Single lumps or nodules in the thyroid are common and can occur at any age , women are likely to be affected than men . A single thyroid nodule varies in size from that of a pea to a golf ball or even larger . like a goiter , the nodule is usually discovered by accident while you are washing or looking in a mirror . bleeding into the nodule may cause pain which alerts you to it’s presence , alternatively , the nodule may be discovered during a medical examination for some quite unrelated problem , although neither you nor your family had noticed it before . most women are aware of the significance of a lump in the breast and so naturally suspect that a nodule in the thyroid may also mean cancer . this is why your GP will probably want you to see a specialist , in fact , the great majority of single thyroid nodules are not cancers of the thyroid .
HOW IS IT DIAGNOSED ?
If you have a single thyroid nodule , your blood test will show normal levels of T3 , T4 and TSH , which means you are classified medically as “Eee thyroid “ the exception is the “toxic adenoma “ in which the thyroid blood tests will demonstrate an over active thyroid gland , the thyroid specialist will wish to examine your neck carefully , as about of all patients thought to have a single nodule are in fact found to have generalized nodular enlargement . the thyroid known as multi nodular goiter in this case , you can be assured that your condition is not serious . people who need further investigations may have an x- ray , ultrasound or radioisotope scan of their thyroid but the single most important test is fine needle aspiration (FNA)of the lump . the technique is simple quick and if necessary can be carried out two or three times as it does not cause pain or undue discomfort . FNA is one of the most important advances in the case of people with thyroid disease . in the past , the majority of those with a single thyroid nodule had to have surgery , but many operations can now be avoided simply by examining a small sample of thyroid cells obtained by aspiration in the out patient clinic .
This is treated either with surgery or with radio active iodine, unlike some one with Grave’s disease, you are unlikely to develop hypothyroidism . It used to be fashionable after surgery to prescribe thyroxine to prevent re growth of the goiter , which is common over a period of some 20 years but this is not really useful unless you are to develop hypothyroidism .
1.around three-quarters of cases of hypothyroidism are caused by Grave’s disease
2.many people with Grave’s disease may have inherited a tendency to develop it , although other factors are also involved in triggering the condition .
3.the people most likely to develop Grave’s disease are women between the ages of 40 and 50 years.
4.drags surgery and radio active iodine are all possible ways of treating Grave’s disease but there is no single treatment that is right for every one .
5.you specialists may want to discuss the treatment options with you before making the final decision on which approach is best for you .
6.after treatment you will need regular check up to ensure that you stay well.
- most people with Grave’s disease will experience some degree of eye problem , although they only be minor irritations . more serious symptoms can be treated , and they usually settle over time.
MILD HYPOTHYOIDISM KEY POINTS
1.Hypothyroidism usually comes on slowly and your symptoms are likely to be vague at first
2.your GP will be able to confirm the diagnosis with a simple blood test
3.treatment is with tablets ,which you will probably need to take for the rest of your life .
4.some people who have been hypothyroid for many years may suffer from chest pain caused by angina and because thyroxine aggravates the problem , their dosage will need careful monitoring , if you already have angina when your thyroid condition is first discovered , your treatment will be adjusted to take account of this
5.if your thyroid blood test is only slightly abnormal you may be given preventive treatment with thyroxine .
UNDER ACTIVE THYROID
An under active thyroid (hypothyroidism) occurs when the thyroid gland stops producing enough of the thyroid hormones T3 and T4 in its most common form affecting 1%of the population (mainly middle aged and elderly women )the thyroid gland shrinks as its cells are all destroyed by a subtle defect in the patient’s immune system
HOW DOES IT DEVELOP : ? hypothyroidism does not come on overnight but slowly over many months , and you and your family may not notice the symptoms at first or may simply put them down to ageing .
GP’s now have ready access to the appropriate laboratory tests and as a result , hypothyroidism is increasingly likely to be diagnosed at a relatively early stage when symptoms are mild . Hypothyroidism in it’s advanced state is some times known as “myxoedima “. It would be unusual to have all the symptoms mentioned below unless the diagnosis had been delayed for some reason for months or even years ,you are more likely to go to your GP with rather vague complaints such as tiredness and weight gain , which could be due to a variety of causes . you will have a blood tests and if the result shows that you have low T4 and high TSH levels , this will be confirmation that you are suffering from hypothyroidism . unless there is a complication , such as angina , you will be treated by your family doctor .
WHAT ARE THE SYMPTOMS:
Under activity of the thyroid gland slows down the chemical reactions in the body causing the following weight gain . most patients gain from five to ten kgs.,although your appetite is normal or even less than usual .
SENSITIVITY TO THE COLD : you will feel the cold very badly and want to wear extra layers of clothing and sit close to the fire ,you may well suffer from muscle stiffness and spasm when you move suddenly ,especially when it’s cold
You may feel tired or sleepy and slow down intellectually .your reactions get slower but fortunately your sense of humor is unaffected . older patients may e wrongly thought to be suffering from dementia ,while some people experience depression and paranoia , which are the basis for what is popularly known as “myxoedema madness “
SLRRED SPEECH ; your voice becomes slow and husky and speech is often slurred
HEART PROBLEMS : In contrast to a person with an over active thyroid gland ,your pulse rate is slow , at around 60 beats per minute you may have high blod pressure , and an elderly patient with severe long standing hypothyroidism is at risk of heart failure . angina can be symptom of hypothyroidism.