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Thyroid Diseases

Thyroid Testing May Shed Light on Baffling Problems

For something that plays such an important role in the body's metabolism, the thyroid keeps a surprisingly low profile.

The butterfly-shaped gland located in the front of the neck doesn't exactly shout out clear warning signs when it has a problem. So with January marking Thyroid Awareness Month, it's a good time to make sure your thyroid is not the cause of any baffling health issues you might be experiencing.

Health Risks

The thyroid makes and stores hormones that help regulate the heart rate, blood pressure, body temperature and the rate at which food is converted to energy. Health risks include underactive or overactive thyroid, enlarged thyroid (goiter) and cancer.

Someone who has an underactive thyroid, known as hypothyroidism, might feel tired or experience weight gain or cold intolerance. Such symptoms can have many causes, but it's a good idea to have the thyroid tested sooner rather than later.

It's a very simple blood test, and for patients with those symptoms it's the first test given. If it comes back normal, the thyroid can be ruled out as the problem.

An overactive thyroid, known as hyperthyroidism, tends to have more overt symptoms. Patients might be jittery, experience irregular or fast heartbeats or lose weight without trying.

Treatment for Thyroid Diseases

Underactive thyroid can be treated with the synthetic thyroid hormone levothyroxine, marketed under several brand names including Synthroid, Levoxyl and Levothroid. It's taken in pill form, with the proper dosage determined via blood test monitoring.

Treatment of overactive thyroid is more complicated and can involve surgery, drugs or radioactive iodine. It is recommended that patients consult an endrocrinologist to determine the proper course of therapy.

In checking the thyroid for cancer, the first step is palpation, which simply feeling the lower neck under the Adam's apple to see if there are any nodules in the thyroid. If an abnormality is felt, an ultrasound can be performed that is more sensitive and specific in searching for cancer.

A generation ago, physicians relied almost exclusively on palpation so a cancer had to be pretty big to be discovered. Now, with ultrasound, health care professionals can find cancers one centimeter or smaller.

Patients who have nodules that are large or suspicious on ultrasound should have an ultrasound-guided fine needle biopsy to exclude malignancy, since 90 to 95 percent of nodules are benign.

This article originally appeared in UC Health Line (1/15/09), a service of the University of Cincinnati Academic Health Center Public Relations Department and was adapted for use on NetWellness with permission, 2007.

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Last Reviewed: Jan 26, 2009

David  L Steward, MD David L Steward, MD
Professor of Otolaryngology
College of Medicine
University of Cincinnati