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“НАШЕ ЖИТТЯ”, БЕРЕЗЕНЬ 2017 WWW.UNWLA.ORG 33 Could It Be My Thyroid Gland? by Ihor Magun, M.D., F.A.C.P. The title of this month’s column is the question that tops the list of most frequently asked ques- tions in the medical world. What makes this an in- teresting question is that it deals with an organ that weighs less than an ounce and measures only about two inches in length. Nonetheless this but- terfly-shaped organ, located at the base of the neck, is quite impressive. Despite its size, the thy- roid gland is a very potent part of the human body that (for better or worse) has quite a bit of influ- ence on how that body works. For starters, the thyroid gland releases hormones that control metabolism (the mecha- nism that dictates how your body utilizes energy) and additionally regulates multiple body func- tions. These functions include heart rate, muscle strength, body weight, body temperature, choles- terol levels, and factors involved in the central and peripheral nervous systems. The gland itself pro- duces, stores, and releases a hormone into the blood stream where it is utilized by the cells of the body. It is controlled by two glands located in the brain—the pituitary gland and the hypothalamus. There is a blood-based communication between the glands in the brain and the thyroid. This com- munication provides and controls balance in the body. Concerns about the thyroid gland are war- ranted because one in one hundred individuals have an overactive gland and five in one hundred have an underactive gland. Women are eight times more likely than men to have a thyroid problem. Moreover, the American Cancer Society has esti- mated that about sixty percent of Americans have a form of thyroid disease and are not aware of this condition because symptoms of overactive or un- deractive thyroid gland can be insidious and sub- tle. Symptoms of an overactive thyroid include fast heart rate, atrial fibrillation, hyperactivity, sensitivity to ambient temperature, hair loss, weight loss, diarrhea and irritability. Graves dis- ease is the most common form of overactive thy- roid followed by a toxic multinodular goiter. Symp- toms of an underactive thyroid can include dry skin and hair, fatigue, depressed mood, excessive sensitivity to cold temperatures, frequent heavy menses, sleeping issues, weight gain, and joint pains. An underactive thyroid may also be the cause of elevated cholesterol that may not be re- sponsive to treatment. Underactive thyroid is the most common form of thyroid disease. Risk factors include in- creasing age, personal history of an autoimmune disease (including type one diabetes mellitus), a history of head or neck irradiation, a history of postpartum thyroiditis, or medications such as lithium or iodine, which are frequently used to treat cardiac arrhythmia. Evaluation for thyroid disease is quite straightforward, and testing for thyroid disease is now a part of healthy adult screening, so make cer- tain you take advantage of this fact and stay cur- rent with your routine medical examinations. Di- agnosis is based on laboratory criteria, but physical examinations are as important as laboratory tests. Any palpable nodules/growths in the thyroid gland require additional radiological modalities and may need an actual tissue specimen via a biopsy. Fortu- nately, modern diagnoses now involve easy and quick outpatient procedures that are now routinely done in a radiology facility. Once the diagnosis of a thyroid abnormality is ascertained treatment can be initiated. This is especially useful in early detec- tion and treatment of thyroid cancer as this cancer can be successfully treated in numerous ways, and there is a ninety-eight percent five year survival rate. Overactive thyroids can usually be treated with medications, however, radioactive iodine therapy may be necessary in certain circum- stances. Underactive thyroids are routinely treated with daily medications. These should be taken first in the morning with a full glass of water and wait- ing about thirty minutes before eating. Almost all individuals with a thyroid con- dition will need treatment for life. Blood samples are periodically drawn and analyzed and any ad- justments to medication changes should be imple- mented a minimum of six weeks after dose adjust- ments. Ingestion of oral thyroid hormones can lead to bone loss (osteoporosis). This risk factor should be discussed with your physician. Thyroid supple- mentation change during pregnancy and doses also need to be adjusted, and these issues are rou- tinely addressed by obstetricians.
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