When the thyroid releases an incorrect amount of hormones into the bloodstream, various disorders and abnormalities may result.
The thyroid gland is prone to several disorders which include:
Hyperthyroidism
Hyperthyroidism is a disorder wherein the thyroid produces more thyroid hormones than the body needs. Treatment options include medical and surgical options including but not limited to: anti-thyroid drugs, radioactive iodine and surgical removal of the thyroid. Hyperthyroidism is usually detected during routine blood tests.
Symptoms
In many patients hyperthyroidism is asymptomatic, meaning there are no clear signs that you may have the disorder. However, when symptoms do present themselves, it’s because of an excess amount of thyroid hormone in your system, and as a result your metabolism and sympathetic nervous system may be “sped up” resulting in:
- Nervousness/Anxiety
- Irritability
- Increased perspiration
- Increased heart rate
- Difficulty Sleeping
- Hand tremors
- Weight loss
- Vomiting
- For women, a change in menstrual cycle schedule
Treatment
There are three main ways to treat hyperthyroidism:
- Medication: Initially, hyperthyroidism will attempt to be treated medically in most cases using thyrostatics medication (antithyroid drugs) designed to limit the amount of thyroid hormone produced.
- Radioactive Iodine Ablation: Patient takes a pill of iodine that has radioactive properties associated with it. The iodine travels through the blood to the thyroid and the radioactivity destroys the thyroid tissue, ideally producing the result that the thyroid will not make an excess of thyroid hormone following that therapy.
- Surgery: If medical treatment fails, or if an enlarged thyroid is present and it is compressing neck structures, surgery is recommended to remove part or the entire thyroid (thyroidectomy). Removal of part of the thyroid is recommended when a toxic thyroid nodule may be producing too much hormone.
Traditional Vs. Minimal Access Thyroid Surgery
Most surgeries are done via minimal access thyroid surgery. Whereas the traditional method required a 6-8” incision across the neck and a several night stay in the hospital, minimal access surgery requires a 1.5-2” surgery with patients going home the day of surgery or the following day. Many patients are off of pain medicine by the first or second postoperative day and are back to their regular diet the day of or the morning after surgery. There is no wound care and patients can shower the day of surgery.
Hypothyroidism
Hypothyroidism is a disorder wherein the thyroid does not produce enough thyroid hormones for the body. In many patients hypothyroidism is treated with medicine designed to supply the body with the thyroid hormones it is no longer producing itself.
Symptoms
In many patients hypothyroidism is asymptomatic, meaning there are no clear signs that you may have the disorder. However, when symptoms do present themselves, it’s because of a reduced amount of thyroid hormone in your system, and as a result your metabolism and sympathetic nervous system may be “slowed down” resulting in:
- Fatigue
- Muscle Cramps
- Dry, itchy skin
- Increased sensitivity to cold
- Weight gain
- Constipation
- Decreased sweating
- Depression
- Female infertility
Treatment
Most people just require thyroid hormone supplementation in the form of a pill. Most often it’s Synthroid (Levothyroxine) or triiodothyronine. The pills supply additional thyroid hormone to make up for the deficit found in hypothyroidism. Typically the patient will ingest the pill once a day following identification of the proper dosage. They will then be required to have annual blood work performed to ensure that the medication continues to be effective.
Thyroid Cancer
Thyroid cancer is a fairly common cancer that results when abnormal cells begin to grow in the thyroid gland. Many patients have a high rate of long-term survival because the cancer is usually found early and treatment methodologies work well.
Symptoms
Several symptoms of thyroid cancer include:
- Lump or swelling in the neck
- Pain felt in and around the neck
- Trouble swallowing
- Breathing issues
- Hoarse voice
- Frequent cough
Treatment
Treatment for thyroid cancer usually involves either surgical removal of the thyroid or the use of radioactive iodine.
- Surgery: If medical treatment fails, or if an enlarged thyroid is present and it is compressing neck structures, surgery is recommended to remove part or the entire thyroid (thyroidectomy). Removal of part of the thyroid is recommended when a toxic thyroid nodule may be producing too much hormone.
Traditional vs. Minimal Access Surgery
Most surgeries are done via minimal access thyroid surgery. Whereas the traditional method required a 6-8” incision across the neck and a several night stay in the hospital, minimal access surgery requires a 1.5-2” surgery with patients going home the day of surgery or the following day. Many patients are off of pain medicine by the first or second postoperative day and are back to their regular diet the day of or the morning after surgery. There is no wound care and patients can shower the day of surgery.
- Radioactive Iodine Ablation: It is very rare that patients will require chemotherapy or radiation therapy as part of a treatment regimen for thyroid cancer. With the radioactive iodine approach, the patient takes a pill of iodine that has radioactive properties associated with it. The iodine travels through the blood to the thyroid and the radioactivity destroys the thyroid tissue, ideally producing the result that the thyroid will not make an excess of thyroid hormone following that therapy.
Thyroid Nodules and Goiters
Growths on the thyroid gland are called thyroid nodules; they are usually benign and found in about 50 percent of people over the age of 50. Although they can be cancerous, most are not harmful. Treatment may involve a needle biopsy or surgical removal if deemed harmful.
When the thyroid gland grows larger than normal, it’s known as a thyroid goiter. Often painless and considered not harmful, a large goiter may cause a cough or make it difficult to breathe and swallow. Treatment varies depending on the size of the goiter and the underlying cause. Medication, radioactive iodine and surgery are all options to treat goiters.
Most thyroid nodules don’t cause symptoms. Some may, when they become large enough, be felt, seen or put pressure on your esophagus making it difficult to breathe.
Click the photo to view Dr. Ho discusses about thyroid nodules.
Treatment
Treatment for thyroid nodules depends on the type of thyroid nodule you have.
- Monitoring. There are very clear guidelines regarding when we should be concerned about nodules. When they are larger than one centimeter, that’s when a biopsy should be requested. If you are experiencing abnormal blood flow or calcium deposition in the thyroid, that may also warrant a biopsy. Otherwise, they’re just monitored and checked at regular intervals with a physical exam and thyroid function test. If the benign nodule remains unchanged you may never need further treatment.
- Radioactive Iodine Ablation. With the radioactive iodine approach, the patient takes a pill of iodine that has radioactive properties associated with it. The iodine travels through the blood to the thyroid and the radioactivity destroys the thyroid tissue, ideally producing the result that the thyroid will not make an excess of thyroid hormone following that therapy. The theory is that when the radioactive iodine is absorbed by your thyroid gland, it will cause the nodule or goiter to shrink and return to normal size between two to three months.
- Surgery. If medical treatment fails, or if an enlarged thyroid is present and it is compressing neck structures, surgery is recommended to remove part or the entire thyroid (thyroidectomy). Removal of part of the thyroid is recommended when a toxic thyroid nodule may be producing too much hormone.
Traditional vs. Minimal Access Thyroid Surgery
Most surgeries are done via minimal access thyroid surgery. Whereas the traditional method required a 6-8” incision across the neck and a several night stay in the hospital, minimal access surgery requires a 1.5-2” surgery with patients going home the day of surgery or the following day. Many patients are off of pain medicine by the first or second postoperative day and are back to their regular diet the day of or the morning after surgery. There is no wound care and patients can shower the day of surgery.
