HTDS Guide – About Thyroid Disease: Section Summary
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Section Summary
- Thyroid disease is common, especially among older people and women.
- Checking for thyroid disease involves an evaluation of the thyroid by an experienced doctor.
- If you are concerned about exposure to iodine-131 from Hanford or experience thyroid disease symptoms, you should see your doctor for a thyroid evaluation.
The thyroid gland, located in the front of the neck just below the Adam’s apple, takes iodine from the diet and makes thyroid hormone. Thyroid hormone affects a person’s physical energy, temperature, weight and mood.
Thyroid diseases generally fall into two broad groups of disorders: abnormal function and abnormal growth (nodules) in the gland. These problems are common in the general population, especially among older people and women. Most thyroid problems can be detected and treated.
Functional disorders are usually related to the gland producing too little thyroid hormone (hypothyroidism) or too much thyroid hormone (hyperthyroidism).
Benign nodules in the thyroid gland are common and do not usually cause serious health problems. These nodules occur when the cell growth within the nodule is abnormal. Nodules can occasionally put pressure on the neck and cause trouble with swallowing, breathing or speaking if they are too large. The thyroid usually functions normally even when nodules are present.
Thyroid cancers are much less common than benign nodules. With treatment, the cure rate for thyroid cancer is more than 90 percent.
Checking for Thyroid Disease
Checking for thyroid disease is similar to other kinds of medical evaluations. The doctor considers the patient’s medical history, examines the thyroid and may order a blood test or other diagnostic tests.
A standard physical examination of the thyroid gland is done by palpation – that is, feeling the thyroid gland. The doctor feels for the size and texture of the gland, and whether any masses or nodules are present.
Testing for Thyroid Function
There are two standard blood tests of thyroid function: the measurement of thyroid hormone, usually T4, and the measurement of thyrotropin (TSH). TSH is a hormone secreted from the pituitary gland that controls how much thyroid hormone the thyroid makes.
Abnormal blood tests usually reveal thyroid function problems and not the presence of thyroid nodules or cancer.
Testing for Nodules
If a nodule is found during the physical examination, a test called fine needle aspiration (FNA) biopsy may be done to help find out whether the nodule is cancerous or benign. In addition, a thyroid nuclear scan may help the doctor evaluate thyroid function or nodules. The scan is performed by giving the patient a radioisotope and taking a special picture to see how much of the radioisotope is taken up by the thyroid gland.
A thyroid ultrasound scan is a diagnostic test that shows a picture of the anatomy, or structure, of the thyroid gland. Ultrasound is most often used to determine if a nodule is solid or cystic. Cystic nodules, containing only fluid, are usually benign.
Ultrasound is not usually performed as a routine screening test for thyroid nodules in the general population. The reason is that small, nonpalpable ultrasound abnormalities are very common in people without evidence of thyroid disease.
The treatment of thyroid disease depends on many factors, including the type and severity of the thyroid disorder and the age and overall health of the patient. Treatment must be specific to each individual.
- Thyroid cancer is initially treated with thyroid surgery. Many patients also receive further treatment with iodine-131. Patients treated for thyroid cancer require lifelong thyroid hormone replacement.
- The majority of benign nodules do not require treatment. Patients with benign nodules are usually advised to have periodic follow-up examinations.
- Hypothyroidism usually requires only replacement of thyroid hormone by taking a single daily tablet at a dose adjusted to produce normal thyroid hormone levels.
- Autoimmune thyroiditis is a disorder that may cause hypothyroidism. It usually does not cause symptoms that require treatment unless hypothyroidism develops. In such cases, thyroid hormone replacement is required.
- Treatment of hyperthyroidism may include antithyroid drugs, radioactive iodine-131 or in rare cases, thyroid surgery.
If you have received regular health care and have no symptoms of thyroid disease, you may not need to see a doctor to check for thyroid disease. However, if you are concerned about being exposed to iodine-131 from Hanford or experience thyroid disease symptoms, you should see your doctor for a thyroid examination.