Thyroid for Dummies (3 page)

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Table of Contents

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

Picturing Hyperthyroidism ...........................................................................66

Listing the Signs and Symptoms of Hyperthyroidism ...............................66

The body generally ..............................................................................67

The thyroid............................................................................................67

The skin and hair..................................................................................67

The heart ...............................................................................................68

The nervous system and muscles......................................................68

The reproductive system ....................................................................68

The stomach and intestines................................................................68

The urinary system ..............................................................................68

The eyes.................................................................................................69

Confirming a Diagnosis of Hyperthyroidism ..............................................69

Determining Whether Graves’ Disease Is the Culprit ................................70

Causes of Graves’ disease ...................................................................70

Signs and symptoms specific to Graves’ disease.............................71

Recognising Other Causes of Hyperthyroidism .........................................73

Choosing the Best Treatment for Graves’ Disease ....................................74

Thyroid surgery....................................................................................75

Radioactive iodine treatment .............................................................76

Antithyroid pills....................................................................................77

Other helpful medications ..................................................................79

Treating Other Causes of Hyperthyroidism................................................79

Surviving Thyroid Storm ...............................................................................80

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

Discovering a Thyroid Nodule......................................................................82

Evaluating Cancer Risks ................................................................................83

Securing a Diagnosis......................................................................................83

The fine needle aspiration cytology ..................................................84

The thyroid ultrasound scan ..............................................................85

Treating Cancerous Nodules ........................................................................86

Dealing with Nodules That Are Non-Cancerous .........................................86

Hot nodules ...........................................................................................87

Benign cysts ..........................................................................................87

Warm or cold nodules..........................................................................87

Ignoring Small Nodules..................................................................................87

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

Determining What Causes Thyroid Cancer ................................................90

Identifying the Types of Thyroid Cancer ....................................................91

Papillary thyroid cancer......................................................................92

Follicular thyroid cancer .....................................................................93

Medullary thyroid cancer....................................................................93

Undifferentiated (anaplastic) thyroid cancer ...................................95

Staging Thyroid Cancer .................................................................................96

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Treating Thyroid Cancer ...............................................................................97

Papillary thyroid cancer......................................................................98

Follicular thyroid cancer .....................................................................99

Medullary thyroid cancer....................................................................99

Undifferentiated (anaplastic) thyroid cancer .................................100

Following Up Cancer Treatment.................................................................100

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

Exploring How a Multinodular Goitre Grows Up......................................101

Choosing to Treat It or Ignore It.................................................................103

Making a Diagnosis ......................................................................................104

Treating a Multinodular Goitre...................................................................105

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

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

Revealing the Drug–Food–Thyroid Connection .......................................109

Identifying the Effects of Specific Substances ..........................................112

Initiating or aggravating hypothyroidism .......................................113

Creating false test results ..................................................................117

Causing an increase in thyroid activity ...........................................118

Preventing Harmful Drug Interactions ......................................................119

Discovering Whether You’re at Risk ..........................................................119

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

Putting a Face on Subacute Thyroiditis ....................................................123

Causes and effects..............................................................................124

Laboratory findings............................................................................125

Treatment options..............................................................................126

Coping with Postpartum and Silent Thyroiditis.......................................127

Understanding the disease................................................................127

Interpreting lab results ......................................................................128

Getting treatment ...............................................................................128

Identifying Acute Thyroiditis......................................................................129

Describing the disease.......................................................................129

Confirming the diagnosis with lab tests ..........................................130

Treating acute thyroiditis..................................................................130

Diagnosing a Rare Form of Thyroiditis......................................................131

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

Realising the Vastness of the Problem ......................................................134

Facing the Consequences of Iodine Lack ..................................................135

Pregnancy............................................................................................135

Infancy .................................................................................................136

Childhood ............................................................................................136

Adulthood............................................................................................136

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Endemic Cretinism.......................................................................................137

Looking at the geographic distribution ...........................................138

Contributing factors...........................................................................139

Goitre: The body’s defence ...............................................................140

Neurologic cretinism..........................................................................141

Myxoedematous cretinism................................................................141

Managing the Problem of Iodine Deficiency .............................................142

A sprinkle of salt.................................................................................143

An injection of oil ...............................................................................144

A slice of bread or cup of water .......................................................145

Drawbacks of Iodisation..............................................................................145

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

Deciding When Surgery Is Necessary........................................................147

Talking Things Over .....................................................................................149

Preparing for Surgery ..................................................................................149

What Happens During Surgery ...................................................................150

Surgical obstacles...............................................................................151

Extent of surgery ................................................................................152

Considering a New Approach .....................................................................154

Possible Complications ...............................................................................155

Recuperating After the Operation..............................................................155

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

Preventing Ill Effects of Large Doses of Iodine .........................................157

Finding Out More about Hypothyroidism.................................................158

Treating (or not treating) subclinical hypothyroidism .................158

Finding the right dose of hormone ..................................................159

Determining the prevalence of hypothyroidism ............................160

Linking heart disease and hypothyroidism ....................................160

Dealing with Hyperthyroidism ...................................................................161

Measuring calcium levels ..................................................................162

Controlling weight gain......................................................................162

Revolutionising thyroid surgery.......................................................163

Gathering clues to hyperthyroid eye disease.................................163

Treating Goitres and Nodules.....................................................................164

Performing surgery after ethanol injections...................................164

Shrinking goitres.................................................................................164

Developing New Approaches in Thyroid Cancer .....................................165

Understanding the impact of radioiodine exposure ......................165

Blocking oestrogen slows tumour growth ......................................166

Predicting thyroid cancer..................................................................166

Detecting residual thyroid cancer....................................................166

Following up thyroid cancer treatment...........................................167

Knowing what to expect from medullary thyroid cancer .............168

Using recombinant TSH to treat thyroid cancer ...........................169

Testing calcium levels after cancer surgery ...................................170

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Tackling Iodine Deficiency Disease............................................................170

Recognising the importance of selenium ........................................170

Using iodised oil for goitres ..............................................................171

Increasing the intelligence of babies born to hypothyroid mothers............................................................................................171

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

Guaranteeing Your Best Nutrition..............................................................173

Maintaining a Healthy Weight.....................................................................174

Calculating your body mass index ...................................................175