Signs You Have a Thyroid Disease
The thyroid gland is a small butterfly-shaped organ near the base of the neck that's responsible for creating hormones your body needs to function and regulating body temperature, metabolism, and heart rate. When your thyroid isn't working properly, it can affect your overall well-being making you feel sluggish and not well, while others won't feel symptoms at all. According to the American Thyroid Association, "An estimated 20 million Americans have some form of thyroid disease [and] up to 60 percent of those with thyroid disease are unaware of their condition." Eat This, Not That! Health spoke with Dr. Melanie Goldfarb, M.D., endocrine surgeon and director of the Center for Endocrine Tumors at Saint John's Cancer Institute at Providence Saint John's Health Center in Santa Monica, CA who explained what thyroid disease is and signs to watch out for. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.
What Is A Thyroid Disorder?
Dr. Goldfarb says, "A thyroid disorder is when your thyroid gland is producing either too much or too little thyroid hormone. There are many 'endocrine disruptors' out in the environment and our lives, but we don't know what the threshold is for when exposure or consumption actually leads to the thyroid not working properly. Many people are also genetically predisposed (they have family members whose thyroids didn't work properly). We really don't know the underlying cause of what causes many thyroid disorders. Common health problems that can be affected by imbalances in the thyroid gland are blood pressure, heart arrhythmias (such as atrial fibrillation), obesity, psychological conditions such as depression, anxiety, and mental clarity."
Signs You Have Thyroid Disease
According to Dr. Goldfarb, "Patients with hypothyroidism may experience symptoms such as fatigue/sluggishness, cold intolerance, constipation, hair loss, and weight gain. Those with hyperthyroidism may exhibit a racing heart rate, palpitations, anxiety and nervousness, weight loss with increased appetite, excessive sweating, or abnormal menstrual cycles. When large, thyroid nodules can cause problems swallowing or breathing by compressing the esophagus or airway.
Many people blame their thyroid for many symptoms that are nonspecific and unrelated. If you have some of the symptoms above but your labs look great, you don't have a thyroid problem. Second, thyroid disorders are very treatable and 99% of people will feel normal once they are on the right dose of meds."
Diagnosing A Thyroid Disorder
Dr. Goldfarb says, "The best test to determine if your thyroid is working normally is a blood test called TSH (thyroid stimulating hormone). It will be high if your thyroid isn't working enough and low if it's working too little. Other additional blood tests may be ordered if your TSH is found to be abnormal. If a nodule is palpated, the best test is an ultrasound performed by an experienced thyroid ultrasonographer, surgeon, or endocrinologist."
Hypothyroidism or Underactive Thyroid
"Many (but not all) of these patients have Hashimoto's disease where your body is making antibodies to attack your thyroid," Dr. Goldfarb shares. "The symptoms are nonspecific, but When your thyroid isn't producing enough hormones (you are hypothyroid) you can experience fatigue, sluggishness (mental and physical), cold intolerance, abnormal periods, weight gain, hair loss. You can treat it by replacing thyroid hormone (best and most common is Synthroid, which is just the normal hormone your body makes but made in the lab – there are no side effects). Most patients do very well and are soon back to normal."
Dr. Goldfarb explains, "Graves' disease happens when antibodies are attacking your thyroid. The symptoms are nonspecific, but when your thyroid is producing too much hormone, you can experience a racing heart, palpitations, heat intolerance, sweating, weight loss and irritability. There are three forms of treatment: medicine, radioactive iodine, and surgery. It's best to discuss with your doctor which is best for you."
"Thyroid nodules, or growths, are very common," Dr. Goldfarb states. "50-70% of postmenopausal females have nodules and even 20-30% of women in their 30s and 40s have nodules. However, most are benign and can be watched once discovered. However, 5-10% are cancerous and therefore, if you have a thyroid nodule, it should be examined with a screening ultrasound. This can be ordered by your physician and be performed by a radiologist, endocrinologist, or endocrine surgeon. Solid thyroid nodules generally don't shrink, but may grow slowly over time. If it grows large enough, it could cause symptoms such as problems swallowing or breathing. If it is causing symptoms or is suspicious for removal, then surgery is recommended."
Treatment is Different for Everyone
Dr. Goldfarb shares, "Each patient is treated individually. However, characteristics that usually push me to recommend surgery for a thyroid nodules are:
-Large nodule size (larger than 4-5cm)
-Worrisome ultrasound characteristics
-Suspicious or positive for cancer thyroid biopsy
-Compressive symptoms such as problems swallowing or breathing
-Multiple abnormal nodules that are difficult to follow
-Nodules that are growing into the chest
Since we do not understand the etiology behind the cause of many thyroid disorders, I would say that they are mostly 'treated'. When your thyroid stops working you really can just replace the hormones your body would normally make. As for thyroid cancer, that you can cure, and most people are cured with surgery."
Dr. Goldfarb explains, "There are two conditions when thyroidectomy (removal of thyroid) is recommended: thyroid nodule or cancer OR sometimes for Graves' disease / hyperthyroidism. Your best way to minimize complications is to go to a specialist – many times an endocrine surgeon – who does A LOT of neck surgery and really only does thyroid/parathyroid surgery. In the hands of a specialist, rare complications include voice changes or low calcium levels after surgery.
For hyperthyroidism, surgery is the quickest and most definitive treatment. We definitely recommend it for patients that may want to get pregnant in the next 1-2 years and for patients with eye disease. It is also a good option for many teenagers that really need something to work sooner rather than later because of continued growth and development. For all other patients, it is best to discuss this with your doctor. It is always a good and reasonable option, but so are radioiodine or medicine for a lot of patients."
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