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Biographies of Disease: Thyroid Disease by Roy Phitayakorn and Sareh Parangi (2010, Hardcover)

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Hyperthyroidism is a state in which the body is producing too much thyroid hormone. The main hyperthyroid conditions are:.

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Certain medications can have the unintended side effect of affecting thyroid function. While some medications can lead to significant hypothyroidism or hyperthyroidism and those at risk will need to be carefully monitored, some medications may affect thyroid hormone lab tests without causing any symptoms or clinical changes, and may not require treatment. Diagnosis of thyroid disease depends on symptoms and whether or not a thyroid nodule is present.

Most patients will receive a blood test. Others might need an ultrasound, biopsy or a radioiodine scanning and uptake study. There are several hormones that can be measured in the blood to determine how the thyroid gland is functioning. These include the thyroid hormones triiodothyronine T3 and its precursor thyroxine T4 , which are produced by the thyroid gland. Thyroid-stimulating hormone TSH is another important hormone that is secreted by the anterior pituitary cells in the brain.

Its primary function is to increase the production of T3 and T4 by the thyroid gland.

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The most useful marker of thyroid gland function is serum thyroid-stimulating hormone TSH levels. TSH levels are thus often used by doctors as a screening test, where the first approach is to determine whether TSH is elevated, suppressed, or normal. Because a single abnormal TSH level can be misleading, T3 and T4 levels must be measured in the blood to further confirm the diagnosis. When circulating in the body, T3 and T4 are bound to transport proteins.


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Only a small fraction of the circulating thyroid hormones are unbound or free, and thus biologically active. T3 and T4 levels can thus be measured as free T3 and T4, or total T3 and T4, which takes into consideration the free hormones in addition to the protein-bound hormones. Free T3 and T4 measurements are important because certain drugs and illnesses can affect the concentrations of transport proteins, resulting in differing total and free thyroid hormone levels.

There are differing guidelines for T3 and T4 measurements. Autoantibodies to the thyroid gland may be detected in various disease states. Many people may develop a thyroid nodule at some point in their lives. Although many who experience this worry that it is thyroid cancer, there are many causes of nodules that are benign and not cancerous. If a possible nodule is present, a doctor may order thyroid function tests to determine if the thyroid gland's activity is being affected.

If more information is needed after a clinical exam and lab tests, medical ultrasonography can help determine the nature of thyroid nodule s. There are some notable differences in typical benign vs. The ultrasound may also locate nodules that are too small for a doctor to feel on a physical exam, and can demonstrate whether a nodule is primarily solid, liquid cystic , or a mixture of both. It is an imaging process that can often be done in a doctor's office, is painless, and does not expose the individual to any radiation.

The main characteristics that can help distinguish a benign vs. Although ultrasonography is a very important diagnostic tool, this method is not always able to separate benign from malignant nodules with certainty. In suspicious cases, a tissue sample is often obtained by biopsy for microscopic examination. Thyroid scintigraphy , in which the thyroid is imaged with the aid of radioactive iodine usually iodine , which does not harm thyroid cells, or rarely, iodine , [26] is performed in the nuclear medicine department of a hospital or clinic.

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Radioiodine collects in the thyroid gland before being excreted in the urine. While in the thyroid, the radioactive emissions can be detected by a camera, producing a rough image of the shape a radioiodine scan and tissue activity a radioiodine uptake of the thyroid gland.

A normal radioiodine scan shows even uptake and activity throughout the gland. Irregular uptake can reflect an abnormally shaped or abnormally located gland, or it can indicate that a portion of the gland is overactive or underactive. For example, a nodule that is overactive "hot" -- to the point of suppressing the activity of the rest of the gland—is usually a thyrotoxic adenoma, a surgically curable form of hyperthyroidism that is rarely malignant. In contrast, finding that a substantial section of the thyroid is inactive "cold" may indicate an area of non-functioning tissue, such as thyroid cancer.

The amount of radioactivity can be quantified and serves as an indicator of the metabolic activity of the gland. Overactivity or underactivity of the gland, as may occur with hyperthyroidism or hypothyroidism, is usually reflected in increased or decreased radioiodine uptake. Provide feedback about this page. There's a problem loading this menu right now. Get fast, free shipping with Amazon Prime. Get to Know Us.


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