Caring Medical Solutions for Thyroid Disorders

From daily symptoms that can affect your metabolism to problems having an impact on your long-term heart and bone health, a thyroid gland that is not being functional can cause significant abnormalities. Getting the proper care can help you manage your thyroid disorder and allow you to start feeling better.

At Midtown Surgical & Skin Institute, we care about collaborating with you to find the correct approach for your thyroid concerns. Our compassionate, personalized medical consultations make it easier for you to feel better and enjoy your life.

Signs and Symptoms of Thyroid Disorders

Symptoms can vary, depending on whether your thyroid is producing too much or too little thyroid hormone.

Overactive thyroid (HYPERthyroidism) can result in: 

  • Restlessness / Irritability
  • Racing heart
  • Anxiety
  • Excessive sweating / Heat intolerance 
  • Difficulty sleeping
  • Muscle weakness
  • Diarrhea
  • Hair loss
  • Weight loss / Excessive hunger
  • Bulging eyes / Puffy eyes
  • Irregular menstruation / Light menses
  • Blood clots / Strokes
  • Heart failure
  • Osteoporosis

Underactive thyroid (HYPOthyroidism) can result in:

  • Fatigue
  • Slow heartbeat
  • Increased cold sensitivity
  • Constipation
  • Dry skin
  • Hair loss / Hair thinning
  • Weight gain
  • Puffy face
  • Joint pain / Muscle aches
  • Memory problems
  • Depression
  • Irregular menstruation / Heavy menses 

Other symptoms can include:

  • A growth in your neck (Thyroid goiter or Thyroid nodules)
  • Increased or decreased appetite
  • Tremors

Common Thyroid Disorders

Hyperthyroidism — In this condition, the thyroid gland is overactive

Hypothyroidism — In this condition, the thyroid gland is underactive

Hashimoto’s disease — This is the most common cause of hypothyroidism, Hashimoto’s disease is an autoimmune disorder found most commonly in middle-aged women. Symptoms include heavy or irregular menstruation, fatigue, depression, dry skin, thinning hair, and more. Initially, it causes hyperthyroidism symptoms and then eventually causes hypothyroidism symptoms.

Graves’ disease — This autoimmune disorder affects the thyroid, causing overproduction of thyroid hormone and leading to all the symptoms typical of hyperthyroidism. If left untreated or undiagnosed, it can cause long-term heart problems, strokes, and brittle bones.

Goiter — A noncancerous enlargement of the thyroid gland, often caused by a deficiency in iodine. It can also be a result of an overactive thyroid. Goiters are more common in women over 40, and may cause symptoms of both hyperthyroidism as well as hypothyroidism.

Nodules — These are small growths on the thyroid, usually too small to feel, but they can excrete thyroid hormone causing hyperthyroidism. Most nodules are benign up to 95%; however, they need a biopsy to confirm if they are benign or cancerous.

Thyroid cancer — This is one the most treatable forms of cancer. Signs can include a lump in the neck, hoarseness, and trouble swallowing. Different types of thyroid cancer exist, some acting very aggressively. 

  • Papillary Thyroid Cancer — Most common, 85% of all thyroid cancers.
  • Follicular Thyroid Cancer — 10% of all thyroid cancers.
  • Medullary Thyroid Cancer — 3%  of all thyroid cancers.
  • Anaplastic Thyroid Cancer — 1% of all thyroid cancers. It’s the most rare; however, it’s also the most aggressive form. 

Diagnosing Thyroid Disorders 

If you or your doctor believe you may have a thyroid condition, various tests can include:

  • Blood tests — To assess thyroid hormone production levels as well as thyroid stimulating hormone levels.
  • Physical exam — To assess if a goiter is present and palpate (feel) for larger nodules.
  • Ultrasound, CT scan or MRI, or Sestamibi Nuclear Medicine scan — To identify nodules and measure their size, look for concerning features, or be able to determine if they are a hormonally active nodule.
  • Fine Needle Aspiration (FNA) / Biopsy — Typically performed on a concerning nodule, under ultrasound guidance with local anesthetic, to obtain a sample of tissue from the nodule to diagnose whether it is benign or cancerous.

Concerning Features of a Thyroid Nodule — Any of these necessitate a biopsy:

  • Taller than Wide — When a nodule is taller than it is wide, it is concerning and could be a malignant nodule.
  • Microcalcifications — Small deposits of calcium within the nodule, which is concerning for malignancy.
  • Hypoechoic Solid Nodules — More solid than surrounding tissues and less echogenic. 
  • Increased Vascular Flow — Increased flow of blood in the nodule is concerning for malignancy.
  • Local Invasion — When the nodule is invading surrounding structures, this is highly concerning for a malignancy invasion. 

Medical Solutions

  • Medication — To regulate thyroid hormone production at the proper levels. In turn, this helps control symptoms of hypothyroidism or hyperthyroidism.
  • Surgery — To remove a portion of the thyroid gland, or the entire thyroid gland if necessary. It may be indicated to remove only half of the thyroid, and other times the entire thyroid may need to be removed. 
  • Radioactive iodine doses — This is used to treat some thyroid cancers. It attaches to the thyroid tissue and collects there, and then the radiation destroys the thyroid cells and tissue — including the thyroid cancer cells.

Recovery Time

Hypothyroidism and hyperthyroidism are manageable by daily medication routines that must be maintained throughout your lifetime; otherwise symptoms can return.

Ultrasound guided FNA biopsy is an outpatient procedure, and you are able to return to work immediately. 

Thyroid surgery is a single overnight stay in the hospital to monitor electrolyte levels and monitor the incision. Bruising and swelling is expected around the incision. Some hoarseness can be expected and typically goes away in 1-2 weeks. Steri-strips are placed over the incisions and typically remain until the post-operative appointment.  

Recommended Diet

It is uncommon to have an iodine deficiency in the U.S., due to iodized salt in our diet. However, iodine deficiency is becoming more prevalent as patients are utilizing sea salt or pink Himalayan salt for cooking / everyday use. But it is still unlikely that your doctor will need to recommend supplements. 

Recommended Prescription Usage

Prescription medications that treat thyroid issues may perform better depending on when you take the medication and what you eat with them. It is recommended to take it at the same time every day, preferably at 0700. It is also recommended to take the same brand of thyroid medicine and from the same pharmacy. This is due to different bioavailability of the medicine by different manufacturers, and different pharmacies using different brands of thyroid medicine. Your doctor or pharmacist can provide instructions and recommendations.

FAQs

Is there a special diet or lifestyle changes I can make to improve my thyroid function?

Unfortunately, there is no special thyroid diet. If you are experiencing thyroid issues, a careful medication routine is typically the best treatment.

If I am worried about my iodine levels, what should I do?

The likelihood of being iodine deficient in the U.S. is very low. In general, a balanced healthy diet with plenty of vegetables and fruit, and few processed foods, will be sufficient. Be sure to ask your doctor before taking iodine supplements, as too much iodine can also cause thyroid problems, including a goiter.

I’ve heard thyroid symptoms can be mistaken for menopause. Is that true?

Yes. Women are more likely to experience thyroid issues, and those issues can affect the menstrual cycle. It is important to consult with a medical professional to assess whether changes in your menstrual flow and other symptoms are related to the thyroid, menopause, or other conditions.

When should I be screened for thyroid issues?

Anytime you are having symptoms that could be caused by improper thyroid levels, it is important to have your thyroid levels tested with a blood test. In addition, once you are over the age of 35, a screening every 5 years is recommended, since issues with the thyroid can become more common with aging.

I have a palpable lump in my throat. What should I do?

Anytime you have a new lump or nodule in your neck that has not gone away after 1-2 weeks, it needs to be looked at immediately by a physician. There are a number of possibilities, but it needs to be closely examined. Further tests or imaging may need to be performed — such as an ultrasound and/or blood work. A biopsy may need to be performed as well.

Schedule A Consultation

Take control of your health and your life by choosing medical providers who are caring and concerned, open and honest. Set up a consultation visit today to see firsthand the compassionate care you will receive from our skilled and friendly team.

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Meet your Doctor

William Hanner D.O.

Surgeon and Founder

General Surgery
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