound, a specialist will numb the area and use to fine needle to collect cells from the nodule. The
cells will be further examined.
Treatment
After determining your thyroid problem and its causes, your doctor can create a plan to treat it. Your doctor may prescribe
thyroid hormone pills or medications. Nodules may be closely monitored or removed. The thyroid gland might be
destroyed with radioactive iodine (radioiodine ablation) or removed in surgery (thyroidectomy).
Treating Hypothyroidism
To treat your hypothyroidism, your doctor may prescribe thyroid hormone pills. Your symptoms should begin to
clear up, and an enlarged thyroid gland should return to normal size after beginning thyroid hormones. In order to
maintain the normal thyroid hormone level, you will probably need to take thyroid hormone pills for the rest of your
life. Your doctor will need to regularly monitor your thyroid hormone level in your blood in order to maintain the
correct dosage and make any adjustments if necessary.
Treating Hyperthyroidism
Hyperthyroidism can be treated using several different methods. You doctor may prescribe medications to slow
the production of thyroid hormone in order to maintain normal levels. If the medication does not work, your doctor
may administer radioiodine ablation of the thyroid, or destroying the thyroid gland by giving you a large dose of
radioactive iodine in pill or liquid form to kill thyroid cells. Or, your doctor might remove your thyroid gland
surgically (thyroidectomy). You may need to take thyroid hormone pills to maintain normal hormone levels for
treatment.
Treating Nodules and Goiters
If you have noncancerous nodules, your doctor may prescribe thyroid hormone pills to prevent the nodules from
growing larger. You doctor can check the nodules for size change by performing a physical exam or using
ultrasound. If the nodules grow to be very large, cause difficulty breathing or swallowing, or are cancerous, your
doctor will perform a thyroidectomy. Radioiodine ablation may be done after surgery to ensure all cancerous
tissue has been destroyed. A goiter may be surgically removed if it does not get smaller after treatment. After
surgery, you may need to take thyroid hormone pills to maintain normal hormone levels.
If you need surgery
The best way to treat your thyroid problem may be by removing all or part of your thyroid gland. Your doctor can explain
the procedure with you. A complete physical exam may be necessary before your surgery, which may include a routine
check of your blood and your heart and an x-ray of your chest.
Surgery can be performed to remove a large goiter or nodule, a hyperthyroid gland that medication cannot control, or a
cancerous thyroid gland. The amount of gland removed depends on several factors which your surgeon can discuss with
you.
Your Surgical Procedure
An Intravenous (IV) line provides you with fluids and medications during the surgery. You will be administered
general anesthesia so you will be asleep during the procedure. In your neck, along the crease of your skin, and
incision is made. The surgeon may remove half of the thyroid gland (lobectomy), most of the gland (subtotal
thyroidectomy), or the entire gland (total thyroidectomy). Sometimes, the surgeon can only decide how much
of the thyroid needs to be removed once he or she has made an incision and can examine the area around the
thyroid. When the surgical procedure is finished, the incision is closed using surgical strips, surgical slips or
sutures. A drain may be left in the incision to remove fluid.
After Your Surgical Procedure
The evening after the procedure you can usually begin to eat and drink normally. You may be administered pain
medication the first day or so, but discomfort is usually minimal. You may experience a sore throat or hoarseness
in the first week after surgery. During your hospital stay, you will be monitored for bleeding and to make sure your
parathyroid glands are working properly. If the stress of the surgery stuns these glands, you may be given calcium
supplements.
When to Call Your Doctor
If you notice any of these signs, call your doctor right away.
 Swelling or bleeding at the incision site
 Signs of infections- Warmth, fever, or tenderness
 A sore throat that continues beyond three weeks
 Tingling or cramps in the hands, feet or lips (signs of a problems with the parathyroid glands) to maintain normal
hormone levels
Download

File - Middlesex Surgical Associates