Thyroid Disorders
By Nancy M. Ouhib, MBA, RD, LD/N / March 1, 2017

Your thyroid is an endocrine gland, which means it makes hormones. Your thyroid is in your neck in front of your trachea, just below the larynx. The thyroid is responsible for making two hormones - T3 and T4 - that regulate our metabolism from how fast or slow you burn calories to how fast or slow your heart beats. If your thyroid is too active, it will make more hormones than your body needs. This is called hyperthyroidism. If your thyroid is too slow, it will not make enough of the hormones needed and that is called hypothyroidism. Thyroid nodules are lumps in the thyroid. Goiter is and enlargement of the thyroid gland. Thyroiditis is a swelling of the thyroid.

Endocrinologists are physicians and scientists who study and care for patients with endocrine gland and hormone problems. These specialists use various thyroid tests to diagnose these disorders, along with a medical history and physical.

Hyperthyroidism can cause several problems including irritability and anxiety, menstrual irregularities, vision problems (irritated eyes or difficulty seeing), muscle weakness, intolerance to heat and increased sweating, infertility, diarrhea or
Thyroid Disorders
frequent bowel movements, and fatigue. There are some illnesses that can cause hyperthyroidism including Grave's disease or a viral infection of the gland itself. One of the more common causes of hyperthyroidism is Grave's disease, which is an autoimmune disease. This disease runs in families. Treatment for this disorder usually involves medication to reduce the level of hormones produced by the thyroid gland. More women get hyperthyroidism than do men.

Hypothyroidism is a disorder that occurs when the thyroid is not producing enough hormones possibly resulting in a host of problems including weight gain, fatigue, menstrual irregularities, depression, dry skin and hair, sluggishness, and constipation. Hypothyroidism is frequently caused by Hashimoto's disease. This is another autoimmune disease where the body's immune system attacks the thyroid gland. This disorder is usually treated with a drug called T4. T4 levels need to be closely monitored by a physician and patients usually stay on this drug for the rest of their lives. Hypothyroidism can also be caused by a pituitary gland tumor which blocks the pituitary from producing TSH (thyroid stimulating hormone). In either case, the result is that the thyroid is producing too few hormones causing many physical and mental processes to become sluggish. For example, the body can consume less oxygen and produce less body heat.

Thyroid nodules, or growths on the thyroid gland, can also cause thyroid disorders. These small growths are usually harmless and they can go unnoticed for years. Physicians can sometimes palpate these nodules during a routine examination. These nodules can be cancerous. If your physician determines that you have nodules, he/she may want to perform one or more of the following tests: ultrasound -takes a picture of your thyroid using sound waves; fine-needle aspiration biopsy - the fluid and tissue sample will be examined to diagnose potential disorders; and blood and other laboratory tests that check for abnormal levels of antibodies, enzymes, and other chemicals related to thyroid function. Lastly, there is a thyroid scan where you swallow a radioactive substance and a scan is completed. The radiologist reads the scan to detect the presence of non-functioning thyroid nodules, which can be cancerous. Cancerous nodules must be removed and followed up with treatment. Most nodules are not cancerous, but, it is important to rule out cancer. Some nodules may produce too much thyroid hormone or they may become too large, interfering with breathing, swallowing, or causing neck discomfort.

If you feel that you may have a thyroid disorder, have your PCP either refer you to an endocrinologist or run some preliminary tests to determine whether you need to see a specialist.

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