Thyroid Disorder

What is hypothyroidism?

Hypothyroidism is the most common type of thyroid disorder. It means your thyroid gland is not active enough. This tiny gland is found in the front of your neck. Its job is to make thyroid hormone. If the gland is underactive, it may not make enough thyroid hormone.

Thyroid hormones control how your body uses energy. They affect almost every organ in your body. When your thyroid doesn’t make enough of these hormones, parts of your body slow down.  

What causes hypothyroidism?

The most common cause of hypothyroidism is an autoimmune disorder. This means your immune system starts to attack itself. It makes antibodies against the thyroid gland. The normal thyroid cells are overrun by white blood cells and scar tissue. Another cause may be treatment for an overactive thyroid gland. That may include radioactive iodine therapy or surgery. Hypothyroidism may also develop shortly after pregnancy.

A condition called secondary hypothyroidism can also sometimes happen. It’s when your pituitary gland stops working. The pituitary gland then no longer tells the thyroid gland to make thyroid hormones.

Newborns are tested at birth for hypothyroidism. This condition is called congenital hypothyroidism. It must be treated right away. It can affect a baby’s brain and nervous system.

Who is at risk for hypothyroidism?

You may be more likely to have hypothyroidism if you:

  • Are a woman
  • Are older than age 60
  • Have had thyroid problems or thyroid surgery in the past
  • Have a family history of thyroid problems
  • Have certain conditions, such as type 1 diabetes or rheumatoid arthritis
  • Have Turner syndrome, a genetic condition that affects women
  • Are pregnant or have had a baby within the last 6 months
  • Have an iodine deficiency. Your body needs iodine to make thyroid hormone.

What are the symptoms of hypothyroidism?

Symptoms are different for each person. They are usually hard to notice and start slowly. They may be mistaken for symptoms of depression. Here are the most common symptoms and signs:

  • Dull facial expressions
  • Tiredness and lack of energy (fatigue)
  • Not being able to handle cold
  • Hoarse voice
  • Slow speech
  • Droopy eyelids
  • Puffy and swollen face
  • Weight gain
  • Constipation
  • Sparse, coarse, and dry hair
  • Coarse, dry, and thickened skin
  • Hand tingling or pain (carpal tunnel syndrome)
  • Slow pulse
  • Muscle cramps
  • Joint pain
  • Sides of eyebrows thin or fall out
  • Confusion
  • Increased or irregular menstrual flow in women

These symptoms may look like other health problems. Always see your healthcare provider for a diagnosis.

How is hypothyroidism diagnosed?

Your healthcare provider will ask about your past health. You will also need a physical exam. Blood tests can also help diagnose hypothyroidism. They can measure the amount of thyroid hormone and thyroid-stimulating hormones in your blood.

How is hypothyroidism treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

The goal of treatment is to return your level of thyroid hormone back to normal. You may need to take medicine that gives you a dose of thyroid hormones. This dose may need to be changed over time. You will likely need to take this medicine for the rest of your life. You will need follow-up blood tests to make sure you are taking the correct dose of thyroid hormone replacement.

What are possible complications of hypothyroidism?

If your hypothyroidism is not treated, these complications may happen:

  • Anemia
  • Low body temperature
  • Heart failure

When should I call my healthcare provider?

Tell your healthcare provider if your symptoms get worse or you have new symptoms. If you are a woman of childbearing age and want to become pregnant, talk with your healthcare provider first.

Key points about hypothyroidism

  • Hypothyroidism means your thyroid gland is underactive. It isn’t making enough thyroid hormone. The most common cause is when your immune system starts to attack itself.
  • Symptoms include dull facial expressions, tiredness, and weight gain.
  • Blood tests can help diagnose this condition. They can measure the amount of thyroid hormone and thyroid-stimulating hormone in your blood.
  • The goal of treatment is to return your levels of thyroid hormone back to normal.
  • Untreated hypothyroidism may lead to anemia, low body temperature, and heart failure.
  • Treatment may include medicine that replaces lost thyroid hormones. You often will need to take thyroid hormones for the rest of your life.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.

What is hyperthyroidism?

Hyperthyroidism means your thyroid gland is too active. This tiny gland is found in your neck. An overactive thyroid gland makes too much thyroid hormone. This makes your metabolism work at a faster rate.

What causes hyperthyroidism?

Hyperthyroidism has several causes. These include:

  • Graves' disease. This is an autoimmune disorder. It is the most common cause of hyperthyroidism. It happens when an antibody overstimulates the thyroid. This condition is most often found in young to middle-aged women. It also tends to run in families.
  • Toxic nodular goiter. This condition happens when 1 or more lumps (nodules) of the thyroid gland become too active. Health experts don't know what causes this to happen.
  • Thyroiditis. It occurs when the thyroid becomes irritated. It temporarily causes the thyroid to be overactive. The thyroid then often becomes underactive.

Hyperthyroidism may occur for other reasons. These include:

  • Taking too much thyroid hormone medicine to treat an underactive thyroid
  • Having too much iodine in your diet
  • Having a noncancer (benign) tumor in the pituitary gland that makes your thyroid overactive

Who is at risk for hyperthyroidism?

These things may make it more likely for you to have hyperthyroidism:

  • You are a woman
  • You are older than age 60
  • You have had thyroid problems in the past
  • Your family has a history of thyroid problems
  • You have certain conditions, such as type 1 diabetes
  • You consume too much iodine. This can happen if you eat a lot of iodine-rich foods or take too much medicine that has this chemical.
  • You are pregnant or have had a baby in the last 6 months

What are the symptoms of hyperthyroidism?

Symptoms and signs are different for each person. Here are the most common ones:

  • Nervousness
  • Irritability
  • Sweating more than normal
  • Thinning of the skin
  • Fine, brittle hair
  • Weak muscles, especially in the upper arms and thighs
  • Shaky hands
  • Fast heartbeat (palpitations)
  • High blood pressure
  • More bowel movements than normal
  • Weight loss
  • Problems sleeping
  • Prominent eyes
  • Sensitivity to bright light
  • Confusion
  • Irregular menstrual cycle in women
  • Tiredness and lack of energy (fatigue)
  • Thyroid gland is larger than normal (goiter)

These symptoms may look like other health problems. Always see your healthcare provider for a diagnosis.

How is hyperthyroidism diagnosed?

Your healthcare provider will ask about your medical history. You will also need an exam. Other tests that can help diagnose hyperthyroidism include:

  • Blood tests. They can measure the amount of thyroid hormone and thyroid stimulating hormone in your blood.
  • Thyroid ultrasound. This test can see if your thyroid gland has any nodules. 
  • Thyroid scan. This test uses a radioactive substance to make an image of the thyroid.

How is hyperthyroidism treated?

The goal of treatment is to have your thyroid gland work as it should. The gland will then make normal levels of thyroid hormone. Your healthcare provider will figure out the best treatment for you based on:

  • Your age, overall health, and past health
  • How sick you are
  • How well you can handle certain medicines, treatments, or therapies
  • Your type of hyperthyroidism
  • Your opinion or preference

Treatment may include:

  • Medicine. It can help lower the level of thyroid hormones in the blood.
  • Radioactive iodine. It comes in the form of a pill or liquid. It can help slow down how much thyroid hormones are made.
  • Surgery. You may need to have all or part of your thyroid removed.
  • Beta blockers. These medicines block the action of the thyroid hormone on the body. That helps with rapid heart rate and palpitations.

What are the complications of hyperthyroidism?

If your hyperthyroidism is not treated, these complications may happen:

  • Thyroid crisis, when symptoms get worse because of stress or illness
  • Heart problems, such as an abnormal rhythm or heart failure
  • Weak, brittle bones (osteoporosis)
  • Pregnancy problems, such as miscarriage, early delivery, and preeclampsia or high blood pressure

When should I call my health care provider?

Tell your healthcare provider if your symptoms get worse or you have new symptoms. If you are a woman of childbearing age and want to become pregnant, talk with your provider first.

Key points about hyperthyroidism

  • Hyperthyroidism means your thyroid gland is too active. This tiny gland is found in your neck. If it is overactive, it makes too much thyroid hormone. Your body’s metabolism then begins to work at a faster rate.
  • This condition can be caused by Graves' disease, toxic nodular goiter, thyroiditis, and taking too much thyroid medicine.
  • Symptoms may include nervousness, irritability, extra sweating (perspiration), and fine, brittle hair.
  • Treatment may include medicine, radioactive iodine, surgery, or beta-blocking medicine.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

 

Thyroid Cancer: Introduction

What is cancer?

Cancer is when cells in the body change and grow out of control. To help you understand what happens when you have cancer, let's look at how your body works normally. Your body is made up of tiny building blocks called cells. Normal cells grow when your body needs them, and die when your body does not need them any longer.

Cancer is made up of abnormal cells that grow even though your body doesn't need them. In most cancers, the abnormal cells grow to form a lump or mass called a tumor. If cancer cells are in the body long enough, they can grow into (invade) nearby areas. They can even spread to other parts of the body (metastasis).

What is the thyroid gland?

 

 

Thyroid Gland - Click to Enlarge

The thyroid gland is part of the endocrine system. It helps control hormones in your body. It's in the front of your neck, over your windpipe (trachea). It's under your Adam’s apple and above your collar bone. You often can’t see or feel your thyroid. It faces the front, but it’s underneath your skin.

It’s shaped like a butterfly with 2 lobes, a right and left lobe. The lobes are joined by a bridge of tissue, called the isthmus.

The thyroid is made up of 2 main types of cells. The follicular cells make and store thyroid hormones. Thyroid hormones control your metabolism. The C cells, or parafollicular cells, make the hormone calcitonin. This helps control calcium levels in your body.

What is thyroid cancer?

Thyroid cancer starts in the cells of the thyroid gland.

There are 4 main types of thyroid cancer (carcinoma):

  • Papillary carcinoma. This is the most common type. It affects women more than men.

  • Follicular carcinoma. This is a more aggressive form of thyroid cancer. It accounts for about 10% of all cases. 

  • Medullary thyroid carcinoma. This is a rare type of thyroid cancer. It produces a lot of calcitonin and tends to spread. 

  • Anaplastic carcinoma. This is a very rare type of thyroid cancer. It grows quickly and tends to spread. It can be hard to treat.

Illustration of the thyroid glad and its location

Most thyroid changes are not cancer

Changes in the thyroid gland are often easy to see and feel. Lumps or bumps, called nodules, are common. They may not need to be treated. Not all of them are cancer. Growths that are not cancer don’t spread from the thyroid to other parts of your body. 

Thyroid adenomas are small nodules that start in the cell layer that lines the inner surface of the thyroid gland. They are not cancer. The adenoma itself may produce or secrete thyroid hormone. If it produces enough thyroid hormone, it may cause hyperthyroidism. This is a condition where your body has too much thyroid hormone. This may need to be treated.

Some signs that a nodule may be cancer and not an adenoma include:

  • A thyroid scan shows the nodule is not working

  • The nodule is solid instead of filled with fluid, like a cyst

  • The nodule is hard and not tender

  • The nodule grows fast

  • Lymph nodes around the thyroid gland are enlarged 

How thyroid cancer spreads

When thyroid cancer spreads outside the thyroid gland, it typically goes to nearby lymph nodes. It can also spread to nearby blood vessels and other tissues in the neck. Over time, it can spread to distant parts of the body, such as the lungs and bones.

Talk with your healthcare provider

If you have questions about thyroid cancer, talk with your healthcare provider. Your healthcare provider can help you understand more about this cancer. 

Saint Luke's Endocrinology Specialists

Saint Luke's Endocrinology Specialists treat conditions including diabetes (type 1, type 2, and gestational) and thyroid disease.