Thyroid Problems – Disorders of the thyroid gland affect millions of Americans each year. This gland is located in the middle of the lower neck. It sits below the larynx (voice box) and wraps around the front half of the trachea (windpipe). The thyroid is an endocrine gland. It makes hormones that regulate physiological functions in your body, such as heart rate, sweating and energy consumption.
There are many different types of thyroid problems including:
Patients with an overactive thyroid gland have a condition known as hyperthyroidism. Treatment for hyperthyroidism includes medication to block the effects of excessive thyroid hormone, radioactive iodine to destroy the thyroid gland and surgical removal of the thyroid gland. Symptoms of hyperthyroidism include:
- Weight loss
- Increased heart rate and high blood pressure
- More frequent bowel movements
- Muscle weakness
- Lighter or shorter menstrual periods
- Sensitivity to warm temperatures
Graves’ disease can make a person’s eyes bulge and become dry. Vision may even get blurry. Graves’ disease also causes hyperthyroidism, in which the thyroid gland becomes overactive.
Patients with an underactive thyroid gland have hypothyroidism. Typical treatment for hypothyroidism includes the use of hormone replacement pills. Symptoms of hypothyroidism include:
- Reduced heart rate
- Tingling or numbness in the hands
- Heavier menstrual periods
- Dry skin
- Sensitivity to cold temperatures
An enlarged thyroid gland that creates a visible lump is called a goiter. These lumps can be cancerous but more commonly are just a benign enlargement of the gland. To determine the best treatment approach, an ultrasound (or in some cases a CT or MRI scan) is needed to determine the size and location of nodule(s) in the gland. A fine-needle aspiration of cells from any suspicious nodule can help determine whether the goiter is benign or malignant. If the mass is cancerous or is large enough to compress the patient’s windpipe or esophagus, surgery may be necessary.
While most medical thyroid problems are well-managed by a primary care physician or an endocrinologist, lumps, nodules or tumors of the thyroid gland should be evaluated by an otolaryngologist or endocrine surgeon. Generally, dominant nodules of over 1 cm should be evaluated or closely followed, as they may be cancerous. Cystic nodules are not necessarily benign.
Thyroid cancer is one of the most common cancers in women. Although this disorder does not usually have noticeable symptoms at first, it can cause difficulty swallowing, voice changes or a lump (nodule) in the neck in patients of all ages and genders. Thyroid cancer is often discovered when the patient or the patient’s doctor feels a nodule, or a nodule is found when the patient is undergoing a radiology test not related to the thyroid, such as a CT scan of the neck.
Ultrasound-guided fine-needle aspiration can usually confirm the presence or absence of cancer, but in some cases, cancer can be verified only after surgery. The most common type of thyroid cancer is papillary carcinoma, and it is treated with surgery to remove the thyroid and enlarged lymph nodes, if present. Additional treatment is often recommended.