Thyroid for Dummies (3 page)
Read Thyroid for Dummies Online
Authors: Alan L. Rubin
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Table of Contents
xi
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