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  1. 1. ELLNESS NITIATIVE OW January 2006 A Look at Thyroid Disorders thyroid gland is located further down on your neck, closer to the collarbone. You The thyroid gland, located in the front of the neck just below the may want to repeat this process several Adam's apple, takes iodine from the diet and makes thyroid times. hormone. Thyroid hormone affects a person's physical energy, If you do see any bulges or protrusions in temperature, weight and mood. this area, see your physician immediately. You may have an enlarged thyroid gland or Thyroid diseases generally fall into two broad groups of a thyroid nodule and should be checked to disorders: abnormal function and abnormal growth (nodules) in determine whether cancer is present or if the gland. These problems are common in the general treatment for thyroid disease is needed. population, especially among older people and women. Most thyroid problems can be detected and treated. Checking for Thyroid Disease Functional disorders are usually related to the gland producing Checking for thyroid disease is similar to other too little thyroid hormone (hypothyroidism) or too much thyroid kinds of medical evaluations. The doctor hormone (hyperthyroidism). considers the patient's medical history, examines the thyroid and may order a blood test or other Benign nodules in the thyroid gland are common and do not diagnostic tests. usually cause serious health problems. These nodules occur when the cell growth within the nodule is abnormal. Nodules A standard physical examination of the thyroid can occasionally put pressure on the neck and cause trouble with gland is done by palpation – that is, feeling the swallowing, breathing or speaking if they are too large. The thyroid gland. The doctor feels for the size and thyroid usually functions normally even when nodules are texture of the gland, and whether any masses or present. nodules are present. Thyroid cancers are much less common than benign nodules. With treatment, the cure rate for thyroid cancer is more than 90 Testing for Thyroid Function percent. There are two standard blood tests of thyroid Take the "Neck Check" self-exam to help determine whether function: the measurement of thyroid hormone, or not you have an enlarged thyroid gland or thyroid nodule, usually T4, and the measurement of thyrotropin which may need further examination and testing by an (TSH). TSH is a hormone secreted from the endocrinologist. All you will need is a glass of water and a pituitary gland that controls how much thyroid hand-held mirror hormone the thyroid makes. Hold the mirror in your hand, focusing on the area of your Abnormal blood tests usually reveal thyroid neck just below the Adam's apple and immediately above function problems and not the presence of the collarbone. Your thyroid gland is located in this area of thyroid nodules or cancer. your neck. While focusing on this area in the mirror, tip your head back. Testing for Nodules Take a drink of water and swallow. If a nodule is found during the physical As you swallow, look at your neck. Check for any bulges or examination, a test called fine needle aspiration a protrusion in this area when you swallow. Reminder: (FNA) biopsy may be done to help find out Don't confuse the Adam's apple with the thyroid gland. The whether the nodule is cancerous or benign. In addition, a thyroid nuclear scan may help the
  2. 2. doctor evaluate thyroid function or nodules. The scan is • Depression is often a sign of an performed by giving the patient a radioisotope and taking a underactive thyroid known as special picture to see how much of the radioisotope is taken up hypothyroidism, the most common type by the thyroid gland. of thyroid disease. A thyroid ultrasound scan is a diagnostic test that shows a • Hypothyroidism occurs 4 times more picture of the anatomy, or structure, of the thyroid gland. often in women, and is often called the Ultrasound is most often used to determine if a nodule is solid or “hidden health problem” cystic. Cystic nodules, containing only fluid, are usually benign. • One out of every 5 women over the age of 65 has an above normal TSH (thyroid Ultrasound is not usually performed as a routine screening test stimulating hormone) blood level, called for thyroid nodules in the general population. The reason is that hypothyroidism, or an underactive small, nonpalpable ultrasound abnormalities are very common in thyroid gland. people without evidence of thyroid disease. • Approximately 17% of women and 8% Treatment of Thyroid Disease of men over the age of 60 have signs of hypothyroidism, representing 5.7 million The treatment of thyroid disease depends on many factors, women and 2.7 million men. Half of including the type and severity of the thyroid disorder and the these people are undiagnosed. age and overall health of the patient. Treatment must be specific • Between 20% and 25% of older to each individual. Americans (people over the age of 60) suffer from symptoms of mental illness Thyroid cancer is initially treated with thyroid surgery. that include depression. Patients treated for thyroid cancer require lifelong thyroid hormone replacement. • It is estimated that nearly 20% of the male cases of hyperthyroidism in this The majority of benign nodules do not require treatment. country go unrecognized. Patients with benign nodules are usually advised to have • Hyperthyroidism is triggered by periodic follow-up examinations. different factors; yet most specialists believe stress plays a role in the onset of Hypothyroidism usually requires only replacement of the disease, as does age, since it is most thyroid hormone by taking a single daily tablet at a dose likely to appear between the ages of 20 adjusted to produce normal thyroid hormone levels. and 40. Autoimmune thyroiditis is a disorder that may cause • Nearly 4 million people in the United hypothyroidism. It usually does not cause symptoms that States suffer from an overactive thyroid require treatment unless hypothyroidism develops. In such condition called hyperthyroidism. cases, thyroid hormone replacement is required. • 33%, or 40 million Americans, suffer Treatment of hyperthyroidism may include antithyroid from sleep disorders - a common drugs, or in rare cases, thyroid surgery. symptom of hyperthyroidism. • Hyperthyroidism, an overactive thyroid, Recommendation for Thyroid Check-ups occurs 7 to 9 times more often in women – and the age group most often affected If you have received regular health care and have no symptoms includes those 30 to 40 years of age. of thyroid disease, you may not need to see a doctor to check for thyroid disease. However, if you are concerned about, or • The most common type of experience thyroid disease symptoms, you should see your hyperthyroidism is known as Graves doctor for a thyroid examination Disease, yet there are other reasons the thyroid gland can become overactive, • Women are 5 to 8 times more likely than men to suffer including thyroid nodules and from thyroid disease. inflammation of the thyroid. Patients frequently become hyperthyroid when • Approximately one woman in 8 will develop thyroid they take too much thyroid hormone disease during her lifetime. replacement. • Symptoms are easy to mistake for other health problems and often mimic signs of aging and menopause Used with permission by CDC