At 4-5 centimeters long, 2-2.5 centimeters wide, 1-2 centimeters thick, and weighing approximately 20 grams, the thyroid gland is small but mighty. The butterfly-shaped organ, located in the neck, just below the Adam’s apple, produces and stores hormones that help regulate major functions including body temperature, blood pressure, heart rate, and energy level. January is Thyroid Awareness Month, and to learn more about this important gland, Steward Health Care sat down with Dr. Henry He to discuss thyroid health. Dr. He is the Chief of the Division of Endocrinology at St. Elizabeth’s Medical Center in Brighton, Massachusetts.
If you ever wonder why your doctor palpates your neck to check your thyroid gland, it’s because it is one of the most vital organs in your body. The thyroid hormone controls the function of many of the body’s organs through the regulation of metabolism. A shift in thyroid hormone production – either too much (hyperthyroidism) or too little (hypothyroidism) – can have a significant impact on health.
According to Dr. He, approximately 20 million individuals in the United States have thyroid disease, however, about 50% of those affected are unaware. Good communication between a patient and their health care provider can help more people become aware of their thyroid condition and seek the appropriate treatment for it.
“So many people are undiagnosed. Self-awareness is the key,” said Dr. He. “You live with your body 24/7. If you notice anything deviating from the norm, you want to discuss it with a health care provider who knows your overall condition.”
With more and more people taking over-the-counter supplements, including some that contain the vitamin biotin, which can stimulate hair and nail growth, people need to be aware that biotin can interfere with the outcome of their thyroid blood test, oftentimes producing an artificially generated abnormality, Dr. He said. That’s why it’s important for health care providers to know what medications their patients take, including over-the-counter supplements. In addition, sometimes supplements may contain thyroid hormones or metabolites that are not approved by the U.S. Food and Drug Administration however, a consumer may not necessarily be aware of that, or the effect they can have. It is therefore important to know the contents of the supplements, or if needed, discuss them with your care providers.
Dr. He also encourages people to look in the mirror while brushing their teeth or hair to become familiar with how their neck looks so they can be more likely to spot changes such as an enlarged thyroid, which can indicate that the tiny gland is not functioning properly. Other symptoms that can indicate a thyroid dysfunction include fatigue, insomnia, irregular menstrual cycles, hair loss, and dry skin. On their own, the symptoms are generally very non-specific, Dr. He says, but taken collectively, they can paint an important picture for a health care provider and serve as a guide for further investigation and treatment.
There are two types of thyroid disease: functional disease and structural disease. Functional diseases such as hyperthyroidism occur when the thyroid gland produces too much thyroid hormone. Graves’ disease, an autoimmune disorder, is typically associated with hyperthyroidism in young and middle-aged people. At the other end of the spectrum is hypothyroidism, another form of functional disease, which occurs when the thyroid gland does not produce enough thyroid hormone. The autoimmune disorder Hashimoto’s thyroiditis is probably the most common reason for hypothyroidism. Both conditions need to be managed by qualified providers and sometimes need long-term follow-up. Structural disease of the thyroid, on the other hand, includes the presence of thyroid nodules, and sometimes thyroid cancer. Any suspected incidences of thyroid structural disease need to be assessed by an endocrinologist to determine whether surgery is needed, and if so, to make a referral to surgeons who are specialized in thyroid surgery to ensure the best outcome.
“People can have multiple conditions at the same time,” said Dr. He. “This underscores the importance of working with reliable and experienced health care providers to have an individualized plan to fit a patient’s special needs.”
Interestingly, many people may have a genetic predisposition for developing a thyroid condition that runs in the family, however not everyone who carries such gene(s) for a thyroid disorder will develop full blown disease. There may be preventive measures that individuals can take to decrease their likelihood of developing a thyroid disorder, says Dr. He. They include eating a balanced diet, living a healthy lifestyle, maintaining a healthy weight, and developing skills to handle stress.
Overall, Dr. He encourages anyone with questions about their thyroid to talk with their medical provider. “If you notice your thyroid gland function is deviating from your norm and you’re not recovering, maybe it is a good time to discuss it with your health care providers to decide what to do next. At Steward, we have highly qualified providers and specialists that follow the Endocrine Society and American Thyroid Association guidance,” Dr. He said.
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