Thyroid Disease

January is Thyroid Awareness Month, a month dedicated to talking about thyroid disease.

This awareness event gives us the chance to raise awareness around the different types of thyroid conditions, the symptoms, and the importance of diagnosis and treatment.

Prevalence and Impact of Thyroid Disease

More than 12 percent of the U.S. population will develop a thyroid condition during their lifetime.

  • An estimated 20 million Americans have some form of thyroid disease.
  • Up to 60 percent of those with thyroid disease are unaware of their condition.
  • Women are five to eight times more likely than men to have thyroid problems.

 Facts about the Thyroid Gland and Thyroid Diseases

The thyroid gland, located in the front of the neck just below the Adam’s apple, takes iodine from the diet and makes thyroid hormone. Thyroid hormone plays a key role in regulating blood pressure, body temperature, heart rate, metabolism and the reaction of the body to other hormones.

Thyroid diseases generally fall into two broad groups of disorders: abnormal function and abnormal growth (nodules) in the gland. These problems are common in the general population, especially among older people and women. Most thyroid problems can be detected and treated.

Abnormal function

Functional disorders are usually related to the gland producing too little thyroid hormone (hypothyroidism) or too much thyroid hormone (hyperthyroidism).

Symptoms of hypothyroidism include tiredness, being sensitive to cold, weight gain, slowed heart rate, constipation, dry skin, hoarse voice, changes in menstrual cycles, depression, slow movements, memory issues, muscle aches and weakness, muscle cramps, coarse hair and skin.

Hyperthyroidism symptoms include losing weight without trying, fast or irregular heartbeat, increased hunger, nervousness, anxiety and irritability, tremor, sweating, increased sensitivity to heat, changes in menstrual cycles, more-frequent bowel movements, tiredness, sleep problems, thinning skin, and fine, brittle hair.

Abnormal growth

Benign nodules in the thyroid gland are common and do not usually cause serious health problems. These nodules occur when the cell growth within the nodule is abnormal. Nodules can occasionally put pressure on the neck and cause trouble with swallowing, breathing or speaking if they are too large. The thyroid usually functions normally even when nodules are present.

Thyroid cancers are much less common than benign nodules. With treatment, the cure rate for thyroid cancer is more than 90 percent.

Checking for Thyroid Disease

Checking for thyroid disease is similar to other kinds of medical evaluations. The provider considers the patient’s medical history, examines the thyroid and may order a blood test or other diagnostic tests.

A standard physical examination of the thyroid gland is done by palpation – that is, feeling the thyroid gland. The doctor feels for the size and texture of the gland, and whether any masses or nodules are present.

Testing for Thyroid Function

There are two standard blood tests of thyroid function: the measurement of thyroid hormone, usually T4, and the measurement of thyrotropin (TSH). TSH is a hormone secreted from the pituitary gland that controls how much thyroid hormone the thyroid makes.

Abnormal blood tests usually reveal thyroid function problems and not the presence of thyroid nodules or cancer.

Testing for Nodules

If a nodule is found during the physical examination, a test called fine needle aspiration (FNA) biopsy may be done to help find out whether the nodule is cancerous or benign. In addition, a thyroid nuclear scan may help the doctor evaluate thyroid function or nodules. The scan is performed by giving the patient a radioisotope and taking a special picture to see how much of the radioisotope is taken up by the thyroid gland.

A thyroid ultrasound scan is a diagnostic test that shows a picture of the anatomy, or structure, of the thyroid gland. Ultrasound is most often used to determine if a nodule is solid or cystic. Cystic nodules, containing only fluid, are usually benign.

Ultrasound is not usually performed as a routine screening test for thyroid nodules in the general population. The reason is that small, nonpalpable ultrasound abnormalities are very common in people without evidence of thyroid disease.

Treatment of Thyroid Disease

The treatment of thyroid disease depends on many factors, including the type and severity of the thyroid disorder and the age and overall health of the patient. Treatment must be specific to each individual.

  • The majority of benign nodules do not require treatment. Patients with benign nodules are usually advised to have periodic follow-up examinations.
  • Hypothyroidism usually requires only replacement of thyroid hormone by taking a single daily tablet at a dose adjusted to produce normal thyroid hormone levels.
  • Autoimmune thyroiditis is a disorder that may cause hypothyroidism. It usually does not cause symptoms that require treatment unless hypothyroidism develops. In such cases, thyroid hormone replacement is required.
  • Treatment of hyperthyroidism may include antithyroid drugs, radioactive iodine-131 or in rare cases, thyroid surgery.