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Download Thyroid: Symptoms and what they mean to you
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Thyroid:Symptomsandwhattheymeantoyou ByDRVIVIENLIMCHINCHIN SPECIALISTINENDOCRINOLOGY(GLANDSANDHORMONES) Oneinninepatientsmaysufferfromathyroiddisorderandoverhalfofthemmightnotbeawareof this.Thethyroidisaglandthatresidesbelowthevoicebox(wheretheAdam’sappleisinthemales) intheneck. Themajorthyroidproblemsare: - Toomuchthyroidhormone–knownashyperthyroidism Toolittlethyroidhormones–knownashypothyrioidism Toobigathyroidgland–knownasagoitre Cancer Toomuchthyroidhormones-hyperthyroidism Symptoms: - feelstoohot losingweightevenwithincreasedappetite shakingofhands fastheartrateorfeelingasenseofheartbeatingveryfastinthechest bulgingeyes menstrualirregularities hairloss diarrhoea anxious,restless,fidgety Causes: - mostlikelysecondarytoantibodiesagainstthethyroidglandcausingittoproducemore hormones lesslikely–thyroidnodulethatisactive,glandwithmanynodulesthatareactive,acentral pituitarycausethatisproducingcommandhormonesthattellthethyroidglandtoproduce morethyroidhormones Treatment: - medication–inmostcountriesthisistheinitialtreatmentegmethimazole,carbimazoleor propylthiouracil radioactiveiodine surgery–usuallythisisamethodoflastresortunlessthethyroidglandistoobigandis obstructingtheairwayorforcosmeticreasons Toolittlethyroidhormones–hypothyrioidism Symptoms: - slowingdown weightgain coldintolerance constipation feelingtired menstrualirregularities hairloss Causes - Vastmajorityduetothyroidantibodiesthatdestroythethyroidglandhenceleadingtoa decreaseinproductionofthyroidhormones Treatment - Appropriatereplacementofthethyroidhormone Bigthyroid–goitre Causes: - Bothhyper-andhypo-thyroidismcanbeassociatedwithabigthyroid Anodule(lump)ormultiplenodulesinthethyroid Rarelycancer Treatment: - - - Firsttobeabletovisualisethethyroidglandusinganultrasound.Andtoseeifthereareany nodules.Ifthereare,toascertainwhethertheyarecancerousornot–onewayisbythe ultrasoundcharacteristicsandtheotherbydoingabiopsyofthethyroidnodule–thisis knownasfineneedleaspirationcytology.Asmallneedle(smallerthanthatofaneedleused totakebloodfrompatients)isinsertedintothethyroidnoduleandcellsobtainedfor visualisationunderthemicroscope. Ifthenodulesarenotcancerous–optionsofmanagementarediscussedandwillincludethe following: o Continuewithmonitorregularlywithultrasound o Removalofthelobewhichthenoduleisin Ifthenoduleiscancerous–seebelow. Thyroidcancer Thisisusuallyslowgrowingandmightpresentasanodule.Fortreatmentofnodulesseeabove.If cancerisproven,managementisassuch: - Removalofthewholeofthethyroidgland Decisionmadeastowhetherradioactiveiodineisneeded–thisisusuallydoneforthyroid cancerswithhigherriskofrecurrence Suppressivetherapy–ietosuppressthecommandhormonesforthethyroidglandthatcan alsostimulatecancercells.Thisisusuallydonebygivingthyroidhormonereplacementsata higherdosethannormal.
