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The thyroid is a butterfly-shaped gland that resides at the base of the neck and produces hormones that regulate metabolism (how the body converts food into energy). Abnormal production of thyroid hormones results in thyroid disease. Two main causes of thyroid problems are overproduction of thyroid hormones, known as hyperthyroidism, and underproduction of thyroid hormones, known as hypothyroidism.
Hyperthyroidism can be caused by Grave's Disease (overproduction of the thyroid hormones), growths on the thyroid (either nodules or a goiter), inflammation of the thyroid and, in rare cases, pituitary gland malfunction or cancer. Symptoms include a feeling of speeding up or nervousness, shaky hands, fast heartbeat, sweatiness, red or itchy skin, frequent bowel movements, weight loss and weakness or tiredness. For mild to moderate symptoms, the treatment is usually antithyroid medicine. In more severe cases, radioactive iodine may be swallowed by the patient to destroy the harmful part of the thyroid.
Hypothyroidism is caused by underproduction of thyroid hormones (Hashimoto's Disease), exposure to excessive amounts of iodide (an old treatment for croup in children), high levels of lithium and removal of the thyroid gland. Symptoms usually appear gradually over time and may include feeling tired, weak or depressed, lower energy level, brittle nails, dry skin, constipation, memory problems and feeling cold more often. For women, it may also cause heavy or irregular menstrual periods. Hypothyroidism is treated with thyroid hormone pills.
A thyroid nodule is a growth on the thyroid. A goiter is a swelling of the thyroid gland itself. Thyroid nodules are usually benign - only five out of every 100 thyroid nodules are cancerous. Most thyroid nodules are small and difficult to detect. However, bigger nodules may lead to swelling of the neck and problems with breathing or swallowing. Thyroid nodules and goiters may be indicative of hyperthyroidism. They can be diagnosed with a combination of blood tests to evaluate how well the thyroid is functioning; a thyroid scan, which uses a radioactive material and a camera to visualize the thyroid; ultrasound to see the number, size and placement of nodules; or fine needle biopsy, where a piece of tissue is removed from the nodule to determine if it is benign or malignant. In cases where cancerous or pre-cancerous cells are present, surgical removal is generally recommended.
Thyroid cancer is usually recognized by thyroid nodules or swelling of the thyroid gland (goiter). A benign thyroid nodule is called an adenoma. Diagnostic techniques used to identify thyroid cancer are ultrasound, fine needle biopsy, nuclear medicine or CT scan. Other symptoms include hoarseness, difficulty breathing or swallowing, neck pain, swollen lymph nodes, weight loss or coughing. In addition to surgery to remove the cancerous tissue, your doctor may recommend a radioactive iodine treatment. In more serious cases, radiation and/or chemotherapy may be required. Note that if any or all of the thyroid is surgically removed, you will have to take replacement thyroid hormones in pill form for the remainder of your life to keep your metabolism functioning at an optimal level for your good health.
If you have trouble swallowing or breathing, feel a lump in your throat or experience ongoing swelling in the neck, please contact our office and schedule an appointment with one of our otolaryngologists.