NEW BRUNSWICK – The thyroid is tiny but diseases of this very significant gland affect millions. As many as 27 million Americans may have some form of thyroid disease, according to Dr. Jeffrey R. Garber, president of the American Association of Clinical Endocrinologists. In addition, the National Cancer Institute estimated that 37,200 people would be diagnosed with cancer of the thyroid in 2009.
“This is a highly treatable disease when it’s found early. The problem is, more than half of the people with the disease don’t even know they have it,” says Dr. Meena Murthy, endocrinologist and chief of the Division of Endocrinology, Nutrition and Metabolism at Saint Peter’s University Hospital in New Brunswick. Murthy is also director of Saint Peter’s Thyroid and Diabetes Center.
“Problems with the thyroid often go undetected because the symptoms tend to be subtle and vague – fatigue, constipation, weight gain, weight loss, even depression – and may make you think you have any number of disorders that have nothing to do with your thyroid,” Murthy says. “Some people have no symptoms at all.”
About the Thyroid
This butterfly-shaped gland, located in the neck just beneath the Adam’s apple, is vital to our well-being because it affects every human cell, tissue and organ. The thyroid produces hormones that regulate metabolism, blood pressure, heart rate and body temperature. Left untreated, thyroid disease can lead to numerous problems such as high cholesterol levels, infertility, osteoporosis and even death.
Diseases of the Thyroid
Thyroid disease can occur at any age. “This is not just a disease of old age,” Murthy says. “A lot of young people have thyroid disease, so it’s one of those things that should be on your list when you go for a checkup with your doctor.”
Thyroid diseases include hypothyroidism, which occurs when the thyroid gland produces insufficient amounts of thyroid hormone. This results in an underactive thyroid gland, which reduces the efficiency of bodily functions. Symptoms include pervasive fatigue, forgetfulness, sore muscles, weight gain and increased frequency of miscarriage.
Hyperthyroidism occurs as the result of an overproduction of thyroid hormone. It can be accompanied by a toxic goiter (enlargement of the thyroid) and symptoms include a fast heart rate, weight loss, changes in menstrual pattern and anxiety.
Thyroid Cancer Signs and Symptoms
Thyroid cancer is often found by chance, such as when a doctor finds a lump on the gland during a routine physical exam. Symptoms may also include hoarseness and recurring throat or neck pain. Doctors recommend an at-home “neck check,” using a mirror and a glass of water, which can be effective in detecting a lump. If you see a bulge or protrusion in the area around the thyroid when you swallow the water, you may have an enlarged thyroid that will need testing to detect cancer or other thyroid issues.
What to Ask Your Doctor
Ask your doctor to examine your neck during routine exams because early detection is the key to successful treatment of thyroid diseases. If you suspect you may have thyroid disease, ask your physician to perform a simple test known as a TSH (thyroid-stimulating hormone) blood test to measure your thyroid function.
Risk factors include a family history of thyroid disease or dysfunction; a history of undergoing neck or head irradiation, surgery or radiotherapy targeting the thyroid gland; or a goiter. Women are almost three times more likely than men to develop thyroid cancer.
Other Types of Diagnosis and Treatment
In addition to a physical exam and the TSH blood test, your doctor may order an ultrasound of the thyroid to detect the presence of nodules, which may or may not be cancerous. A biopsy, however, is a better test to diagnose thyroid cancer.
There are many treatment options for people with thyroid cancer. They include surgery, thyroid hormone treatment, radioactive iodine therapy, external radiation therapy (very rarely) or chemotherapy. Most people receive surgery and/or radioactive iodine. Treatment usually begins within a few weeks following the diagnosis.
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