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A Simple Guide to Thyroid Disorders: From Diagnosis to Treatment
A Simple Guide to Thyroid Disorders: From Diagnosis to Treatment
A Simple Guide to Thyroid Disorders: From Diagnosis to Treatment
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A Simple Guide to Thyroid Disorders: From Diagnosis to Treatment

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Do You Have a Thyroid Disorder?

If your doctor has told you that you have a thyroid disorder, perhaps you feel some relief in having pinpointed the source of your troublesome symptoms. As you may know, thyroid ailments often elude a diagnosis since they may mimic other illnesses.

Now that you have a diagnosis, becoming informed will help you receive better health care. The authors, specialists in thyroid treatment, can help you understand both the complex function of your thyroid and how your disorder can best be treated. In A Simple Guide to Thyroid Disorders, they take special care to lay out the basics in a reader-friendly way. Among the topics they discuss:

medical tests you need to diagnose thyroid problems
hypothyroidism...symptoms and treatment
hyperthyroidism...symptoms and treatment
coping with emotional highs and lows
dealing with thyroid-related weight problems
medications and surgeries for thyroid disorders
thyroid nodules and cancers

A Simple Guide to a Complex Disorder
LanguageEnglish
Release dateFeb 1, 2012
ISBN9781936374816
A Simple Guide to Thyroid Disorders: From Diagnosis to Treatment

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    Book preview

    A Simple Guide to Thyroid Disorders - Paul Ruggieri

    Table of Contents

    Cover

    Acknowledgments

    Introduction

    Chapter 1

    Understanding Your Thyroid Gland

    The Thyroid Gland

    How the Thyroid Gland Works

    How Thyroid Hormone Is Produced

    Lock and Key Analogy

    How the Body Regulates Thyroid Hormone

    Risk Factors for Thyroid Disorders

    Gender

    Age

    Heredity

    Diet

    Environment

    Chapter 2

    Getting a Diagnosis

    Medical History

    Medication Review

    Physical Examination

    Common Diagnostic Tests

    Thyroid Stimulating Hormone (TSH) Test

    Free versus Total Thyroid Hormone Levels

    Total Thyroxine (TT4) and Free Thyroxine (FT4)

    Total Triiodothyronine (TT3) and Free Triiodothyronine (FT3)

    Thyroid Ultrasound

    Referral to a Specialist

    Your Relationship with the Specialist

    Importance of the Specialist’s Experience

    Tests Commonly Ordered by Specialists

    Antithyroid Antibodies (ATA)

    Thyroglobulin Level

    Calcitonin Level

    Radioactive Iodine Uptake and Scan

    Fine Needle Aspiration (FNA)

    Direct Laryngoscopy

    Barium Swallow

    Computed Tomography (CT) Scan of the Neck

    Chapter 3 Hypothyroidism: The Underactive Thyroid Gland

    Types of Hypothyroidism

    Who Is at Risk for Hypothyroidism?

    Symptoms of an Underactive Thyroid

    Loss of Appetite and Weight Gain

    Fatigue or Depression

    Swelling of Limbs and Puffiness of the Face

    Forgetfulness, Difficulty Concentrating

    Dry Skin

    Brittle Nails and Hair Loss

    Goiter and Hoarseness

    Increased Cholesterol, High Blood Pressure, and Heart Disease

    Anemia

    Sensitivity to Cold

    Constipation

    Slowing Heart Rate and Congestive Heart Failure

    Stiff or Sore Muscles

    Allergies

    Increased Sensitivity to Medications

    Menstrual Cycle Changes

    Increased Frequency of Miscarriages

    Causes of Hypothyroidism

    Hashimoto’s Thyroiditis

    Subacute Thyroiditis

    Postpartum Thyroiditis

    Reidel’s Thyroiditis

    Congenital Hypothyroidism

    Idiopathic Hypothyroidism

    Damage to Brain or Pituitary Gland

    Result of Treatment for Hyperthyroidism

    Medications

    Radiation Exposure

    Dietary Causes

    Chapter 4 Treatment for Hypothyroidism

    Thyroid Hormone Replacement

    Levothyroxine (T4)

    Possible Side Effects

    Liothyronine (Cytomel) T3

    Combination Thyroid Hormone Products (T4 and T3)

    Possible Side Effects

    Response to Medication

    Symptoms That May Require Additional Treatment

    Goiter

    Depression

    Hypothyroidism and Weight

    Chapter 5

    Hyperthyroidism: The Overactive Thyroid Gland

    Who Is at Risk for Hyperthyroidism?

    Symptoms of an Overactive Thyroid

    Rapid Heart Rate

    Nervousness

    Weight Loss

    Hot Flashes or Feeling Warm

    Diarrhea or Frequent Bowel Movements

    Goiter

    Bulging Eyeballs

    Depression and Mood Swings

    Muscle and Bone Weakness

    Changes in Skin, Hair, and Nails

    Menstrual Cycle Changes

    Causes of Hyperthyroidism

    Graves’ Disease

    Thyroid Nodules (Single or Multiple)

    Toxic Adenoma (Hot Nodule)

    Toxic Multinodular Goiter

    Thyroiditis

    Subacute Thyroiditis

    Silent Thyroiditis (Hashitoxicosis)

    Postpartum Thyroiditis

    Excessive Iodine Ingestion

    Overmedication with Thyroid Hormone

    Chapter 6

    Treatment for Hyperthyroidism

    Choosing the Best Treatment

    Antithyroid Drugs (ATD)

    Possible Side Effects

    Assessing the Effectiveness of ATDs

    Radioactive Iodine (RAI)

    Possible Side Effects of RAI

    Assessing the Effectiveness of RAI

    Precautions after RAI Treatment

    Surgery

    Hair Loss during Treatment

    Symptoms That May Require Additional Treatment

    Rapid Heart Rate

    Possible Side Effects of Beta-Blockers

    Bulging Eyes

    Weight Changes with Hyperthyroidism

    Insomnia

    Pretibial Myxedema

    Depression

    Chapter 7

    Thyroid Nodules and Thyroid Cancer

    Who Is at Risk for Thyroid Nodules?

    Causes of Thyroid Nodules

    Characteristics of Thyroid Nodules

    Types of Thyroid Nodules

    Single Nodules

    Hot Nodules

    Cold Nodules

    Complex Nodules

    Multiple Nodules

    Cystic Nodules (Thyroid Cysts)

    Solid Nodules

    Treatment for Hot Nodules

    Radioactive Iodine

    Antithyroid Drugs (ATD)

    Surgery

    Ethanol Injections

    Treatment for Cold Nodules

    FNA and Surgery

    Thyroid Hormone Suppression Therapy

    Thyroid Cancer

    Chapter 8

    Thyroid Surgery

    Who Performs Thyroid Surgery?

    Types of Thyroid Operations

    Thyroid Lobectomy

    Subtotal Thyroidectomy

    Total Thyroidectomy

    Preparing for Surgery

    The Operation

    Possible Complications

    Damage to the Parathyroid Glands

    Nerve Damage

    Other Possible Complications

    Recovering from Thyroid Surgery

    Recovering at Home

    Resuming Daily Activities

    Chapter 9

    Thyroid Disease and Pregnancy

    Detecting Thyroid Disorders

    Effects of Pregnancy on the Thyroid

    Hypothyroidism during Pregnancy

    Testing for Hypothyroidism during Pregnancy

    Treatment for Hypothyroidism during Pregnancy

    Hyperthyroidism during Pregnancy

    Testing for Hyperthyroidism during Pregnancy

    Treatment for Hyperthyroidism during Pregnancy

    Thyroid Nodules during Pregnancy

    Postpartum Thyroid Disease

    What Causes Postpartum Thyroid Disorders?

    Treatment for Postpartum Thyroid Disease

    Resources

    Glossary

    About the Authors

    Copyright 2004 by Paul Ruggieri, M.D. and Scott Isaacs, M.D. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopied, recorded, or otherwise, without the prior written permission of the publisher. For information, write Addicus Books, Inc., P.O. Box 45327, Omaha, Nebraska 68145.

    ISBN# 978-1-886039-63-6

    Cover design by George Foster and Darcy Lijoodi

    Illustrations by Jack Kusler

    Typography by Linda Dageforde

    This book is not intended to serve as a substitute for a physician, nor is it the authors’ intent to give medical advice contrary to that of an attending physician.

    Ruggieri, Paul, 1959-

    A simple guide to thyroid disorders / Paul Ruggieri, Scott Isaacs.

    p. cm.

    An Addicus Nonfiction Book.

    Includes bibliographical references and index.

    ISBN 1-886039-63-1 (alk. paper)

    1. Thyroid gland--Diseases--Popular works. I. Isaacs, Scott, 1967-

    II. Title.

    RC655.R84 2003

    616.4'4--dc22

    2003016226

    Addicus Books, Inc.

    P.O. Box 45327

    Omaha, Nebraska 68145

    www.AddicusBooks.com

    Printed in the United States of America

    Acknowledgments

    I would llike to thank all my patientspast and present for the privilege of being involved in their care. I would also like to acknowledge my patients’ family members. Their love, understanding, and support is vital for ensuring a healthy recovery for patients.

    I wish to thank all the nurses at Charlton Hospital on Atwood 3 and at St. Anne’s Hospital on 1N for taking care of my thyroid patients. I am also grateful for the editorial efforts of Dr. Charles Eils and Dr. Tamer Yacoub toward the completion of this manuscript.

    This book would not have been possible without the efforts of all those involved at Addicus Books. I especially thank Rod Colvin for his uncompromising focus and drive for perfection. I acknowledge Kate Maloy, Mary Campbell, Jane Kenyon, and Susan Adams for their editorial support; and I thank Jack Kusler for his work on the illustrations.

    Finally, I would like to thank my office staff at the Truesdale Clinic for their work and daily efforts in taking care of my patients.

    —Paul Ruggieri, M.D.

    I would like to dedicate this book to my grandmother, Minna Rothberg, who has been on thyroid replacement for over fifty years, and who has been an incredible example of how to live in harmony with thyroid disease. I would also like to thank all of my patients with thyroid disease, who have taught me about its many faces and how illness can be overcome. I would also like to thank my family, Sheryle and Howard Isaacs, and Lori and Chase Johns for their love and support. Finally, I would like to thank my staff at Intelligent Health Center and my office manager, Holyn Ivy for their daily efforts and hard work in taking care of my patients with thyroid disease.

    —Scott Isaacs, M.D.

    Introduction

    If you have been told you have a thyroid disorder, know that you are not alone. Every year, some 20 million Americans receive treament for thyroid problems. If you’re like may of those diagnosed, you probably have a lot of questions. You may wonder what caused the problem . How can your disorder be brought under control? What are the treatment options? What can you do to help yourself?

    In this book, you will find the information you need to better understand your thyroid gland. The thyroid exerts more power over the human body than any other glandular structure; simply stated, it influences every cell in your body. Every organ and every bodily system—cardiac, respiratory, reproductive, circulatory, nervous, skeletal—is affected by this small powerhouse.

    If you have a thyroid disorder, the good news is that most thyroid problems can be treated with conventional medicine so you can live normally. It is our hope that within these pages you will find understandable explanations of thyroid diseases and treatments to help you feel better.

    Chapter 1

    Understanding Your Thyroid Gland

    If you’re like most people, you may not have given much thought to your thyroid gland. Over the years, you’ve probably heard about other people having thyroid problems; but the truth is that most of know very little about this gland. In fact, we usually don’t feel we need to know much about it…until it causes us a problem. Then, many of us want to gain a better understanding of how this small but powerful gland can have such a dramatic impact on our health.

    One in ten Americans is affected by thyroid problems. And unfortunately, as many as half of those people have not been diagnosed. The reasons for the large number of undiagnosed cases include lack of public awareness about thyroid disorders as well as lack of knowledge about the thyroid gland itself. To lay a foundation for a better understanding of thyroid disorders, let’s first examine the thyroid gland and its function.

    The Thyroid Gland

    The thyroid gland is located at the front of your throat, just below your voice box (larynx). It is a light purplish-red, about the size of a hen’s egg, weighs less than three-quarters of an ounce, and is encased in a thin layer of tissue.

    Shaped like a butterfly, the thyroid has wings, or rubbery lobes

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