Tag Archives: Thyroid Gland

THE DOCTORS 101 CHRONIC SYMPTOMS & CONDITIONS #50: HASHIMOTO’S DISEASE

Hashimoto’s thyroiditis is the most common cause of thyroid deficiency. As a practicing allergist, I would routinely palpate the front of the neck area around the windpipe where the thyroid is located. Every few months or so, I would feel an enlarged thyroid, order a high sensitivity TSH test, and, if positive, check for thyroid antibodies.

This saved my patients from having to go through the symptoms of underactive thyroid(hypothyroidism), since I detected the problem at an early stage, before symptoms developed.

Major symptoms of an underactive thyroid include fatigue, increased sensitivity to the cold, constipation, unexplained weight gain, and depression. Be sure to seek medical care if you are suffering from these symptoms.

An elevated LDL cholesterol is one of the biochemical results of hypothyroidism, and can lead to heart problems. I have been hearing that the routine physical examination it is becoming less common, and may even be replaced by telemedicine. The early detection of Hashimoto’s thyroiditis will be one of the casualties, since the doctor can’t find an enlarged thyroid unless she palpates for it.

You might wonder why an enlarged thyroid gland is associated with decreased thyroid production. The way it works is that the pituitary gland at the base of the brain detects a decrease in thyroid production. It responds by secreting a thyroid stimulant, TSH. The TSH causes enlargement of the thyroid gland, leading to the association of an elevated TSH with decreased thyroid activity.

Hashimoto’s  is one of the large number of autoimmune diseases. A person who has an autoimmune disease, such as rheumatoid arthritis, type one diabetes, or celiac disease, is more likely to develop others, and should be alert to that possibility.

Finding that you have  low thyroid activity is only part of the problem. It takes several visits plus input from both patient and doctor in order to arrive at the proper medication schedule. There are several different thyroid medications, and people respond differently to them.

Be on the alert for hypothyroidism. It can sneak up on you.

—Dr. C.

Endocrinology: Thyroid Nodule Treatment (Video)

The Endocrine Surgery Program at Massachusetts General Hospital provides multidisciplinary, specialized treatment for thyroid nodules, a lump that commonly occurs in the thyroid. If you think that you may have a thyroid nodule, you should be evaluated by a physician. In this video, Sareh Parangi, MD, endocrine surgeon at Mass General, shares more about what to expect for diagnosis and treatment of thyroid nodules.

THE DOCTORS 101 CHRONIC SYMPTOMS & CONDITIONS #40: HYPOTHYROIDISM

Hypothyroidism is a very common hormonal deficiency where there is an insufficient amount of thyroid hormone, T4. The thyroid gland regulates your metabolic activity. If you have insufficient thyroid hormone, everything seems to slow down; Your energy level, your muscle strength, your heart rate, your brain activity, and even your intestinal activity are all slower.

The causes of thyroid hypothyroidism. Infographics. Vector illustration on isolated background

One of my habits in practice was to check the size of the thyroid, which is an H shaped gland astride the windpipe beneath the voice box. It becomes enlarged in a condition known as Hashimoto’s thyroiditis, the most common cause of adult hypothyroidism.

As you recall from the last posting, when the thyroid function is low, the brain causes a release of TSH, which stimulates the thyroid gland. In order to produce more thyroid hormone, the gland enlarges and the examining physician can feel it.

Babies can be born without a thyroid. I had one such patient when I was in training. The baby was inexplicably limp, and did not cry vigorously like other babies. When given thyroid hormone, she developed normally. Such babies often go undetected, don’t grow and become mentally deficient.

The thyroid gland produces thyroxine, which is T4.  In the tissues, the T4 is converted into the much more active T3. This is often the medication of choice in hypothyroidism. In giving thyroid Hormonal, the physician must adjust the dose, depending on the patients  response. Only after a number of visits is the proper dose found.

Please refer to the Mayo clinic article on hypothyroidism. The use of the TSH as a blood test is also discussed.

—Dr. C.

Mayo Clinic Article

DR. C’S JOURNAL: THYROID STIMULATING HORMONE

Thyroid stimulating hormone (TSH) is one of a series of regulatory hormones to come from the pituitary gland, often called the “master gland“ of the body. Most of the pituitary hormones are released upon signals from the hypothalamus, part of the real master coordinator of the body, the brain.

TSH Instructs the Thyroid gland to produce more Thyroid hormone. When more Thyroid hormone is produced, The increase of Thyroxin in the  bloodstream causes the TSH level to drop.

Our metabolism is full of these servomechanisms which control the level of critical substances. When the thyroid does not function properly, and the thyroid level drops, the TSH is increased. An elevated TSH it is presently the best test we have for hypothyroidism.

Conversely, when there is excessive thyroid activity (hyperthyroidism), the TSH level drops to vanishingly low amounts. Tomorrow the subject will be thyroxin.

—Dr. C.