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Two For You and Your Health by Ihor Magun, M.D. Doctor, Could It Be My Thyroid? T h e th y ro id g la n d is a b u tte rfly -sh a p e d o rg an lo c ate d at th e b ase o f th e n e c k an d can b e d escrib ed as th e b o d y ’s reg u lato r. Its fu n ctio n is to m ak e, sto re and rele ase h o rm o n es w h ich a ffec t m a n y b o d y fu n ctio n s. T h y ro id d isease is o ften o v e rlo o k e d b ec au se it is n o t th a t com m on. T h e ca u se s vary. P eo p le w ith a fam ily h isto ry o f th y ro id d ise ase , ex p o su re to n eck rad ia tio n , o r au to -im m u n e d ise a se s su ch as rh eu m a to id arth ritis m ay be at risk. M o re p re v a le n t in w o m en th an in m en , its clinical p re se n ta tio n can b e v ery subtle. S o m e o f th e ch an g es th e b o d y u n d erg o e s b ec au se o f th y ro id d ise ase can b e p re se n t fo r m o n th s o r even y ea rs b efo re a th y ro id c o n d itio n is su sp ected . T h y ro id d isease m a n ife sts its e lf as h y p o th y ro id ism (u n d er-activ e th y ro id ) o r h y p erth y ro id ism (o v er-a ctiv e th y ro id ). T h e ca u se s o f an u n d er-ac tiv e th y ro id are n o t w ell k n o w n . T h e m o st co m m o n form o f th is d isease is a co n d itio n ca lle d H a sh im o to ’s d isease. A n o v er-activ e th y ro id g la n d is less co m m o n . T h e m o st co m m o n d iso rd e r th a t ca u ses th is d ise ase is G rav es disease. T h e sy m p to m s o f an u n d er-ac tiv e th y ro id are w eig h t gain, dry skin, fo rg e tfu ln ess, o r feelin g co ld o r tired. T h ese sy m p to m s can b e ea sily ex p lain e d by n o rm al aging, an d fo r th is rea so n , m ay n o t be asso cia te d w ith th y ro id d isease. T h e sy m p to m s o f an o v er-ac tiv e th y ro id are u n e x p la in e d w e ig h t loss, h eart p alp ita tio n s, n erv o u sn ess, irritab ility , trem b lin g o f the h an d s, in c re ase d sw eatin g , an d lig h te r m en stru al p erio d s. A classic, b u t o ften o v erlo o k e d sy m p to m , is b u lg in g eyes. U n d iag n o sed an d u n trea ted , h y p erth y ro id ism an d h y p o th y ro id ism ca n lead to o th e r p h y sic al p ro b lem s. A n o v er-activ e g la n d can p ro d u ce h ea rt arrh y th m ias, esp ecially a co n d itio n called atrial fib rillatio n . It can also ca u se b o n e loss, le ad in g to o steo p o ro sis. A n u n tre a te d u n d e r-a c tiv e g lan d can cau se d ep ressio n , w ea k n ess a n d ch ro n ic fatigue. D iag n o sin g th y ro id a b n o rm a lities req u ires a sim p le b lo o d test. M y re c o m m e n d a tio n is a b aselin e sc reen in g b y ag e fifty fo llo w ed b y p erio d ic screen in g s th ereafter. F am ily h isto ry an d sy m p to m s su g g e stin g th y ro id d y sfu n ctio n sh o u ld p ro m p t ea rlier an d m o re freq u en t testing. T re atin g an u n d e r-a c tiv e th y ro id g land req u ires life -lo n g m e d ica tio n . P erio d ic b lo o d tests are n ec essary to a d ju st h o rm o n e req u irem en ts. T reatm en t o f an o v e r-a c tiv e th y ro id g la n d u su a lly in v o lv es rad io a ctiv e iodine. T h is e v e n tu a lly d estro y s th e g land co m p letely an d iro n ic ally , p atien ts b ec o m e “u n d er ac tiv e” an d re q u ire life -lo n g th y ro id rep lacem en t therapy. A t th is p o in t, m a n y rea d ers m ay w o n d er w h eth e r th e ir w e ig h t p ro b le m s m ay be th y ro id related. I f th e w e ig h t p ro b le m is ac co m p an ie d by other sy m p to m s, a b lo o d te st sh o u ld p ro b a b ly be o b tained. A las, a th y ro id co n d itio n is rarely th e reaso n for w eig h t p ro b le m s a n d h o p in g to so lv e w eig h t p ro b lem s th ro u g h th y ro id m e d ic a tio n is w ish fu l th in k in g th at is n eith er lo g ical n o r p rac tica l. A sk y o u r p h y sician . Stereotactic Breast Biopsy A 21st Century Approach W id e sp re a d p u b lic co n c ern ab o u t b reast ca n cer has h ad a p o sitiv e im p a ct on d iag n o sis and trea tm e n t m e th o d s. M o re w o m en th an ev er are d oing b rea st se lf-e x a m in a tio n s an d are h av in g the rec o m m en d e d m a m m o g ra p h ic screen in g s. A n ew d e v e lo p m e n t th a t is cu rren tly av ailab le to w o m en is a so p h is tic a te d co m p u te r g u id an ce system th at p erm its a m in im a lly in v a siv e b rea st b io p sy . T he en tire p ro c e d u re ty p ic a lly lasts an h o u r an d can be p erfo rm ed w ith lo cal an esth esia. T h e b io p sy its e lf is p ain less, b u t th e a d m in istra tio n o f th e local an esth etic can ca u se so m e d isc o m fo rt to th e n ec k o r shoulders. D u rin g th e p ro ce d u re , th e c o m p u ter system tak es tw o im ag es o f a b re a st lesion. It is th en ab le to p o sitio n th e b io p sy d ev ice w ith an ac cu racy o f 1 to 2 m illim eters. A sm all in c isio n (3 to 4 m illim e te rs) is m ade, th e p ro b e is p o sitio n e d an d th e ta rg e ted b reast tissu e is re m o v e d fo r b io p sy . T h is p art o f the p ro ce d u re tak es a b o u t th ree m in u tes an d req u ires th at th e p a tie n t re m a in p e rfe c tly still w ith th e arm raised ab o v e th e sh o u ld er. It is im p o rta n t to n o te th a t n o t all lesio n s are am en a b le to th is ty p e o f b io p sy an d th at a su rg eo n sh o u ld d e te rm in e w h e th e r th e p ro ce d u re is ap p ro p riate on a ca se b y case b asis. S tereo tactic b re a st b io p sy eq u ip m en t is read ily a v ailab le an d o ffe rs a u se fu l n ew d ia g n o stic to o l for b reast can cer. F o r m a n y in d iv id u als, th is m in im ally in v asiv e te c h n iq u e w ill m ak e d ia g n o sis an d treatm en t m u ch easier, an d w ill also p ro v id e m o re h o p e o f cu rin g a d e v a sta tin g d isease. Видання C оюзу Українок A мерики - перевидано в електронному форматі в 2012 році . A рхів C У A - Ню Йорк , Н . Й . C Ш A.
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