Thyroid Disorders

9 RISK FACTORS FOR THYROID DISEASE
It is impossible to predict who will suffer from a thyroid disease and who will not. At the same time, there are a number of risk factors which have been associated with thyroid disease. Unfortunately, many of these risk factors are out of your control. If you are serious about thyroid health, you should control as many factors as possible. This list includes 9 risk factors, both within your control and outside of your control.

3 Risk Factors for Thyroid Disease You Can Control

Smoking
Cigarettes contain a dangerous chemical that can adversely affect the thyroid gland because it acts as an anti-thyroid agent. It is known as thiocyanate. There’ve been a studies which have tied cigarette smoking to the increased risk of thyroid disease. For example, it increases severity and side effects of hypothyroidism for people who suffer from Hashimoto’s Thyroiditis. It can also increase the effects of thyroid eye disease as well as reduce the effectiveness of thyroid treatments. While you can lower this risk by no longer smoking, you will still have a higher risk than someone who has never smoked.
Iodine
There are two ways that iodine can increase your risk for thyroid disease. The first is iodine deficiency. It has been directly linked to increasing the risk of hypothyroidism and goiter. Since iodine is added to salt, iodine deficiency is more common among people who restrict their salt intake. On the other end of the spectrum is the use of supplement very high in iodine like Iodoral. An overdose of iodine can increase the risk of autoimmune thyroid disease and hypothyroidism. Fortunately, there are iodine supplements specifically designed to eliminate this risk, since the provide an appropriate amount of daily iodine that would not cause an overdose but give you the physiological amounts of iodine/iodide needed for optimal health.

Foods
There are two primary foods to pay attention to. The first is soy. Soy has been shown in some studies to contribute to hypothyroidism because it can interfere with thyroid hormone absorption in some people. The second is any food high in goitrogens. Giotrogenic foods include radishes, kale, cabbage, and Brussels sprouts. This is only an issue when these foods are eaten raw and in large quantities because they contain a chemical which can promote goiter and potentially cause hypothyroidism.

6 Risk Factors for Thyroid Disease You Cannot Control

Gender
It has been reported that women are 6 to 8 times more likely to develop thyroid disease than men.
Age
As you age, your risk for thyroid disease continually increases. This is particularly true once you reach 50 years of age and beyond.

History
There are two different ways to look at your history. The first is your personal history. If you have already developed a thyroid disease, then your risk for developing another significantly increases. This may sound obvious, but some thyroid diseases resolve on their own and you may not even know that you suffered from it. The second thing to look at is your family history. A family history of having any autoimmune disease will increase your risk of thyroid disease. If you have a family history of thyroid disease, then your risk becomes significantly greater. This is especially true if you have a first-degree female relative suffering from it.

Pregnancy
During pregnancy and during the first year postpartum, the risk of developing an autoimmune thyroid disease and temporary thyroiditis increases.

Stress
Everyday stress, when significant and if you don’t know how to deal with it may affect your thyroid. Major stressors such as death, divorce, or a physical stress such as an automobile accident can trigger autoimmune thyroid disease especially Grave’s disease which causes hyperthyroidism.

Healthcare
There is a growing number of risk factors associated with the healthcare industry.

  • Certain medical treatments and drugs increase the risk of an underactive thyroid. This includes bone marrow transplants, lithium, immunosuppressants, and antiretrovirals – among others.
  • Imaging such as a CT Scan using an iodine-based contrast agent can increase the risk (slightly) of temporary thyroiditis, hyperthyroidism, and hypothyroidism.
  • Removing all or part of the thyroid through surgery normally results in hypothyroidism
  • Exposure to surgical anesthetic can increase your risk of temporary thyroiditis, hypothyroidism, and hyperthyroidism; however this risk only exists during a very short window following exposure.

Hashimoto’s Thyroiditis

What is Hashimoto’s Thyroiditis?
The immune system is supposed to prevent us from getting sick but sometimes it can malfunction and attack our healthy cells causing autoimmune diseases. Hashimoto’s thyroiditis is a chronic, ongoing autoimmune attack on the thyroid gland that causes inflammation and destruction of cells in the thyroid gland. Eventually the damaged thyroid cannot produce sufficient amounts of thyroid hormone. In other words, this condition can cause a constant state of hypothyroidism, or low thyroid. Hashimoto’s thyroiditis actually affects the thyroid gland in different ways. Sometimes the autoimmune attack infiltrates cells and transforms them from their functional form. The attack can also destroy thyroid gland cells all together. Regardless of the effect on the gland and how enlarged the thyroid gland (goiter), which is the consequence of inflammation, the end result may be an underactive thyroid (hypothyroidism). This is the most common cause of hypothyroidism and affects 15-20% of women. Many people, however, who suffer from Hashimoto’s thyroiditis, do not suffer from hypothyroidism.Common symptoms of hypothyroidism are fatigue, weight gain, body aches, constipation, dry skin, brittle hair, hair loss, feeling cold all the time, depression, mental sluggishness, forgetfulness, emotional instability and inability to focus and pay attention. Many people with Hashimoto’s thyroiditis suffer from depression, fatigue and other symptoms even though their thyroid levels are normal.

 
How Common is Hashimoto’s?
Today, the most common autoimmune disease and endocrine disorder is Hashimoto’s thyroiditis. However when it was initially described, it was considered a rare affliction. To celebrate the centennial of Hashimoto’s thyroiditis, the journal, Thyroid, official journal of the American Thyroid Association, published a review of the disease’s pathology cases at Johns Hopkins Hospital and it’s quite interesting! Pathologists looking to understand the disease better kept detailed logs of patient history and diagnoses. Results from Hopkins were similar to reports from Krakow, Poland where approximately 6% of all thyroid surgical specimens done during autopsy found Hashimoto’s Thyroiditis. The occurrence of Hashimoto’s Thyroiditis has increased significantly with time. Currently, Hashimoto’s thyroiditis is the most common autoimmune disease in humans as well as the most common cause of hypothyroidism.

 

The frequency of Hashimoto’s thyroiditis begins to rise significantly around puberty. At menopause women become even more vulnerable to this autoimmune disorder, and this explains why nearly 10-15% of postmenopausal women become hypothyroid. Hashimoto’s thyroiditis is quite common, affecting 10% of the population and women are 5 to 7 times more affected than men. Many patients suffering from Hashimoto’s thyroiditis have normal thyroid function and never become hypothyroid. However, they are at a high risk for becoming hypothyroid at any point in their lives.

 
Diagnosing Hashimoto’s
Hashimoto’s thyroiditis can cause a person to have an enlargement of the gland (i.e.: goiter). If you have Hashimoto’s thyroiditis, you are likely to suffer from symptoms such as fatigue, mood disturbances, and lack of well-being, even if your gland functions properly and your thyroid tests are perfectly normal. The diagnosis of Hashimoto’s thyroiditis can be suspected by your doctor through a manual exam of your thyroid gland and can be confirmed by thyroid antibody tests. Antithyroid antibodies, (chemicals produced by the immune system) are immune markers in the blood and reflect the immune attack on the thyroid gland. They can be tested to diagnose the disorder, however, only 60-80% of patients with Hashimoto’s thyroiditis have positive antithyroid antibodies. The most sensitive antithyroid antibody is anti-TPO antibody (anti-thyroperoxidase). A thyroid ultrasound is a very good test to look at the architecture of the thyroid gland and to establish the diagnosis of Hashimoto’s thyroiditis.

 
Hashimoto’s Under the Microscope
Looking at the thyroid gland under the microscope, scientists can identify the thyroid changes of this disease. Under the low power setting of the microscope immune system components called lymphocytes that are invading the thyroid gland can be seen. Zooming in on the tissue that’s affected with this disease is where lesions in the tissue can be seen. These lesions are where the healthy thyroid cells have changed to a different kind of cell called Hurthle cells or have died.

 

 
Iodine and Hashimoto’s Disease
There seems to be a relationship between dietary iodine and Hashimoto’s Thyroiditis. Research in China and Denmark indicated that Hashimoto’s was more prominent in populations with an excessive amount of iodine intake. Exactly how increased iodine induces Hashimoto’s is still being explored. Do not take supplements containing very high amounts of iodine, since this can trigger or worsen Hashimoto’s thyroiditis.

 

 
What should you do If you have Hashimoto’s thyroiditis?
Currently, there are several treatment options if you have any indication of low thyroid, even minimal, you may benefit from thyroid hormone medication which will help rebalance your thyroid hormone levels affected by Hashimoto’s and will help relieve symptoms.

  • Have your thyroid hormone levels rebalanced with thyroid medication such as Levothyroxine (i.e. Synthroid, Tirosint, Armour Thyroid, or other T4/T3 combination treatment)
  • Avoid iodine excess (especially from high iodine supplements and kelp)
  • Keep the thyroid gland and the immune system healthy with healthy nutrition (See: The Thyroid Solution Diet), taking the right amount of antioxidants, selenium, vitamin D and Omega 3 fatty acids.
  • Effective weight loss long term (obesity makes people more prone to having this condition)
  • Inform your relatives so that they can be tested and follow the lifestyle changes listed above.

Does Your Child Have Hashimoto’s Thyroiditis?
Genetic predisposition and environmental factors can trigger Hashimoto’s thyroiditis in children. If you have Hashimoto’s, your child is at a higher risk for having Hashimoto’s thyroiditis. Hashimoto’s thyroiditis many times leads to hypothyroidism and a simple T4 blood test can determine the level of hypothyroidism. For children with hypothyroidism who experience symptoms, treatment with levothyroxine is recommended with thyroid testing done regularly.

 
Graves’ Disease
Graves’ disease is also an autoimmune condition that typically results in overactive thyroid and affects one to two percent of the population. The antibodies that attack the thyroid, (thyroid stimulating antibodies) stimulate the thyroid gland and make it produce excessive amounts of thyroid hormone. The damaging antibodies of Graves’ disease can also attack the eyes. Graves’ eye disease, also called thyroid Orbitopathy, is the result of inflammation of the structures around the eyes, including the eye muscles. The most common cause of hyperthyroidism in both men and women is Graves’ disease. Graves’ disease is also 5 to 7 times more common in women than men. Blood tests that indicate the presence of Graves’ disease are high thyroid hormone levels, a high radioactive iodine uptake levels, and low TSH levels. Doctors can also perform a neck check for the presence of a goiter, which indicates an autoimmune thyroid disorder. A person with Graves’ disease could suffer from a sore thyroid. Sometimes Hashimoto’s thyroiditis takes over, making the person become hypothyroid soon thereafter. People with Graves’ disease typically suffer from hyperthyroidism and its consequences, such as an increased risk for cardiovascular disease and losing weight. Just like with hyperthyroid patients, people with Graves’ disease need to be aware that their metabolism may speed up, but then it will eventually lose effectiveness and possibly result in weight gain. Treatment of Graves’ disease ranges from taking medication or radioactive iodine treatment to destroy a portion of the gland to removal of part of the gland through surgery.

If you have an autoimmune thyroid disorder, you are prone to have other autoimmune conditions
Having Hashimoto’s Thyroiditis or Grave’s Disease makes a person become more vulnerable to having immune attacks on several parts of your body including the adrenal glands, the connective tissue (i.e. joints), muscles, pituitary, skin, GI tract and even the brain.

  • Immune attacks on the adrenals can cause adrenal insufficiency which results in fatigue, weight loss, depression, GI symptoms and low blood pressure. A severe form of adrenal insufficiency is called Addison’s Disease. If you have this condition, your skin becomes darker or hyper pigmented. Mild forms of adrenal insufficiency cause primarily fatigue.
  • Vitiligo is a loss of pigmentation of the skin. It could be in spots or more diffused. It is the result of an attack of the immune system on the skin.
  • Celiac Disease and gluten sensitivity, autoimmune reactions, causing inflammation in the GI tract and in your body are caused by sensitivity to gluten. They are much more common in patients with thyroid disease than in the general population.
  • Other autoimmune disorders which are much more common among thyroid patients are:
      • Type I Diabetes (immune attack on beta-cells of the pancreas)
      • Multiple Sclerosis
      • Pernicious Anemia
      • Myositis
      • Lupus
      • Rheumatoid Arthritis
      • Sjorgens Syndrome
      • Chrons Disease
      • Ulcerative Colitis
      • Autoimmune Hypophysitis (attack on the pituitary gland)

Hypothyroidism

What Causes Hypothyroidism?
You can become hypothyroid as a result of Hashimoto’s thyroiditis, the autoimmune condition that can destroy your gland over time and make your T3 and T4 levels decline gradually. You can also become hypothyroid as a result of the treatment of Graves’ disease. An underactive thyroid can also be caused by surgical removal of part or all of the thyroid gland. It can also be caused by other types of inflammation of the thyroid, such as subacute thyroiditis (a viral illness that can damage the thyroid gland), and silent thyroiditis (another form of immune attack on the thyroid gland). Postpartum thyroiditis, radiation to the head and neck, deficiency of iodine, and deficiency of important nutrients, such as selenium, can also make your thyroid slow down. Some medications and disorders of the hypothalamus, or pituitary gland, can also result in hypothyroidism.

 

Most Common Physical Symptoms of Hypothyroidism:

  • Fatigue
  • Weight Gain
  • Aches and pains in joints and muscles
  • Constipation
  • Dry and itchy skin
  • Brittle hair
  • Hair loss, including loss of eyebrow hair
  • Feeling cold even in warm temperatures
  • Milky discharge from breasts
  • Infertility
  • Heavy Menstrual Periods

 

Most Common Mental Symptoms of Hypothyroidism:

  • Depression
  • Mental sluggishness
  • Forgetfulness
  • Increased sleepiness
  • Emotional instability
  • Inability to focus and pay attention
  • Irritability

 
Hypothyroidism and Menopause
Menopause is defined as the end of the menstruation cycle in women, typically in their late 40’s or early 50’s. Levels of estrogen in the body fall during this time and this fall of estrogen can result in symptoms such as decreased libido, night sweats, hot flashes, depression, and mood swings. Having hypothyroidism, even low-grade, while going through menopause or after menopause can make menopausal symptoms worse. Menopausal women are also more likely to become hypothyroid than women in their reproductive years. In fact, research has shown that as many as 10 to 15 percent of menopausal women have hypothyroidism. Hypothyroidism symptoms and menopause symptoms can be similar. For this reason, any women going through menopause that has symptoms and lower quality of life should be tested for hypothyroidism. Menopause can also make symptoms of hypothyroidism worse. It is also more likely for thyroid patients to experience more menopausal symptoms than non-thyroid patients.
Hypothyroidism in Children and Adolescents
Children and adolescents can be affected by hypothyroidism as well. The symptoms are more or less the same as in adults; however, pay attention to concentration and attention issues, low-grade depression and weight gain. It is interesting that at puberty, the occurrence of hypothyroidism in girls increases. Hashimoto’s Thyroiditis is the most common cause of hypothyroidism in children and adolescents. As a mother, if you have been diagnosed with hypothyroidism, you should have your child tested if they start experiencing any symptoms suggestive of low thyroid. Research has shown that children and adolescents of mothers diagnosed with hypothyroidism are more likely to be hypothyroid than children and adolescents of mothers with normal thyroid. For more accurate diagnosis, the upper limit of the normal range for TSH levels should be lower in children and adolescents.
Subclinical Hypothyroidism in Children
Around 2% of the population’s children is affected by subclinical hypothyroidism. Children with subclinical hypothyroidism may progress to more severe hypothyroidism and therefore experience delayed growth and brain development. It may be beneficial to start the child on thyroid medication if they have symptoms. If they do not have any symptoms then treatment may not be necessary.
Thyroid Function in Small Newborns
Delayed growth of newborn babies can result from decreased levels of thyroid hormone. These babies are described as small gestation age. These infants are born with lower T4 levels than healthy infants. For these babies it is important to begin thyroid medication to normalize the growth rate and prevent hypothyroidism.
How to Detect and Treat Congenital Hypothyroidism>
Congenital hypothyroidism, or a baby born with hypothyroidism due to improper thyroid gland development or no thyroid gland development, is a condition that causes delayed mental and physical development. Screening is typically done a few days after birth to prevent any permanent damage. Treatment with levothyroxine needs to begin promptly at diagnosis of congenital hypothyroidism. With treatment, the child should develop normally and not suffer any lasting effects.

Hyperthyroidism

What Causes Hyperthyroidism?
Graves’ disease is the most common cause of hyperthyroidism. In this condition, the immune system sends signals to the thyroid to make it produce excessive amounts of thyroid hormone. Other causes of hyperthyroidism are autonomous thyroid nodules (nodules that take over the function of the gland and produce excessive amounts of thyroid hormones) and multinodular toxic goiters (several hyperactive nodules that produce too much thyroid hormone). Silent thyroiditis and subacute thyroiditis typically cause high thyroid hormone levels for a few weeks due to release of preformed T3 and T4 caused by the inflammation. The transient hyperthyroidism is typically followed by underactive thyroid and then restoration of normal thyroid function in most people. Many patients with subacute thyroiditis or silent thyroiditis will continue to have some deficiency in thyroid hormone, often minimal, that can affect them.

Most Common Physical Symptoms of Hyperthyroidism:

  • Weight loss
  • Fatigue
  • Shakiness
  • Restlessness
  • Feeling hot and becoming intolerant of warm temperatures
  • Hair loss
  • Eye irritation
  • Increased sweating
  • Rapid heartbeat
  • Irregular menstrual periods
  • Decreased fertility
  • Increased frequency of bowel movements

 

Most Common Mental Symptoms of Hyperthyroidism:

  • Anxiety
  • Panic attacks
  • Depression
  • Paranoia
  • Aggressive behavior
  • Emotional withdrawal
  • Emotional mood swings

 
Fibromyalgia and Thyroid
Both hypothyroidism and hyperthyroidism can cause Fibromyalgia symptoms and even full blown Fibromyalgia Syndrome. Bonafide Fibromyalgia is often the result of a thyroid imbalance and even if the thyroid gland functions properly, this disorder can be the result of thyroid hormone resistance in some tissues and in particular the connective tissue. Fibromyalgia causes pains and aches in different areas over certain spots in the body called “tendor points”. Other symptoms include: sleep disturbances, and depression.

 

SUBCLINICAL HYPERTHYROIDISM

 
What is Low Grade Hyperthyroidism and Health consequences
 

People suffering from significant hyperthyroidism for an extended period of time may develop heart disease, bone loss, osteoporosis and cardiac arrhythmias. However, research has shown discordant results with respect to low grade hyperthyroidism causing heart disease and fractures. Low grade hyperthyroidism, also called subclinical hyperthyroidism, is a conditionthat shows up as low TSH normal T3 T4. Low grade hyperthyroidism may be caused by Graves’ disease, toxic nodules, or overdose with thyroid hormone from treatment.

 

Recently, researchers in Scotland studied a large number of patients with subclinical hyperthyroidism and showed that these patients are more prone to having cardiovascular disease, cardiac arrhythmias, fractures, and dementia. However, these patients do not have an increased risk of cancer. The advantage of this study is that it looked at a large number of people and the follow-up was long term. This research and older research show that low grade hyperthyroidism (minimal thyroid hormone excess) should not be taken lightly and should be treated or addressed.

 

How commonly does low grade hyperthyroidism progress to a more severe hyperthyroidism over time?

 

Low grade hyperthyroidism, or subclinical hyperthyroidism, is a condition often caused by Graves’ disease or multi-nodular toxic goiters. Hyperthyroidism caused by Graves’ disease may evolve into a more severe hyperthyroidism over time. A study which evaluated patients with subclinical hyperthyroidism over a 6 year period found that 8% of these patients became more severely hyperthyroid after one year of follow-up. After 2 years, 16% had become more severely hyperthyroid and after 5 years, as many as 26% had become more severely hyperthyroid. If you have low grade hyperthyroidism, or subclinical hyperthyroidism, and your physician has elected to not give you any therapy, you need to know, as illustrated by this research, that you need frequent monitoring to make sure that your T3 and T4 levels have not worsened over time.

 

When Graves’ disease is the cause of subclinical hyperthyroidism, it is the activation of the immune attack on the thyroid that explains the worsening. As a thyroid patient, always remember to take good care of your immune system with healthy nutrition, relaxation techniques, vitamins and antioxidants, as well as Omega 3 fatty acids.

 
Subacute Thyroiditis
Subacute thyroiditis occurs when a viral infection temporarily destroys the thyroid gland, resulting in transient hyperthyroidism. You can often see characteristics of this condition: fever and pain in your neck area and possibly as far as your ears. The common cold, mumps, and measles, amongst other viruses can cause subacute thyroiditis. A third of patients with subacute thyroiditis suffer from intense pain and severe inflammation in the thyroid gland. In some cases of subacute thyroiditis, patients become hypothyroid after treatment of the original condition.

 
Silent Thyroiditis
Silent thyroiditis is a temporary immune attack on the thyroid gland that causes hyperthyroidism, which is often mild and only lasts for a few weeks. In some cases the hyperthyroidism can continue for as long as three months. Sometimes hypothyroidism follows the initial stage of hyperthyroidism. Silent thyroiditis enlarges the thyroid glands. It can make you suffer from fatigue, irritability, increased appetite, increased heart rate, or any symptom of hyperthyroidism.

 
Postpartum Thyroiditis
Nearly 5 to 8% of pregnant women suffer from a thyroid imbalance after delivery of their baby. Most women who suffer from postpartum thyroid conditions begin to experience transient state of hyperthyroidism for two to three months before they switch into a state of hypothyroidism. In most cases, hypothyroidism goes away after a few weeks to a year, but sometimes women continue to suffer from thyroid imbalance. What happens to a woman’s body after giving birth is a drop in estrogen and progesterone, and this provokes low mood or further depression. As the depression worsens, and the responsibilities of motherhood stress out the woman, the immune reactions heighten. This is why women sometimes experience autoimmune attacks in the postpartum stage. When the thyroid antibodies initially attack, the thyroid starts releasing too much hormone in the blood stream, later the thyroid cannot produce enough thyroid hormone. Some women have a higher chance of an autoimmune attack in the postpartum period, because they already have some thyroid antibodies throughout pregnancy. Postpartum thyroid issues need to be addressed to ensure that the temporary imbalance does not become a permanent issue. The ideal treatment for postpartum thyroid imbalance needs to include supplementation with antioxidants, in particular selenium, and should address postpartum stress and depression.

 
Thyroid Nodules
 

Nodules, or “lumps” in the thyroid gland, are quite common. Lumps that can be felt by your doctor during an examination are found in at least five percent of people. Most nodules are benign and only fifteen percent are cancerous. There are two types of nodules – the ones that do not pick up radioactive iodine on a thyroid scan are called “cold” and do not cause thyroid imbalance. However, these are the nodules that would be more likely to be cancerous.

 

Hyperactive thyroid nodules or “hot” nodules are much less common than cold nodules. They tend to cause hyperthyroidism and are almost never cancerous.

 

If you have a thyroid nodule and your TSH is normal, that indicates that most likely you have a cold nodule and the next step should be an ultrasound guided fine needle aspiration biopsy. You are at a higher risk of having thyroid cancer if you received radiation treatment to the neck or if you were exposed to radiation when you were a child. Men with a thyroid nodule have a higher chance of thyroid cancer than women. If your thyroid nodule increases over time, this could be an indication that you have thyroid cancer. Remember that a Fine Needle Aspiration Biopsy is not always 100% full proof. Small nodules, less than one centimeter, are found in more than ten percent of people, and are typically detected by ultrasound or other imaging procedures of the neck. Like big nodules, some small nodules may be cancerous. Insist on having proper follow-up on your nodule regardless of the size.

 

New Guidelines for nodules and differentiated thyroid cancer management

 

The American Thyroid Association has updated and revised the guidelines for managing patients with thyroid nodules and differentiated thyroid cancer. For individuals with thyroid nodules the guidelines have now been updated and include ultrasound criteria, managing benign thyroid nodules, and initial evaluation. For thyroid cancer, several new guidelines are provided pertaining to surgery management, suppression therapy, radioiodine remnant ablation, and laboratory testing as well as ultrasound surveillance.

 
Thyroid cancer
 

The frequency of thyroid cancer has been increasing in recent years. There are different kinds of thyroid cancer:

 

Well-differentiated thyroid cancer, (papillary and follicular thyroid cancer) or undifferentiated cancer (anaplastic thyroid cancer), which is a very aggressive and rare form of thyroid cancer, and Medullary thyroid cancer.

 

The most common form of thyroid cancer is papillary thyroid cancer. This form of cancer generally grows slowly and is less aggressive. Papillary thyroid cancer accounts for seventy percent of all thyroid cancers. Environmental factors including lack of antioxidants, in addition to genetic factors and external radiation, contribute to the occurrence of thyroid cancer. Papillary thyroid cancer can run in your family and can occur in conjunction with colon cancer. Beware of this genetic association!
Medullary thyroid cancer can also affect individuals or certain families. When it is familial, other types of endocrine tumors can occur at the same time. For instance, some patients may have MEN (multiple endocrine neoplasia). The endocrine tumors that can occur along with medullary thyroid cancer are pituitary tumors, pheochromocytoma, and parathyroid tumors, which can cause blood calcium levels to become high.

 

Treatment of well differentiated thyroid cancer should always include a thyroidectomy, which is removal of the thyroid gland, followed by a treatment with radioactive iodine. Monitoring of papillary and follicular thyroid cancer requires periodic measurement of the Thyroglobulin level (a blood marker for residual thyroid cancer). An ultrasound of the neck to look for suspicious neck lymph nodes and whole body survey scans using radioactive iodine are also important techniques to search for cancer spread. The treatment of medullary thyroid cancer is essentially surgical removal of the thyroid gland.

 

Why is Thyroid Cancer becoming more common?

 

Recent reports have been issued that suggest that there has been an upward trend in thyroid cancer the past thirty years. The diagnosis of thyroid cancer is in fact increasing at the fastest pace compared to other cancers. One reason for the increase is the fact that there is more screening being done and definitely more tests being run to detect thyroid cancer, but this is definitely not the sole contributor to the increase. Certainly, technology is much more efficient and able to detect and diagnose thyroid cancer than before. But many other factors may play a role in the thyroid cancer increase such as the patient’s genetics, diet, obesity, radiation exposure, and environmental pollution.
Thyroid Problems in Men
Although thyroid disease is much more common among women than men, it should be suspected in any man who has a genetic predisposition of family history of thyroid disease and who complains of symptoms of hyperthyroidism or hypothyroidism. Fatigue, dry skin, constipation, and decreased libido and even erectile dysfunction can be the result of thyroid imbalance in men. Thyroid nodules are also less common than in women-that is why when a man is diagnosed with a thyroid nodule, the probability of cancer is higher than in women.
Thyroid Conditions in Children
Children can have many of the same thyroid conditions present in the adult population. Graves’ disease resulting in hyperthyroidism is fairly rare in the pediatric population. When it does occur, treatment with Methimazole is recommended and sometimes surgery as well. Children can also develop thyroid nodules. These nodules are often malignant and require surgical removal.