Thyroid for Dummies (2 page)

My thanks to Dr. Catherine Bain for the technical editing of the book.

Librarians Mary Ann Zaremska and Nancy Phelps at St. Francis Memorial Hospital were tremendously helpful in providing the articles and books upon which the information in this book is based.

My teachers are too numerous to mention, but one person deserves special attention. Dr. Francis Greenspan at the University of California Medical Center gave me the sound foundation in thyroid function and disease upon which this book is based.

Finally, there are my patients over the last 28 years, the people whose trials and tribulations caused me to seek the knowledge that you will find in this book.

This book is written on the shoulders of thousands of men and women who made the discoveries, tried the medications, and held the committee meet-ings. Their accomplishments cannot possibly be given adequate acclaim. We owe them big time.

From Sarah:
Thanks to Alan L. Rubin, MD, author of the original US version of
Thyroid For Dummies
. The quality of his original script made my job easy, as I had so very little to do when adapting his excellent book for the UK market.

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Publisher’s Acknowledgements

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Contents at a Glance

Introduction .................................................................1

Part I: Understanding the Thyroid..................................7

Chapter 1: Bigging It Up: The Huge Role of a Little Gland.............................................9

Chapter 2: Feeling Fragile: The Emotional Effects of Thyroid Problems...................17

Chapter 3: Discovering How Your Thyroid Works .......................................................25

Chapter 4: Testing Your Thyroid ....................................................................................37

Part II: Treating Thyroid Problems ...............................51

Chapter 5: Dealing with an Underactive Thyroid ........................................................53

Chapter 6: Taming an Overactive Thyroid ....................................................................65

Chapter 7: Getting the Low-Down on Thyroid Nodules...............................................81

Chapter 8: Coping with Thyroid Cancer........................................................................89

Chapter 9: Learning about Multinodular Goitres ......................................................101

Part III: Managing Your Thyroid ................................107

Chapter 10: Taking Care with Drugs That Affect Your Thyroid ................................109

Chapter 11: Spotting Thyroid Infections and Inflammation......................................123

Chapter 12: Overcoming Iodine Deficiency Disease ..................................................133

Chapter 13: Going In: Surgery on the Thyroid Gland.................................................147

Chapter 14: Exciting New Approaches in Thyroid Treatment .................................157

Chapter 15: Living with Thyroid Problems: Diet and Exercise ................................173

Chapter 16: Helping Yourself: Herbs and Homeopathy.............................................197

Part IV: Special Considerations in Thyroid Health .......205

Chapter 17: Examining the Genetic Link to Thyroid Disease ...................................207

Chapter 18: Controlling Thyroid Disease during Pregnancy ....................................221

Chapter 19: Developing Thyroid Conditions in Childhood.......................................233

Chapter 20: Maturing: Thyroid Disease in Later Life .................................................247

Part V: The Part of Tens ............................................257

Chapter 21: Ten Myths about Thyroid Health ............................................................259

Chapter 22: Ten Ways to Maximise Thyroid Health...................................................269

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Part VI: Appendixes ..................................................277

Appendix A: Glossary of Terms ....................................................................................279

Appendix B: Sources of More Information ..................................................................283

Index .......................................................................285

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Table of Contents

Introduction..................................................................1

About This Book...............................................................................................2

Conventions Used in This Book .....................................................................2

What You Don’t Have to Read ........................................................................2

Assumptions .....................................................................................................3

How This Book Is Organised...........................................................................3

Part I: Understanding Your Thyroid.....................................................3

Part II: Treating Thyroid Problems.......................................................3

Part III: Managing Your Thyroid............................................................3

Part IV: Considering Special Aspects of Thyroid Health ...................4

Part V: The Part of Tens.........................................................................4

Part VI: Appendices................................................................................4

Icons Used in This Book..................................................................................4

Where to Go from Here....................................................................................5

Part I: Understanding the Thyroid ..................................7

Chapter 1: Bigging It Up: The Huge Role of a Little Gland . . . . . . . . . . .9

Discovering the Extent of the Problem .......................................................10

Identifying an Unhappy Thyroid ..................................................................11

Recognising Who’s at Risk ............................................................................11

Realising the Importance of a Healthy Thyroid .........................................12

Treating What Ails You ..................................................................................12

Understanding the Consequences of Delaying Treatment .......................14

Giving Your Thyroid a Hand: Healthy Lifestyle Choices ...........................14

Paying Special Attention: Pregnant Women, Children,

and Older People ........................................................................................15

Staying Informed ............................................................................................16

Chapter 2: Feeling Fragile: The Emotional Effects

of Thyroid Problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

Exploring How an Underactive Thyroid Slows Your Thoughts ...............18

Seeing How an Overactive Thyroid Can Trigger Anxiety..........................19

Fighting Depression .......................................................................................20

Finding out if your thyroid is causing depression ...........................21

Using thyroid hormone to treat depression .....................................22

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Thyroid For Dummies

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Chapter 3: Discovering How Your Thyroid Works . . . . . . . . . . . . . . . . .25

Locating the Thyroid .....................................................................................26

Producing Thyroid Hormones ......................................................................28

Identifying the importance of iodine .................................................29

Regulating thyroid hormones .............................................................29

Moving thyroid hormones around .....................................................30

Understanding the Function of Thyroid Hormones ..................................31

General functions .................................................................................32

Specific functions .................................................................................33

Chapter 4: Testing Your Thyroid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37

Checking Blood Levels of Thyroid Hormones............................................38

Total thyroxine .....................................................................................38

Resin T3 uptake ....................................................................................40

Free thyroxine index ............................................................................40

Free thyroxine (FT4) ............................................................................41

Free triiodothyronine (FT3) ................................................................42

Thyroid-stimulating hormone (TSH) .................................................42

Taking Non-Hormonal Blood Tests ..............................................................43

Thyroid autoantibodies .......................................................................44

Serum thyroglobulin ............................................................................45

Determining the Size, Shape, and Content of Your Thyroid .....................46

Radioactive iodine uptake and scan ..................................................46

Thyroid ultrasound ..............................................................................48

Fine needle aspiration biopsy (FNAB) ...............................................49

Part II: Treating Thyroid Problems ................................51

Chapter 5: Dealing with an Underactive Thyroid . . . . . . . . . . . . . . . . .53

Living with Autoimmune Thyroiditis...........................................................54

The extent of the problem...................................................................54

Symptoms of chronic thyroiditis........................................................55

Approach to treatment ........................................................................55

Identifying Hypothyroidism..........................................................................56

Signs and symptoms of hypothyroidism...........................................56

Confusing conditions ...........................................................................57

Pinpointing the Causes of Hypothyroidism ......................................58

Removal of the thyroid ........................................................................58

Absence of brain hormones ...............................................................58

Foods that cause hypothyroidism .....................................................59

Drugs that cause hypothyroidism......................................................59

Coexisting autoimmune diseases .......................................................60

Diagnosing Severe Hypothyroidism.............................................................61

Treating Hypothyroidism ..............................................................................61

Taking the right hormones ..................................................................61

Getting the right amount .....................................................................63

Testing hormone levels .......................................................................64