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Thyroid Basics

Wednesday, January 13, 2016

Years ago when my kiddos were preschoolers, I went to the doctor for what I thought was a run of the mill visit for an upper respiratory infection.  As part of that exam, my physician felt the glands on my neck and pronounced, “My dear, your thyroid is enlarged.  Are you fatigued?”  I looked at him and said, “I have two small children and work – yes, I’m tired but isn’t everyone?”  It turns out, I had been living with hypothyroidism (my thyroid was not producing enough thyroid hormone) and I had no idea.   My story is not all that unusual.  According to the American Thyroid Association, more than 12% of the U.S. population will develop a thyroid condition during their lifetime. Furthermore, an estimated 20 million Americans currently have some form of thyroid disease and up to 60% of them are unaware of their condition.  Many of those people are women in that women are five to eight times more likely than men to have thyroid problems.  One woman in eight will develop a thyroid disorder during her lifetime. Given these numbers it is worth looking at this small gland, its functions, types of diseases, and treatments.

The thyroid gland is a butterfly-shaped endocrine gland that is normally located in the lower front of the neck.  It has two cone-like lobes. Each lobe measures about 5 cm long, 3 cm and 2 cm thick (a little less than 2 inches by 1 inch by ¾ inch).  This small glands job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. Thyroid hormone helps the body use energy, stay warm and keep the brain, heart, muscles, and other organs working as they should.  When the thyroid is not functioning properly, the gland may become enlarged and the person may experience several other symptoms.

According to the Centers for Disease Control and Prevention, thyroid functioning falls into two broad categories: hypothyroidism and hyperthyroidism.   If the gland is producing too little thyroid hormone, it is called hypothyroidism.  If the gland is producing too much thyroid hormone, it is called hyperthyroidism.   The following is a list of symptoms associated with both.  It is important to remember, however, that not all people will experience all symptoms.  

Hypothyroidism Symptoms

Depression or feeling blue

Trouble Concentrating

Forgetfulness

Tiredness/fatigue

Dry skin and hair

Weight gain

Feeling cold all the time

Hyperthyroidism Symptoms

Nervousness and anxiety

Weight loss

Tremor (shaking)

Muscle weakness

Fast, irregular pulse

Tiredness/sleep disturbances

Vision problems/eye irritation

Feeling hot all the time

If you are experiencing any of these symptoms on a regular basis, a visit to your physician is in order.  The doctor will feel for the size and texture of the gland and check for masses known as nodules.  In addition, he or she will order a simple blood test to check your thyroid hormone levels. Most nodules are benign and usually do not cause any problems; but sometimes, nodules put pressure on the neck and cause trouble with swallowing, breathing or speaking.  In addition, some masses may be cancerous.  This is much less common and with treatment, the cure rate for thyroid cancer is 90%.  

Treatments differ depending on the diagnosis.  According to the CDC, hypothyroidism usually requires only thyroid hormone replacement by taking a single daily tablet at a dose adjusted to produce normal thyroid hormone levels.  Hyperthyroidism treatments may include antithyroid drugs, radioactive iodine-131, or in rare cases, surgery.  If a nodule is found, the doctor may order a biopsy to determine if it is benign or cancerous.  Further tests could include a nuclear scan or an ultrasound.  If appropriate, the patient may need to undergo surgery.  

The American Thyroid Association indicates that undiagnosed thyroid disease may put patients at risk for certain conditions such as cardiovascular disease, osteoporosis, and infertility.  That being said, diagnosis is simple and pain free and most thyroid diseases are life-long conditions that can be managed with medical attention.   

To learn more about the thyroid, its functions, diseases, and treatments, visit the American Thyroid Association website at:  http://www.thyroid.org/.   

Lorraine Wichtowski is a community health educator at UR/Noyes Health in Dansville.  If you have questions or suggestions for future articles she can be reached at lwichtowski@noyeshealth.org or 585-335-4327.  

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