Thyroid

The thyroid gland is located on the front part of the neck below the thyroid cartilage (Adam's apple). The gland produces thyroid hormones, which regulate body metabolism. Thyroid hormones are important in regulating body energy, the body's use of other hormones and vitamins, and the growth and maturation of body tissues.

Signs and Symptoms of Thyroid Disease

Thyroid Disease has many symptoms. Some people will have all the symptoms listed here others will have none. There are so many functions in the body that are affected by the thyroid gland. This makes it very easy for many things to go wrong. Below is a list of symptoms of hypothyroid and hyperthyroid. If you have some or all of these symptoms please ask your doctor to run a thyroid panel blood test.

Hypothyroid

• Tiredness
• Loss of Interest and/or
• Dry, coarse hair
• Forgetfulness
• Loss of Lateral Eyebrow Hair
• Puffy face and Eyes
• Depression
• Muscle aches
• Hair Loss
• Headaches
• Brittle nails
• Constipation
• Heavy menstrual periods
• Weight Gain
• Dry Skin
• Slow Heartbeat
• Goiter

Hyperthyroid

• Muscle weakness
• Infertility
• Fine tremor of fingers
• Hair loss
• Soft nails
• Warm, moist palms
• Frequent bowel movements
• Scant menstrual periods
• Unexplained weight loss
• Heat intolerance
• Increased sweating
• Bulging Eyes
• Rapid Heartbeat
• Difficulty Sleeping
• Irritability
• Nervousness
• Goiter

Causes

Your thyroid gland consists of two lobes that resemble the wings of a butterfly. The lobes are separated by a thin section — think of it as the butterfly's body — called the isthmus. The thyroid takes up iodine from food you eat and uses it to manufacture two main hormones, thyroxine (T-4) and triiodothyronine (T-3). These hormones maintain the rate at which your body uses fats and carbohydrates, help control your body temperature, influence your heart rate and help regulate the production of protein. Your thyroid gland also produces calcitonin, a hormone that regulates the amount of calcium in your blood.

Just why normal thyroid tissue develops into nodules isn't clear. What is known is that several types of nodules can develop in the thyroid gland:

• Colloid nodule. Most thyroid nodules are colloid nodules — benign overgrowths of normal thyroid tissue. You may have just one colloid nodule or many. Although these nodules may grow larger, they don't spread beyond the thyroid gland.
• Follicular adenoma. This type of nodule also is benign.
• Thyroid cyst. These fluid-filled areas of the thyroid can range in size from less than 1/3 inch in diameter to one inch or more. Many thyroid cysts are entirely filled with fluid, but some cysts, called complex cysts, also have solid components. Fluid-filled cysts are usually benign, but complex cysts are sometimes malignant.
• Inflammatory nodule. This occasionally develops as a result of chronic inflammation of the thyroid gland (thyroiditis). One rare type of thyroiditis — subacute thyroiditis — causes severe pain in the thyroid gland. Other types are painless and sometimes occur after pregnancy (postpartum thyroiditis).
• Thyroid cancer. Although the chances that a nodule will be malignant are small, you're at higher risk if you have a family history of thyroid or other endocrine cancers, are younger than 20 or older than 60, are a man, or have a history of head or neck radiation. Malignant nodules are usually large and hard and may cause neck discomfort or pain.
• Multinodular goiter. Goiter is a term used to describe any enlargement of the thyroid gland. Several factors can lead to a goiter, including the presence of a number of thyroid nodules. This condition, called multinodular goiter, can cause a tight feeling in your throat and difficulty breathing or swallowing.
• Hyperfunctioning thyroid nodule (toxic adenoma, toxic multinodular goiter, Plummer's disease). These nodules grow and produce thyroid hormones independent of the influence of thyroid-stimulating hormone (TSH), a substance released by the pituitary gland, which normally regulates the production of thyroid hormones. Hyperfunctioning thyroid nodules cause high blood levels of thyroxine and low or nonexistent levels of TSH. A genetic defect of the TSH receptors may play a role in the overactivity of these nodules.

Treatment

Working together with your doctor can determine the best treatment for you. Depending on the type of thyroid nodule you have, your options may include:

• Watchful waiting. If an FNA biopsy shows you have a benign thyroid nodule, your doctor may suggest simply watching your condition, which usually means having a physical exam and thyroid function tests at regular intervals. You're also likely to have another biopsy if the nodule grows larger. If a benign thyroid nodule remains unchanged, you may never need treatment beyond careful monitoring. Talk to your doctor if you're not comfortable with this approach or want more information on other options.
• Thyroid hormone suppression therapy.This involves treating a benign nodule with levothyroxine (Levoxyl, Synthroid), a synthetic form of thyroxine that you take in pill form. The idea is that supplying additional thyroid hormone will signal the pituitary to produce less TSH, the hormone that stimulates the growth of thyroid tissue. Although this sounds good in theory, levothyroxine therapy is a matter of some debate. There's no clear evidence that the treatment consistently shrinks nodules or even that shrinking small, benign nodules is necessary. What's more, levothyroxine therapy isn't without risks. Excess doses can lead to heart problems and osteoporosis, although these problems can usually be avoided with careful monitoring. In addition, levothyroxine therapy isn't recommended for older adults or for people with thyroid cysts or nodules that produce thyroid hormone.
• Radioactive iodine. Doctors often use radioactive iodine to treat hyperfunctioning adenomas or multinodular goiters. Taken as a capsule or in liquid form, radioactive iodine is absorbed by your thyroid gland, causing the nodules to shrink and symptoms of hyperthyroidism to subside, usually within two to three months. But because thyroid hormone is released into your bloodstream as the nodules are destroyed, in rare cases your symptoms may worsen for a few days or weeks after therapy. You also might experience neck tenderness or a sore throat. And because this treatment eventually causes thyroid activity to slow considerably, you may develop hypothyroidism.
• Alcohol ablation. In this procedure, small, hyperfunctioning nodules are injected with ethyl alcohol (ethanol), which helps shrink the nodules and improve symptoms of hyperthyroidism. Although some people may need up to eight injections — usually given at two-month intervals — other people require only one. You receive these treatments on an outpatient basis and unlike some other treatments, alcohol ablation doesn't cause hypothyroidism. Side effects of the procedure include headache and burning pain at the injection site that may radiate to the jaw, although the pain rarely lasts more than a few days. In the United States, this therapy is primarily available at referral centers.
• Surgery. The usual treatment for malignant nodules is surgical removal, often along with the majority of thyroid tissue — a procedure called near-total thyroidectomy. Occasionally, a nodule that's clearly benign may require surgery, especially if it's so large that it makes it hard to breathe or swallow. Surgery is also considered the best option for people with large multinodular goiters, particularly when the goiters constrict airways, the esophagus or blood vessels. Nodules diagnosed as indeterminate or suspicious by FNA biopsy also must be surgically removed so that they can be examined more thoroughly for signs of cancer. Risks of thyroid surgery include damage to the nerve that controls your vocal cords and damage to your parathyroid glands — four tiny glands located on the back of your thyroid gland that help control the level of calcium in your blood. After thyroidectomy, you'll need lifelong treatment with levothyroxine to supply your body with normal amounts of thyroid hormone.