FitSugar

Does Thy Know About Her Thyroid?

FitSugar — Mon, 28 Jul 2008 05:30:00 -0700

Recently a few of the girls over here at Sugar HQ and I were talking about our thyroids and how we've all had to have them checked out at some point or another. Luckily none of us were found to have anything serious but there are a few things we should all be aware of so we know when to take potential risks to a doctor - after all Oprah's wake up call came from her thyroid. Take this little quiz to see how much you know.

Source

Take the quiz

Oprah's Health Wake Up Call Came from Her Thyroid

FitSugar — Wed, 17 Oct 2007 12:30:00 -0700

Did you know that millions of women suffer from thyroid conditions? In the most recent issue of O Magazine, Oprah shares the tale of her wild health ride with thyroid issues.

She was plagued first by hyperthyroidism, which sped up her metabolism and prevented sleep. Oprah eventually "blew out" her thyroid and experienced classic symptoms of hypothyroidism: Her metabolism slowed and she felt sluggish and tired.

After discovering the cause of her health problems, Oprah decided this was a wake up call. She was determined, not only to get back in balance, but to highlight this particular women's health issue. According to The Wisdom of Menopause author Dr. Christiane Northrup, 25 percent of perimenopausal and menopausal women experience some kind of issue with their thyroid at some time, and most women don't know the cause of their deteriorating health.

I, for one, hope that with Oprah highlighting this issue that it receives more attention, both in research and educational outreach. You know Oprah knows how to stir things up! You can read much of the article, which explores the "break down to break through" moments of personal health, online at Oprah.com – hopefully it will help you learn to listen to your body.

Source

You Asked: Thyroid Problems and Weight Gain

FitSugar — Mon, 07 May 2007 03:00:00 -0700

While weight gain can most often be attributed to eating more calories than you are expending, there can also be some kind of hormonal imbalance at play. Recently a reader asked if thyroid problems can cause weight gain, and while the short answer is yes I have done a bit of research to provide a little more information on a rather complicated system (human biology is pretty amazing!!!).

Hormones produced by the thyroid influence how quickly or slowly you burn energy, aka your metabolism. If you don't produce enough hormones you have what is known as hypothyroidism and your metabolism slows way down. This condition can also cause lethargy, reduced appetite and brittle nails. While hypothyroidism is rarely the only culprit in weight gain it can be a contributing factor.

Having your thyroid hormone levels checked is relatively easy and merely requires a blood test - and you don't even need to fast before having your blood drawn. The test measures the thyroid stimulating hormone (TSH) levels in your blood. If the level is above 5 IU/liter, your body is trying to stimulate an under-performing thyroid.

If you think you are experiencing thyroid problems make an appointment to discuss the issue with your primary care physician.

Source

Thyroid supplement (By mouth)

admin — Thu, 04 Sep 2008 19:50:31 -0700

Overview

Introduction
Brand Name(s)
When This Medicine Should Not Be Used
How to Use This Medicine
How to Store and Dispose of This Medicine
Drugs and Foods to Avoid
Warnings While Using This Medicine
Possible Side Effects While Using This Medicine

HEALTH GUIDE REFERENCE FROM A.D.A.M

Introduction

Treats hypothyroidism (the body does not produce enough thyroid hormone).

Brand Name(s)

Synthroid, Levoxyl, Levothroid, Armour Thyroid, Cytomel, Thyrolar, Westhroid, Nature-Throid NT-1, Nature-Throid NT-2, Unithroid, Nature-Throid, Synthroid RP, Nature-Throid NT-1/2, Nature-Throid NT-3

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to any type of thyroid hormone or if you have an overactive thyroid gland.

How to Use This Medicine

Capsule, Tablet

Your doctor will tell you how much to take and how often
Take your medicine at the same time every day.
Take the medicine on an empty stomach.
Do not stop taking this medicine without first checking with your doctor, you may need to take smaller and smaller doses before completely stopping the medicine.

If a dose is missed:

Take the missed dose take as soon as possible.
Skip the missed dose if it is almost time for your next regular dose.
You should not use two doses at the same time.

How to Store and Dispose of This Medicine

Store at room temperature, away from heat, light, and moisture.
Keep all medicine out of the reach of children.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Make sure your doctor knows if you are taking a blood thinner (Coumadin®), cholestyramine (Questran®), medicine for diabetes (insulin, Diabenese®, Glucotrol®), estrogens, birth control pills, or products used for colds, asthma, appetite control, hay fever, or sinus problems.

Warnings While Using This Medicine

Check with your doctor before taking this medicine if you have heart disease, high blood pressure, diabetes, or an underactive adrenal or pituitary gland.
Tell your doctor if you are pregnant or breastfeeding.
Large doses of thyroid hormones, especially when taken with diet pills, can result in dangerous side effects.
Make sure you see your doctor for regular check-ups so your condition can be followed closely.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

Skin rash or hives
Shortness of breath or trouble breathing
Chest pain
Fast or pounding heartbeat
Inability to stand heat
Extreme nervousness or irritability, tremors
Severe diarrhea, intense sweating

If you notice these less serious side effects, talk with your doctor:

Anxiety
Headache
Trouble sleeping
Appetite changes, weight loss
Irregular menstrual periods

Review Date: 8/4/2008

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

A.D.A.M. Copyright

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-2009 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

adam.com

Source Doc: 45_0401

Thyroid (By mouth)

admin — Thu, 04 Sep 2008 19:47:48 -0700

Overview

Introduction
Brand Name(s)
When This Medicine Should Not Be Used
How to Use This Medicine
How to Store and Dispose of This Medicine
Drugs and Foods to Avoid
Warnings While Using This Medicine
Possible Side Effects While Using This Medicine

HEALTH GUIDE REFERENCE FROM A.D.A.M

Introduction

Thyroid (THYE-royd)

Treats hypothyroidism (the body does not produce enough thyroid hormone).

Brand Name(s)

Armour Thyroid, Westhroid, Nature-Throid NT-1, Nature-Throid, Nature-Throid NT-3, Nature-Throid NT-1/2, Nature-Throid NT-2

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to any type of thyroid hormone.

How to Use This Medicine

Tablet, Capsule

Your doctor will tell you how much to take and how often
Take your medicine at the same time every day.
Take the medicine on an empty stomach.

If a dose is missed:

Take your medicine as soon as you remember that you missed a dose.
Skip the missed dose if it is almost time for your next dose.
You should not use two doses at the same time.

How to Store and Dispose of This Medicine

Store at room temperature, away from heat and moisture.
Keep all medicine out of the reach of children.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

If you are taking cholestyramine (Questran®), take it either 4 hours before or 4 hours after you take levothyroxine.

Warnings While Using This Medicine

Talk with your doctor before taking this medicine if you have heart disease, high blood pressure, or diabetes.
Do not stop taking this medicine without first checking with your doctor.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

Skin rash or hives with intense itching
Shortness of breath or trouble breathing
Chest pain
Severe irritability or nervousness, tremors
Fast or irregular heartbeat
Severe diarrhea or intense sweating

If you notice these less serious side effects, talk with your doctor:

Anxiety
Headache
Trouble sleeping
Appetite changes, weight loss
Irregular menstrual periods

Review Date: 8/4/2008

A.D.A.M. Copyright

adam.com

Source Doc: 45_0188

Foreign Product Alert - Lexscl Fat Rapid Loss

FitSugar — Mon, 16 Apr 2007 14:30:00 -0700

If you've come across and/or are taking the weight loss drug Lexscl Fat Rapid Loss, there is something you should be warned about.

Health Canada is advising consumers to beware of Lexscl Fat Rapid Loss as this alert has been issued:

The Hong Kong Department of Health found Lexscl Fat Rapid Loss capsules to be adulterated with sibutramine and thyroid hormones. Sibutramine is a prescription drug used for the treatment of obesity, while thyroxine and liothyronine are prescription thyroid hormones. These drugs are not intended for self-care, and should only be taken under the guidance of a health care professional.

Side effects of the drug include increased heart rate and blood pressure, hyperthyroidism (overactive thyroid gland) and chest pain. The pills (pictured here) are packaged in a white bottle bearing an orange and red label, inside a box with similar coloring.

Scary.

Source

Thyroiditis

FitSugar — Wed, 08 Oct 2008 17:35:33 -0700

HEALTH GUIDE REFERENCE FROM A.D.A.M

Thyroiditis is an inflammation of the thyroid gland. There are several types of thyroiditis. Most result in three phases: overactive thyroid (hyperthyroidism), underactive thyroid (hypothyroidism), and return to normal. When the thyroid is inflamed, it often releases an excess of thyroid hormone, resulting in hyperthyroidism. As the supply of thyroid hormone is depleted, the body has too little, and hypothyroidism the results. Young to middle-aged women seem most at risk, although some forms of thyroiditis occur in both men and women of all ages. With some forms, hypothyroidism may develop years later even if the thyroiditis has resolved.

Signs and Symptoms

Depending on the type of thyroiditis, the thyroid gland can have one of the following characteristics:

Firm and enlarged, but not tender
Enlarged and painful, with pain extending to the jaw or ears
Enlarged but not painful
Enlarged on only one side, hard like a stone, and sticking to other neck structures

You may also have one or more of the following symptoms:

Cool, dry skin, slow pulse rate (less than 60 beats per minute), swelling around the eyes, hoarseness, or slow reflexes
No desire to eat, feeling tired and unenergetic, and a slight fever
A rapid heartbeat, slight nervousness, anxiety, weight loss of 5 - 10 pounds, and increased sweating

What Causes It?

Immune disorders, viruses, and fever disorders can cause thyroiditis. Sometimes thyroiditis develops if you have Graves' disease (an autoimmune disorder that causes hyperthyroidism). In some cases, there is no identifiable cause.

What to Expect at Your Provider's Office

Your health care provider will feel your neck to see what the thyroid gland feels like and may order blood tests to check the levels of thyroid hormones and other factors. You may be given pain medication or something to help you feel more normal.

Natural medicine practitioners often take a different view of laboratory analysis of thyroid function. Many naturally oriented physicians pay particular attention to levels of T3 hormone, the active form of thyroid hormone that is converted in the body from T4, an inactive thyroid hormone. Conventional lab tests usually monitor T4 and thyroid stimulating hormone (TSH) without examining levels of T3. People with hypothyroidism may be treated with T4 to bring their levels of T4 to normal limits. Meanwhile, if you are unable to convert T4 to T3, your tests may be normal but you may still experience the symptoms of hypothyroidism. Talk to your doctor about including T3 lab tests in the treatment of hypothyroidism.

Treatment Options

Thyroiditis generally involves three phases: overactive phase, underactive phase, and return to normal. Treatment is individualized to type and phase.

Drug Therapies

Depending on the particular type of thyroiditis, a physician may prescribe one or some of the following treatments:

Levothyroxine, if hypothyroidism or large goiter present
Aspirin, to relieve pain and inflammation
Corticosteroid medications (such as prednisone or dexamethasone), to reduce inflammation in severe cases
Propanolol, for hyperthyroidism
Thyroxine, to replace thyroid hormone (in cases of hypothyroidism)
Short-term beta-blockers, for hyperthyroid symptoms
Antibiotics

Surgical and Other Procedures

Rarely, partial thyroid removal may relieve pressure.

Complementary and Alternative Therapies

Alternative therapies can help when used along with the medications your health care provider prescribes, but do not replace your conventional medications.

Nutrition and Supplements

Foods that depress thyroid activity are broccoli, cabbage, brussels sprouts, cauliflower, kale, spinach, turnips, soy, beans, and mustard greens. You should include these foods in a diet for hyperthyroid conditions -- and avoid them if you have a hypothyroid condition. Use caution because people with thyroiditis can switch from hyperthyroidism to hypothyroidism very quickly.
Avoid refined foods, sugar, dairy products, wheat, caffeine, alcohol.
Essential fatty acids (1,000 - 1,500 mg three times per day), found in flaxseed oil, fish oil, and borage oil, are anti-inflammatory and necessary for hormone production.
Bromelain (250 - 500 mg three times per day between meals), an enzyme from the pineapple plant, may reduce inflammation.
Vitamin C (1,000 mg per day), vitamin A (10,000 - 25,000 IU per day), B complex [(50 -100 mg per day), augmented with vitamins B2 (riboflavin, 10 mg), B3 (niacin, 10 - 25 mg), and B6 (pyridoxine, 5 - 15 mg)], selenium (200 mcg per day), vitamin E (400 IU per day), and zinc (30 mg per day) are necessary for normal thyroid hormone production.
Calcium (1,000 mg per day) and magnesium (200 - 600 mg per day) may help metabolic processes function correctly.
If you take thyroid hormone medication, talk to your doctor before consuming soy products. Some evidence suggests that soy may interfere with absorption of thyroid hormone.
Iron may also interfere with the absorption of thyroid hormone medication.

Your health care provider may also recommend specific nutritional supplements for a hyperthyroid or hypothyroid condition.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to get your problem diagnosed before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

Talk to your health care provider before taking herbs for thyroiditis, particularly if you are also taking prescription medication.

For hyperthyroid conditions:

Bugleweed (Lycopus virginica) and lemon balm (Melissa officinalis) help normalize the overactive thyroid. Steep the following amount in one cup of boiling water. Strain and cool. For bugleweed, 1 - 2 g; for lemon balm, 2 tablespoons. These herbs may be combined.
Motherwort (Leonurus cardiaca) can help regulate rapid heartbeat. Steep 2 g in one cup of boiling water. Strain and cool. Drink three times per day.
Turmeric (Curcuma longa) makes the effect of bromelain stronger and should be taken between meals, 500 mg three times per day.
Avoid ashwagandha (Withania somnifera) and bladderwrack (Fucus vesiculosus ), as they can stimulate hyperthyroidism.

For hypothyroid conditions:

Coleus forskohlii (50 - 100 mg two to three times per day) may stimulate thyroid function to increase thyroid hormone.
Herbs such as guggul (Commiphora mikul) (25 mg of guggulsterones three times per day) and hawthorne (Crataegus monogyna) (500 mg twice a day) are taken to counteract high cholesterol, which often accompanies hypothyroidism.

You should carefully monitor any treatment for lowering or raising thyroid function because thyroiditis may switch from hyperthyroidism to hypothyroidism very quickly.

Homeopathy

Homeopathy may be useful as a supportive therapy for both "hyper" and "hypo" conditions of the thyroid.

Physical Medicine

Exercise helps improve thyroid function for both hypothyroidism and hyperthyroidism..

Acupuncture

Acupuncture may help correct hormonal imbalances and address underlying deficiencies and excesses involved in thyroiditis.

Massage

Therapeutic massage may relieve stress and increase the sense of well-being.

Following Up

You may need to see your health care provider each year.

Special Considerations

If you are pregnant or just had a baby, you may develop Hashimoto's thyroiditis.

Supporting Research

Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, Mass: Integrative Medicine Communications; 1998:432.

The Burton Goldberg Group, compilers. Alternative Medicine: The Definitive Guide. Tiburon, Calif: Future Medicine Publishing Inc; 1997.

Ferri FF. Ferri's Clinical Advisor: Instant Diagnosis and Treatment. St. Louis, Mo: Mosby-Year Book;1999.

Hoffman D. The New Holistic Herbal. New York, NY: Barnes & Noble Books; 1995:95.

Messina M, Redmond G. Effects of soy protein and soybean isoflavones on thyroid function in healthy adults and hypothyroid patients: a review of the relevant literature. Thyroid. 2006 Mar;16(3):249-58.

Murray MT, Pizzorno JE. Encyclopedia of Natural Medicine. 2nd ed. Rocklin, Calif: Prima Publishing; 1998:386-390.

Noble J, ed. Textbook of Primary Care Medicine. 2nd ed. St. Louis, Mo: Mosby-Year Book; 1996.

Panda S, Kar A. Changes in thyroid hormone concentrations after administration of ashwagandha root extract to adult male mice. J Pharm Pharmacol. 1998;50:1065-1068.

Roger PP, Servais P. Dumont JE. Regulation of dog thyroid epithelial cell cycle by forskolin, an adenylate cyclase activator. Exp Cell Res. 1990;172:282-92.

Tierney LM Jr, McPhee SJ, Papadakis MA, eds. Current Medical Diagnosis and Treatment. Norwalk, Conn: Appleton & Lange; 1994.

Review Date:
6/15/2006
Reviewed By:
Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Thyroid nodule

admin — Thu, 04 Sep 2008 19:20:40 -0700

Overview

Definition
Alternative Names
Causes, incidence, and risk factors
Symptoms
Signs and tests
Treatment
Expectations (prognosis)
Complications
Calling your health care provider
Prevention
References

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

A thyroid nodule is a growth (lump) in the thyroid gland. The thyroid gland is located at the base of the neck.

Alternative Names

Thyroid tumor; Thyroid adenoma; Thyroid carcinoma; Thyroid incidentaloma

Causes, incidence, and risk factors

Thyroid nodules are growths of cells in the thyroid glands. These growths can be non-cancerous (benign) or cancerous (malignant). Some nodules are fluid-filled (cysts), while others are completely made of thyroid gland cells. Sometimes, what feels like one nodule will actually be a collection of small nodules close together.

Thyroid nodules that are big enough to feel during a physical exam occur in 5 - 7% of the population. Smaller nodules occur in as many as 50% of people aged 60 or older. Thyroid nodules are more common in women than in men. A person's chance of a thyroid nodule increases with age.

Only 4 - 5% of thyroid nodules are cancerous. (See: Thyroid cancer)

The following characteristics increase the risk for a cancerous nodule:

A hard nodule
A nodule that is stuck to nearby structures
Family history of multiple endocrine neoplasia Type II
Family history of thyroid cancer, especially medullary thyroid carcinoma
Hoarse voice due to vocal cord paralysis

Other risk factors for a cancerous nodule include:

Age -- younger than 20 years or older than 70
History of radiation exposure to the head or neck
Male gender

Causes of thyroid nodules are not always found, but can include:

Hashimoto's disease
Iodine deficiency
Suppression of thyroid hormone

Symptoms

Most thyroid nodules produce no symptoms.

Large nodules can press against other structures in the neck. Symptoms may include:

Nodules that produce thyroid hormones will cause symptoms of hyperthyroidism, including:

Bounding pulse
Clammy skin
Increased appetite
Nervousness
Restlessness
Skin blushing or flushing
Weight loss

Thyroid nodules are found in Hashimoto's disease. Hashimoto's disease may cause hypothyroidism, with symptoms such as:

Signs and tests

Very often, nodules produce no symptoms. Doctors will find thyroid nodules only during a routine physical exam. If the doctor finds a nodule or you have symptoms of a nodule, the following tests may be done:

Treatment

Surgery is recommended for nodules that:

Are cancerous
Are overactive
Cannot be diagnosed as cancer or non-cancer
Cause symptoms

Patients with overactive nodules may be treated with radioactive iodine, which reduces the size and activity of the nodule. However, the treatment can cause hypothyroidism and inflammation of the thyroid gland (radiation-induced thyroiditis). Pregnant women should not be given this treatment. Women being treated with radioactive iodine should not get pregnant.

Levothyroxine (Synthroid, Levoxyl, Levothroid, Unithroid) is a drug that suppress the production of the thyroid hormone T4. A doctor may prescribe levothyroxine to treat non-cancerous nodules only in special cases, including:

A growing nodule
A nodule causing pressure on other structures in the neck
Many nodules growing in the thyroid gland

Levothyroxine does not seem to benefit most people with thyroid nodules. It also can cause serious complications, including heart problems and loss of bone density.

Careful follow-up is the only recommended treatment for benign nodules that do not cause symptoms and are not growing. A thyroid biopsy may need to be repeated 6-12 months after diagnosis. An ultrasound may be repeated as well.

Newer treatments include ethanol (alcohol) injection into the nodule and laser therapy.

Expectations (prognosis)

Non-cancerous thyroid nodules are not life-threatening. Many do not require treatment, only follow-up. Non-cancerous nodules that do need treatment have an excellent outlook.

The outlook for cancerous nodules depends on the type of cancer.

Complications

Hyperthyroidism is a common complication of non-cancerous thyroid nodules.

Complications of treatment can include:

Hoarse voice if vocal cord nerves are damaged during surgery
Hypothyroidism from surgery or radioactive iodine therapy
Low blood calcium (hypocalcemia) from hypoparathyroidism if parathyroid glands are accidentally damaged or removed during surgery

Calling your health care provider

Call your health care provider if you feel or see a lump in your neck, or if you experience any symptoms of a thyroid nodule.

If you have been exposed to radiation in the face or neck area, call your health care provider. A neck ultrasound can be done to look for thyroid nodules.

Prevention

The reason for most thyroid nodules is unknown. A diet with enough iodine will help prevent some nodules.

References

Sriram U, Patacsil LM. Thyroid Nodule. Dis Mon 2004; 50(9):486-526.

Hegedus L. The Thyroid Nodule. N Eng J Med 2004;351:1764-71.

Goldman L, Ausiello D. Cecil Textbook of Medicine, 22nd ed. Philadelphia, Pa: WB Saunders; 2004.

Rakel RE. Textbook of Family Practice. 6th ed. Philadelphia, Pa: WB Saunders; 2005.

Ladenson P, Kim M. Thyroid. In: Goldman L and Ausiello D, eds. Goldman: Cecil Medicine. 23rd ed. Philadelphia, Pa:Saunders; 2007:chap 244.

AACE/AME. American Association of Clinical Endocrinologists and Associazione Medici Endocrinologi. Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules. Endocr Pract. 2006;12:63-102.

Review Date: 6/17/2008

Reviewed By: Elizabeth H. Holt, MD, PhD, Assistant Professor of Medicine, Section of Endocrinology and Metabolism, Yale University. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M. Copyright

adam.com

Source Doc: 1_007265

Thyroid cancer

admin — Wed, 03 Sep 2008 17:55:11 -0700

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Thyroid cancer is a cancerous growth of the thyroid gland.

Alternative Names

Tumor - thyroid; Cancer - thyroid

Causes, incidence, and risk factors

Thyroid cancer can occur in all age groups.

People who have had radiation therapy to the neck are at higher risk. This therapy was commonly used in the 1950s to treat enlarged thymus glands, adenoids and tonsils, and skin disorders. People who received radiation therapy as children have a higher incidence of thyroid cancer.

Other risk factors are a family history of thyroid cancer and chronic goiter. The disease affects 1 in 1,000 people.

There are several types of thyroid cancer:

Anaplastic carcinoma (also called giant and spindle cell cancer) is the most dangerous form of thyroid cancer. It is rare, but does not respond to radioiodine therapy. Anaplastic carcinoma spreads quickly and invades nearby structures such as the trachea, causing breathing difficulties.
Follicular carcinoma accounts for about 30% of all cases and is more likely to come back and spread.
Medullary carcinoma is a cancer of non-thyroid cells in the thyroid gland and tends to occur in families. It requires different treatment than other types of thyroid cancer.
Papillary carcinoma is the most common type, and usually affects women of childbearing age. It spreads slowly and is the least dangerous type of thyroid cancer.

Symptoms

Cough or cough with bleeding
Difficulty swallowing
Enlargement of the thyroid gland
Hoarseness or changing voice
Neck swelling
Thyroid lump (nodule)

Note: Symptoms may vary depending on the type of thyroid cancer

Signs and tests

A physical examination can reveal a thyroid mass or nodule (usually in the lower part of the front of the neck), or enlarged lymph nodes in the neck.

Tests for thyroid cancer:

Elevated serum calcitonin (for medullary cancer) or serum thyroglobulin (for papillary or follicular cancer)
Laryngoscopy showing paralyzed vocal cords
Thyroid biopsy showing anaplastic, follicular, medullary, or papillary cancer cells
Thyroid scan showing a nodule that does not light up on the scan (cold nodule)
Ultrasound of the thyroid showing a nodule

This disease may also affect the results of the following tests:

Treatment

Treatment varies depending on the type of tumor.

Surgery is usually the treatment of choice, and the entire thyroid gland is usually removed. If the physician suspects that the cancer has spread to lymph nodes in the neck, these will also be removed during surgery.

Radiation therapy with radioactive iodine is often used with or without surgery. Radiation therapy with beam radiation can also be used.

After treatment, you need to take thyroid hormone to replace what your glands used to make. The dose is usually a little higher than what your body needs, which helps keep the cancer from coming back.

If the cancer does not respond to surgery or radiation and has spread to other parts of the body, chemotherapy may be used, but this is only effective for a third of patients.

Support Groups

You can ease the stress of illness by joining a support group made up of people who share common experiences and problems. See cancer - support group.

Expectations (prognosis)

Anaplastic carcinoma has the worst outcome of all the types of thyroid cancer. Follicular carcinomas are often fast growing and may invade other tissues, but the outlook is still good -- most patients are cured.

The outcome with medullary carcinoma varies. Women under age 40 have a better chance of a good outcome.

Papillary carcinomas are usually slower growing. Most people are cured and have a normal life expectancy.

Many patients who have surgery or radiation for thyroid cancer must take thyroid hormone pills for the rest of their lives.

Complications

Injury to the voice box or nerve and hoarseness after surgery
Low calcium levels from accidental removal of the parathyroid glands during surgery
Spread of the cancer to the lung or other parts of the body

Calling your health care provider

Call your health care provider if you notice a lump in your neck.

Also call if your symptoms get worse during treatment.

Prevention

There is no known prevention. Awareness of risk (such as previous radiation therapy) can allow earlier diagnosis and treatment.

References

Sherman SI, Angelos P, Ball DW, Byrd D, Clark OH, Daniels GH, et al. Thyroid carcinoma. J Natl Compr Canc Netw. 2007;5:568-621.

Sampson E, Brierley JD, Le LW, Rotstein L, Tsang RW. Clinical management and outcome of papillary and follicular (differentiated) thyroid cancer presenting with distant metastasis at diagnosis. Cancer. 2007;110:1451-1456.

Tuttle RM, Leboeuf R, Martorella AJ. Papillary thyroid cancer: monitoring and therapy. Endocrinol Metab Clin North Am. 2007;36:753-758.

Review Date: 3/24/2008

Reviewed By: Stephen Grund, MD, PhD, Chief of Hematology/Oncology and Director of the George Bray Cancer Center at New Britain General Hospital, New Britain, CT. Review provided byVeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M. Copyright

adam.com

Source Doc: 1_001213

Chronic thyroiditis (Hashimoto’s disease)

admin — Wed, 03 Sep 2008 17:49:14 -0700

Overview

Definition
Alternative Names
Causes, incidence, and risk factors
Symptoms
Signs and tests
Treatment
Expectations (prognosis)
Complications
Calling your health care provider
Prevention
References

Illustrations

Endocrine glands

Thyroid enlargement - scintiscan

Hashimoto's disease (chronic thyroiditis)

Thyroid gland

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Chronic thyroiditis is swelling (inflammation) of the thyroid gland that often results in reduced thyroid function (hypothyroidism).

Alternative Names

Hashimoto's thyroiditis; Chronic lymphocytic thyroiditis; Autoimmune thyroiditis

Causes, incidence, and risk factors

Chronic thyroiditis or Hashimoto's disease is a common thyroid gland disorder. It can occur at any age, but is most often seen in middle-aged women. It is caused by a reaction of the immune system against the thyroid gland.

The disease begins slowly. It may take months or even years for the condition to be detected. Chronic thyroiditis is most common in women and people with a family history of thyroid disease. It affects between 0.1% and 5% of all adults in Western countries.

Hashimoto's disease may, in rare cases, be associated with other endocrine disorders caused by the immune system. Hashimoto's disease can occur with adrenal insufficiency and type 1 diabetes. In these cases, the condition is called type 2 polyglandular autoimmune syndrome (PGA II).

Less commonly, Hashimoto's disease occurs as part of a condition called type 1 polyglandular autoimmune syndrome (PGA I), along with:

Adrenal insufficiency
Fungal infections of the mouth and nails
Hypoparathyroidism

Symptoms

Constipation
Difficulty concentrating or thinking
Dry skin
Enlarged neck or presence of goiter
Fatigue
Hair loss
Heavy and irregular periods
Intolerance to cold
Mild weight gain
Small or shrunken thyroid gland (late in the disease)

Other symptoms that can occur with this disease:

Note: There may be no symptoms.

Signs and tests

Laboratory tests to determine thyroid function include:

Free T4 test (low)
Serum TSH (high)
T3 (low or normal)
Thyroid autoantibodies:
- Antithyroid peroxidase antibody
- Antithyroglobulin antibody

Imaging studies are generally not needed to diagnose Hashimoto's thyroiditis.

This disease may also change the results of the following tests:

Complete blood count
Radioactive iodine uptake
Serum prolactin
Serum sodium
Total cholesterol

Treatment

A lack of thyroid hormone may develop. You may receive thyroid hormone replacement therapy (levothyroxine) if your body is not producing enough of the hormone. Or, you may receive it if you have signs of mild thyroid failure (such as elevated TSH). This condition is also known as subclinical hypothyroidism.

If there is no evidence of thyroid hormone deficiency, you may just need regular observation by a health care provider.

Expectations (prognosis)

The outcome is usually very good. The disease stays stable for years. If it does slowly progress to thyroid hormone deficiency (hypothyroidism), it can be treated with thyroid replacement therapy.

Complications

This condition can occur with other autoimmune disorders. In rare cases, thyroid cancer may develop.

Calling your health care provider

Call your health care provider if you develop symptoms of chronic thyroiditis.

Prevention

There is no known way to prevent this disorder. Being aware of risk factors may allow earlier diagnosis and treatment.

References

Ladenson P, Kim M. Thyroid. In: Goldman L and Ausiello D, eds. Goldman: Cecil Medicine. 23rd ed. Philadelphia, Pa:Saunders; 2007:chap 244.

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