Proper thyroid function is crucial for good health; guess the signs, treatment of thyroid disease

Dr. Oliver Fakelmeier
University of Kentucky Health

Your thyroid is a small but vital gland and the hormones it produces help regulate many bodily functions, such as heart rate, body temperature and menstrual cycles. So, if the thyroid gland is not working properly, the quality of life can be significantly affected.

More than 12 percent of Americans will develop thyroid disease at some point in their lives, and women are five to eight times more likely than men to experience these problems, according to the American Thyroid Association.

What does the thyroid gland do?

(Photo by iStock / Getty Images Plus, University of Kentucky)

The thyroid gland is a butterfly-shaped gland that lies above your trachea. It produces thyroid hormone, a critical factor in fetal development in early childhood, as well as metabolism in adulthood.

Thyroid hormone is not just for gaining or losing weight; it is essential for life and acts on every tissue in your body to regulate protein synthesis and turnover.

What is thyroid disease?

Thyroid disease occurs when there are too many or too few thyroid hormones – hyperthyroidism or hypothyroidism. It also develops if there is a structural problem with the gland – enlargement of the thyroid gland, thyroid nodules or thyroid cancer.

Hyperthyroidism, usually from Graves’ disease, can be cured by surgical removal of the thyroid gland. Hypothyroidism is often caused by Hashimoto’s thyroiditis, an inflammation of the thyroid gland that burns the thyroid gland, reducing its function.

What are the symptoms associated with thyroid disease?

Often, thyroid nodules do not cause any symptoms and are found in images taken for other reasons. When they cause symptoms, you may notice:

• A lump or swelling in the front of the neck
• Difficulty swallowing
• Feeling stuck in your throat
• Feeling of suffocation, especially when lying down
• Voice changes

Symptoms of hyperthyroidism include:

• Heartbeat or beating heart
• Anxiety
• Tremor
• Weight loss
• Heat intolerance
• Excessive sweating
• Menstrual disorders

Symptoms of hypothyroidism include:

• Fatigue
• Weight gain
• Intolerance to cold
• Constipation
• Dry skin
• Menstrual disorders

In addition, women with hyperthyroidism or hypothyroidism may have difficulty conceiving.

How is thyroid disease diagnosed?

The first step in any thyroid assessment is to assess thyroid function. Thyroid-stimulating hormone (TSH) is produced by the brain in response to low-circulating thyroid hormone, so elevated TSH indicates decreased thyroid function and low TSH means overactive thyroid.

The best way to structurally assess the thyroid is an ultrasound of the neck, which examines the entire thyroid gland as well as the lymph nodes in the neck.

At UK HealthCare, we strive to provide a comprehensive visit for every patient. All surgeons perform an ultrasound in the office and, if necessary, a biopsy in the office to diagnose and guide the surgical treatment plan. We achieve with one visit for most patients what usually requires three separate visits to different wards on different days.

How is thyroid disease treated?

Thyroid disease often requires surgery to remove a potentially cancerous nodule or nodule that is causing annoying symptoms.

If your doctor decides that your entire thyroid gland needs to be surgically removed, you should take thyroid hormone for the rest of your life as a small pill every morning. We can often limit surgery to remove only half of the thyroid gland, and in many cases these patients will continue to produce enough thyroid hormones to not need supplements.

Oliver Fakelmeier, MD, is an endocrine surgeon from the University of Kentucky who specializes in the surgical treatment of benign and cancerous conditions of the thyroid, parathyroid and adrenal glands.

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