EVALUATING THYROID DISORDERS
Thyroid disorders can be fairly easy to diagnose. Your doctor can identify thyroid disorders by evaluating your medical history, conducting a physical exam and ordering blood tests. Based on these results, further testing may be necessary or you may be referred to an endocrinologist. Make sure to give your doctor as much information as possible about your medical history and symptoms you’ve noticed. During the physical exam, your doctor will check your thyroid glands for changes in size or shape by feeling your neck. There are several blood tests that may be ordered including a TSH test (to see how much TSH is being produced by your pituitary gland) and a T4 test (to see how much thyroid hormone is in the blood).
Additional diagnostic tests that may be ordered based on the results of your exam and blood test includes: thyroid antibody tests, ultrasound, radioactive iodine uptake test, thyroid scan or a fine needle aspiration (FNA) if you have a nodule.
Hyperparathyroidism occurs when one or more of the parathyroid glands are too active resulting in increased blood calcium levels. This usually happens when the gland becomes enlarged which, most often, is caused by a benign growth called an adenoma. Increased blood calcium levels can lead to hypercalcemia, causing other problems throughout the body. Treatment involves surgery to remove any enlarged parathyroid glands in order to restore the level of calcium in the blood to a normal level.
Common symptoms of hyperparathyroidism include:
- Muscle weakness
- Poor memory
- Nausea and vomiting
- Pain in the stomach area (abdomen)
- Hard stools (constipation)
- Stomach ulcers
- Increased frequent urination
- Kidney stones
- Joint or bone pain
- Bone disease (osteopenia or osteoporosis)
Hyperthyroidism is a result of the thyroid gland producing too much hormone. The most common cause of hyperthyroidism is Graves’ Disease. This is a problem where the immune system within the body overstimulates the thyroid. A nodule in your thyroid gland can also cause hyperthyroidism if the cells in the nodule produce more hormone than the rest of the gland. Nodules are lumps of tissue felt in the thyroid gland and although they may seem alarming, they are usually a normal occurrence and don’t always cause thyroid problems. While most nodules are benign (noncancerous) it is important to note that nodules can be cancerous on occasion (10-15% malignancy in solid nodules). Your doctor may suggest regular exams and ultrasound tests to see if the nodules grow before seeking further treatment such as surgery or thyroid hormone pills.
There are three main treatments for hyperthyroidism: anti-thyroid medication (to reduce the amount of hormone made by the thyroid gland); radioiodine ablation (a pill or liquid dose of radioactive iodine that destroys overactive thyroid cells); and surgery (to remove part or all the of the thyroid gland).
Common symptoms of hyperthyroidism include:
- Shaking, nervousness, irritability
- Feeling hot
- A rapid, irregular heartbeat
- Muscle weakness, fatigue
- More frequent bowel movements
- Shorter, lighter menstrual periods
- Weight loss
- Hair loss
Hypothyroidism is a result of the thyroid gland producing an insufficient amount of hormone. Hashimoto’s thyroiditis is the most common form of hypothyroidism (decreasing thyroid function) in which the immune system mistakenly attacks the thyroid glands.
Since thyroid glands rely on iodine to produce the necessary hormones, hypothyroidism may occur if you have an iodine deficiency. Hypothyroidism can also occur due to pituitary gland problems or if the thyroid gland has been removed. Treatment for hypothyroidism involves taking thyroid hormone pills to replace the hormones your thyroid doesn’t make. This is a daily dosage and may be adjusted over time.
Common symptoms of hypothyroidism include:
- Low energy, fatigue, depression
- Feeling cold
- Muscle pain
- Slowed thinking
- Longer, heavier menstrual periods
- Weight gain
- Dry and brittle skin, hair, nails