Most Common Diseases of 50 Plus - Thyroid Diseases III - Thyroid Adenoma: Preventions, Managements and Treatments

Most common diseases of 50 plus Thyroid Diseases III
Thyroid Adenoma: Preventions, Managements

and Treatments
By Kyle J. Norton
Health article writer and researcher; Over 10.000 articles and research
papers have been written and published on line, including world wide health,
ezine articles, article base, healthblogs, selfgrowth, best before it's news, the
karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO
READ by Disilgold.com Named 50 of the best health Tweeters Canada Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as
international journal Pharma and Bio science, ISSN 0975-6299.
Thyroid disease
Thyroid disease is defined as a condition of malfunction of thyroid gland.
Thyroid disease: Thyroid adenoma
Thyroid adenoma is a benign tumor started in the layer of cell lined the inner
surface of the thyroid gland. The disease is relatively common among adults
living in the United States. Most thyroid nodules are Thyroid adenoma.
A. Risk factors
1. According to the study by the University of Campinas
a. Graves disease
The prevalence of thyroid nodules and thyroid carcinoma in Graves'
disease was 27.78% and 5.05%, respectively.
b. Older age with larger thyroid volumes are associated to increased risk of
nodules.
c. Younger age and larger thyroid volume are associated to risk of thyroid
carcinoma.
d. In patient with Hashimotos thyroiditis, the prevalence of thyroid nodules
and carcinomas was 50.7% and 7.8%, respectively(8).
2. Metabolic syndrome
Metabolic syndrome such as hypertension, prediabetes and diabetes was all

associated to independent risk factors for thyroid nodules(TN) after
adjustment for sex, age, body mass index, blood lipid levels, smoking status,
and alcohol consumption(10)
4. Insulin resistance (IR)
According to the study by the Baskent University Faculty of Medicine,
patients with impaired glucose metabolism have significantly increased
thyroid volume and nodule risks(11)(12).
5. BRAF mutations
BRAF mutation (BRAFmut) was significantly associated with increased risk
of thyroid lesions including Hashimotos thyroiditis, nodular goiters,
hyperplastic nodules, follicular adenomas (FA), etc., according to the study
by the King Abdulaziz University(13).
B. Causes
1. Iodine deficiency and excess
Iodine, as a trace element, is essential for thyroid gland to produce thyroid
hormones thyroxine (T4) and triiodothyronine (T3). According to study,
iodine deficiency can cause hypothyroidism, developmental brain disorders
and goiter, leading to mental retardation and brain damage as well as
induced miscarriages, stillbirths, and other complications in in pregnant
women(4). On the other hand, iodine excess induced colloid goiter, the
benign, noncancerous overgrowths of thyroid tissue with diagnosis of
normal serum T4 and slightly decreased TSH. Depending to the severity of
iodine deficiency or extent of iodine excess, each condition has a different
thyroid tumor promotion mechanism(5).
2. Radiation therapy
Patients received radiotherapy to the head, neck, and upper thorax are
at increased risk of developing subsequent thyroid malignancies, according
to the University of Western Ontario(6).
3. Hashimotos thyroiditis
B-Raf protein is responsible for cell signalling inside cells in regulation
of cell growth.
According to the study by the University of Crete, deregulation of B-Raf
showed to postpone onset of benign and malignant thyroid disease by more
than 10 years(7).
C. Symptoms
Most people with thyroid adenoma are experience no symptoms. Symptoms
may include the below, if the tumor has been growth large enough to
interfere the function of nearby cells or organs or if it is a functional tumor,
which produce excessive thyroid hormone to cause hyperthyroidism.
1. Difficulty breathing and swallowing
If the tumor is growth large enough, it may interfere with breathing of the
lung such as partial blocking the air way or the food passing to the pharynx.
2. Voice changes
If the tumor is growth large enough, it may interfere with the voice box.
3. Neck pain
If the tumor is growth large enough, it may suppress the nerve cell in the
neck.
4. Hypertension
Hyperthyroidism is associated with unpleasant symptoms and hypertension
due to increased adrenergic tone, according to the study by the Harran
University Faculty of Medicine(1).
5. Other symptoms
Depending to the age of the patients with thyroid adenoma, the presence of
hyperthyroidism may be experience certain symptoms of tachycardia,
fatigue, and weight loss, hyperactive reflexes, increased sweating, heat
intolerance, tremor, nervousness, polydipsia, and increased appetite,
anorexia, atrial fibrillation and goiter, according to the study by the Centre
Hospitalier et Universitaire de Rouen(2).
6. If thyroid adenoma is presented in people who have Hashimotos
disease
According to the article by Dr. Bethany Taylor, posted in Steadyhealth,
patients with Hashimotos disease may experience general muscle slowdown leads to tiredness, while reduced body metabolism causes dry skin,
hair loss, constipation and weight gain. Joints commonly swell up, while
shortage of breath may develop due to effects on the heart. In women,
periods may become heavy and slower brain activity might result in memory
loss or poor concentration. Youngsters may fail to grow and may not do well
at school(3).
D. Complications and Disease associated to Thyroid adenoma
D.1. Complications
Hyperfunctioning nodules of the thyroid, found mostly in younger and
predominantly female population contribute to 3% of thyroid cancer,
according to the University of Texas Southwestern Medical Center(14).
D.2. Disease associated to Thyroid adenoma
1. Laryngopharyngeal primary squamous cell carcinoma
Laryngopharyngeal primary squamous cell carcinoma is found to coexist
with thyroid nodules in some patients and patients with advanced
malignancy of the upper aerodigestive tract(15).
2. Gastric adenocarcinoma than urine iodine level
Iodine deficiency, is more likely to be associated with gastric
adenocarcinoma compared to the existing iodine deficiency itself(16).
3. Papillary thyroid carcinoma
Although thyroid nodules are less common among children than among
adults, In children cwith thyroid cancer, the finding of a thyroid nodule is
20%, according to the study by the University of Pittsburgh Medical
Center(17).
E. Misdiagnosis
1. Hyalinizing trabecular tumors (HTT)
Hyalinizing trabecular tumors (HTT) are very rare and difficult diagnosed
thyroid tumors. The disease in some cases are misdiagnosed as papillary
carcinoma initially(18).
2. Totally cervical thymoma
Totally cervical thymoma arised from ectopic thymic tissue is extremely rare
. In some case it may be misdiagnosed as a thyroid nodule(19).
3. Papillary thyroid carcinoma (PTC)
Papillary thyroid carcinoma (PTC) may be diagnosed as papillary thyroid
carcinoma (PTC) by FNA cytology(20).
4. Pharyngoesophageal diverticulum
A pharyngoesophageal diverticulum can be mistaken for a thyroid nodule on
ultrasound scan as a result of nonthyroidal lesions can mimic thyroid

nodules on imaging, according to the study by the Alexandra Hospital,
Singapore(21).
5. Primary thyroid paraganglioma
Thyroid PGs are exceptionally rare tumors. In some cases, the diseases were
misdiagnosed as medullar thyroid carcinoma (MTC) due to its anatomically
mimic MTCs(22).
6. Anaplastic thyroid cancer
Riedels thyroiditis with a rapidly growing, hard, fixed, thyroid mass may
mimic anaplastic thyroid cancer(23).
7. Hodgkins lymphoma
Hodgkins lymphoma of the thyroid is rare and can mimic a primary thyroid
epithelial tumor or thyroiditis clinically(24).
F. Diagnosis
After recording the past and present history and completing a physical exam,
including searching the nodule in the surrounding tissue and abnormal
lymph nodes nearby. The tests ordered may include
1. Blood test
The aim of the test is to measure the level of thyroid stimulating hormone
(TSH) and free thyroid hormones (FT4 and FT3), anti-thyroperoxidase
antibodies (anti-TPO), stimulating antibodies (TSI) levels for exclusion of
other thyroid diseases(25).
2. Echography and Thyroid scintigraphy
Echography is the first line examination to evaluate thyroid nodules by
providing information of their structure, as well as abnormalities associated
with thyroiditis. Thyroid scintigraphy not only allows establishing the
functional characteristics of thyroid nodules (warm or cold) but also precises
the origin of a hypothyroidism(25).
3. Ultrasonography
All ultrasound examinations for thyroid nodule should include a malignancy
risk assessment based on tissues or structures nature of the nodule. In
patients with multinodular thyroid gland, precise nodule mapping is
necessary to allow accurately identify the nature of nodule(s) on iodine scan.
Guide fine needle aspiration (FNA) is used for suspicious nodules(26).

4. Fine-needle aspiration biopsy (FNA) and Core needle biopsies (CNBs)
Ultrasound-guided fine-needle aspiration biopsy (FNA)is the most
commonly used diagnostic method for the preoperative diagnosis of thyroid
nodules. Core needle biopsies (CNBs) is used for the diagnosis of papillary
thyroid carcinoma and other non-follicular thyroid lesions and in cases if
FNA finding is suspicious for malignancy(27).
The below sections only apply, if Thyroid adenoma has become
cancerous excepted section of Treatments in conventional medicine.
G. Preventions
G.1. Diet
1. Legumes, organic soy and peanut
Daidzein, is a phytochemical in the Isoflavones, belonging to the group of
Flavonoids (polyphenols), found abundantly in food of the family of
legumes, soy, peanut, etc. Combination of N-t-Boc-hexylenediamine
derivative of 7-(O)-carboxymethyl daidzein (cD-tboc) and cytotoxic drugs
showed to inhibit human thyroid cancer cell growth through deduction of
tumor volume with no apparent toxicity(28).
2. Organic Soybean
An acidic methanolic extract and . Genistein from soybeans inhibited
thyroid peroxidase-(TPO) catalyzed reactions essential to thyroid hormone
synthesis(29).
3. Green tea
Epigallocatechin-3-gallate (EGCG), a major catechin found abundantly in
green tea, showed to possess remarkable therapeutic potential against
various types of human cancer cells including thyroid cancer in vitro and in
vivo models(30).
G.2. Phytochemicals
1. Epigallocatechin-3-gallate (EGCG)
According to the study by University of Calabria, Epigallocatechin-3gallate inhibited cell proliferation and reduced motility of human anaplastic
thyroid carcinoma cells through suppression of EGFR/ERK pathway and
cyclin B1/CDK1 complex in cell division(32).
2. Isoflavone derivatives
Isoflavone derivatives, N-t-Boc-hexylenediamine derivative of 7-(O)carboxymethyl daidzein (cD-tboc) exhibited anti proliferative effect through
increased apoptosis and cell necrosis(death of most or all of the cells),
according to study by the Tel-Aviv University(33).
3. Phytoestrogens
Epidemiological and pathological data suggest that thyroid cancer may well
be an estrogen-dependent disease. Dietary phytoestrogens (including
isoflavones, daidzein and genistein, daidzein lignan, secoisolariciresinol)
containing both estrogenic and antiestrogenic properties, showed to strongly
associate with risk reduction,, according to the present data from a
multiethnic population-based case-control study of thyroid cancer conducted
in the San Francisco Bay Area. Of 817 cases diagnosed between 1995 and
1998(34).
G.3. Antioxidants
1. Alpha-lipoic acid (ALA)
ALA, a potential agent could be used as an adjunctive agent to increase
efficacy of radioiodine therapy if combined with a strategy to increase NIS
protein in transport iodide into follicular cells of the thyroid gland, according
to the study by the University of Ulsan College of Medicine(35).
2. Selenium
According to the study by the Cancer Registry of Norway, mineral selenium
(Se) might reduce the risk of cancer and according to a pre-diagnostic casecontrol study from 1986, patients with low levels of selenium are associated
to increase risk of thyroid cancer(36).
3. Vitamin D
According to study, vitamin D(3), 25(OH)D(3) and 1,25(OH)(2)D(3) all
exhibit antiproliferative effect on two thyroid cancer cell lines(37).
4. Coenzyme Q
Coenzyme Q was found in reduced levels in the thyroid tissue of patients
with Graves disease and follicular and papillary thyroid carcinomas(38).
H. Treatments
H.1. In conventional medicine perspective
1, Watchful waiting
In most cases of benign thyroid nodules, diagnosed by fine-needle aspiration

biopsy differentiating benign from malignant thyroid nodules, your doctor
may suggest only simply watching your condition with regular interval
physical exam and thyroid function tests(39).
2. Radiofrequency ablation
Audio frequency ablation is an effective and well tolerated treatment option
for benign thyroid nodules. Radiofrequency ablation of recurrent thyroid
cancers may be an alternative to surgery in patients at high surgical risk(41).
3. Surgery
If the tumor is growth large enough to interfere with function of nearby
tissues or organs, surgery may be necessary.
5. In case of nodules that cause hyperthyroidism
a. Radioactive iodine
RAI therapy combined with lithium showed a higher cure rate, safe and time
to cure was less than RAI alone(42). Treatment with radioactive iodine in
patients with hyperthyroidism such as Graves' disease patient may induce
swelling of the tissue(40).
b. Medication such as methimazole (MMI)
The aim of the medication is to reduce the symptoms of the disease but
causes serious side effect(42a).
c. Surgery
In some cases if treatment with radioactive iodine or anti-thyroid
medications has not been effective, surgery may be necessary.
H.2. In Herbal medicine perspective
1. Green tea
Epigallocatechin-3-gallate (EGCG), a major catechin in green tea, was
shown to possess remarkable therapeutic potential against various types of
human cancer cells in in vitro and in vivo models(43).
2. Polentilla alba
The main tasks during treatment of hyperplastic thyroid disease is to stop the
growth of thyroid nodules. compensation of hypothyrosis; normalization of
thyroid size. Pphytodrug of Polentilla alba could be recommended for
monotherapy in combination with conservative therapy, according to the

strudy by Kvacheniuk AN and Kvacheniuk EL(44). Polentilla alba in other
study, also showed to reduce the volume of thyroid, normalize its
function(45).
3. Shilajit (Fulvic Acid)
Shilajit is a multi-component natural occurring mineral substance used in
Ayurveda and Siddha systems of medicine originated in India. According to
the article of A NATURAL CURE FOR THYROID NODULES, posted in
Coffeys place, fulvic acid acts as a a chelator and detoxifier of heavy
metals, chemical toxins and radiation from the body for treatment of n
thyroid nodules(46).
H.3. In traditional Chinese medicine perspective
1. Ruanjian Xiaoying Decoction
Ruanjian Xiaoying Decoction (RJXYD), according to Shanghai University
of Traditional Chinese Medicine, showed to shrink and soften the enlarged
thyroid gland and thyroid nodules and improved the immune function of
human(47).
2. According to TCM assistant
a. In case of thyroid nodules as a result of Qi and Blood Deficiency
Xiang Bei Yang Rong Tang with function to tonifiy Qi, regulates the Qi
nourishes Blood and transforms Phlegm.
b. In case of thyroid nodules as a result of stagnation of Dampness,
phlegm, Qi, and Blood in the area between the skin and flesh on the
neck.
Hai Zao Yu Hu Tang with function to transform Phlegm, softens what is
hard, reduce thyroid nodules; Eliminates thyroid nodules.
c. In case of Goiter or thyroid nodules due to a lack of iodine or Phlegm
accumulation
Hai Zao Wan with function to eliminate thyroid nodules and releases the
tension(48).
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References
(1) http://www.ncbi.nlm.nih.gov/pubmed/22571552
(3)
http://www.steadyhealth.com/articles/Hashimoto_s_Disease___Hyperthyroi
dism_a261.html
(17) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933378/
(39) http://www.ncbi.nlm.nih.gov/pubmed/?term=thyroid+nodule+watch
(42a) http://www.ncbi.nlm.nih.gov/pubmed/25178068
(46) http://coffeysplace.blogspot.ca/2010/04/natural-cure-for-thyroidnodules.html
(48) http://www.tcmassistant.com/symptoms/thyroid-nodule.html

Most Common Diseases of 50 Plus - Thyroid Diseases III - Thyroid Adenoma: Preventions, Managements and Treatments

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Most common diseases of 50 plus Thyroid Diseases III

Thyroid Adenoma: Preventions, Managements

Metabolic syndrome such as hypertension, prediabetes and diabetes was all

ultrasound scan as a result of nonthyroidal lesions can mimic thyroid

Guide fine needle aspiration (FNA) is used for suspicious nodules(26).

In most cases of benign thyroid nodules, diagnosed by fine-needle aspiration

monotherapy in combination with conservative therapy, according to the

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