The Doctor Is In: Thyroid Health

Content is sponsored and provided by Henry Ford Health System. 

Shiri Levy, M.D.
Endocrinologist, Henry Ford Health System

January is Thyroid Awareness Month and it's a great time to talk about thyroid health. Located in the front of the neck just below the Adam's apple, the thyroid takes iodine from the diet and makes thyroid hormone, which affects a person's physical energy, temperature, weight and mood. Thyroid diseases generally fall into two broad groups of disorders: abnormal function and abnormal growth (nodules) in the gland. These problems are common in the general population, especially among older people and women. Most thyroid problems can be detected and treated.


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Detecting Thyroid Disease

· The doctor considers the patient's medical history, examines the thyroid and may order a blood test or other diagnostic tests.
· A standard physical examination of the thyroid gland is done by palpation, or feeling, of the thyroid gland.

o The doctor feels for the size and texture of the gland, and whether any masses or nodules are present.
· There are two standard blood tests of thyroid function: the measurement of thyroid hormone, usually T4, and the measurement of thyrotropin (TSH).

o TSH is a hormone secreted from the pituitary gland that controls how much thyroid hormone the thyroid makes.

o Abnormal blood tests usually reveal thyroid function problems and not the presence of thyroid nodules or cancer.
· If nodules are present, a fine needle aspiration (FNA) biopsy may be performed to help determine whether the nodule is cancerous.

o A thyroid ultrasound may also be performed to help determine whether the thyroid nodule is solid or cystic.

Often Overlooked Signs of Overactive Thyroid

· Tremors
· Nervousness
· Difficulty concentrating
· More frequent bowel movements
· Rapid heartbeat
· Difficulty sleeping
· Menstrual irregularity
· Difficulty conceiving
· Sensitivity to heat
· Muscle weakness

Often Overlooked Signs of Underactive Thyroid

· Constipation
· Foggy thinking
· Anxiety and depression
· Recurrent miscarriages
· Menstrual irregularities
· Carpal tunnel syndrome
· Puffy face
· Hoarseness
· Sensitivity to cold
· Hair loss

Thyroid Disease Treatments

· Hypothyroidism is typically treated with a daily dose of replacement thyroid hormone. o Thyroid hormone must be taken on an empty stomach. A number of factors can interfere with absorption, including other hormones, multivitamins, coffee, autoimmune inflammation, and prescription medications.
· Hyperthyroidism may include antithyroid drugs, radioactive iodine-131 or in rare cases, thyroid surgery.
· Thyroid cancer is initially treated with surgery. Patients treated for thyroid cancer need lifelong thyroid hormone replacement.
· The majority of benign nodules do not require treatment, but patients are advised to have periodic follow up appointments for monitoring.