What Is A Thyroid Disorder
The most common disorders of the thyroid are hypothyroidism , and hyperthyroidism . A patient may also have a goiter or nodules, when part of the thyroid gland becomes inflamed leading to coughing and difficulty swallowing or breathing.
Thyroid cancer can kill normally functioning thyroid cells and form tumors. Hashimotos is a more difficult condition in which the bodys immune system itself attacks the thyroid.
The Difference Between An Endocrinologist Thyroidologist And Osteopathic Doctor
An endocrinologist is probably going to be your first choice in top thyroid doctors when you are looking for a purely medical approach to treatment. Endocrinologists treat diseases associated with the hormone systems in the body. The thyroid is a major player in the bodys hormone production.
A thyroidologist is more specific. They specialize only in thyroid function and disease and are often surgeons who can perform the delicate thyroid surgery needed to remove tumors or nodules on the thyroid gland that can cause hypothyroidism.
A doctor of osteopathy is a more all-around physician who is trained to consider the patients whole health when making a diagnosis. In many ways, those who find traditional thyroid testing incomplete or inaccurate to diagnose their thyroid problems will have a more positive outcome from a doctor who isnt focused on a single type of test to diagnose a thyroid condition.
|Facts About Thyroid Disease
Once you have narrowed down your choices near you, it is important to make the best choice for you. Even the best thyroid doctors may not be a perfect fit for you or your personality.
Make an initial consultation appointment.
During this meeting, you should seek information from the doctor regarding his philosophy of treating hypothyroidism. This isnt an examination or testing. Dont expect, or even request blood tests at this time. As the doctor how he evaluates possible thyroid problems.
What Is The Thyroid And What Does It Do
The thyroid is a butterfly-shaped gland located in the lower portion of the front of the neck, just above the collarbone.
The thyroid affects various organs in the body, Dr. Mary Vouyiouklis Kellis, an endocrinologist at Cleveland Clinic, told Newsweek. It can control temperature regulation, metabolism, gastrointestinal health, heart health, and bone and brain health.
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Diagnosis Of An Underactive Thyroid Function Is Made Based On A Combination Of Thyroid Blood Test Results Symptoms And Several Other Factors
is evaluated and diagnosed by a physician, usually an endocrinologist or your primary care doctor. Symptoms, signs, andmore criticallyblood tests are taken into consideration when evaluating the possibility of an underactive , all of which help identify the cause and severity of the disease.
A diagnosis is reached after a thorough review of the patients personal medical and family histories, any risk factors, findings on physical examination, and the results of . There are several types of hormones checked in a blood test to assess your thyroid statusthe most definitive one is the . Often, physicians may decide to check the free , or T4, free T4 index, or total T4 to aid in the diagnosis.
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Benefits Of Working With A Pathologist For Thyroid Nodule Care
Pathologists can accurately diagnose thyroid cancer and benign nodules, allowing for the best possible treatment plan.
Pathologists can provide guidance on which type of surgery may be necessary to remove the nodule.
Pathologists can use molecular testing techniques such as PCR to detect genetic mutations in the tissue sample.
Pathologists can use radioactive iodine to treat cancerous thyroid nodules.
Pathologists can provide detailed information about a patients condition, helping them make informed decisions about their care.
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Find The Right Doctor
Identifying the signs that you need to see an endocrinologist is one thing, but finding a suitable doctor to treat your condition is another. Make sure you find a doctor who is conveniently locatedsomeone you can reach quickly in an emergency and with whom you feel comfortable. Dr. Philip Rabito is considered among the best endocrinologists in New York City. He has extensive training and experience in diagnosing and treating thyroid disorders.
What To Consider In Your Personal And Family Medical Histories
Its important to give your physician as many details as possible about your personal medical history, as well as family history . Be sure to discuss:
Your general state of healthparticularly any changes you have noticed in your general overall health.
Your familys health historyespecially if a close relative has been diagnosed with hypothyroidism .
Whether youve ever had , or radiation to your neck to treat cancer.
Any medicines you may be taking that could cause hypothyroidism .
Hashimotos disease can slowly progress over many years, and you may not experience symptoms at all.
But, eventually, your thyroid hormone production will decline and lead to any of the symptoms below:
Heavy or irregular menstrual cycles
When to see a medical professional about your symptoms
Hashimotos disease symptoms arent always specific to just that condition and can vary from person to person.
Since different conditions can also cause these symptoms, its essential you see your doctor immediately to receive a timely and proper diagnosis.
Thyroid disease-related emergencies dont occur often, but they can occur. For example, extremely severe and untreated hypothyroidism can lead to hypothyroid coma . This is an endocrine emergency that requires urgent care.
When theres a thyroid hormone deficiency, HC is typically triggered by various factors,³ such as:
Congestive heart failure
HC accounts for around 0.1% of hypothyroid patients³ in hospital. It especially affects women who are older than 60.
Surgical Experience And Complications
Research indicates that the more experience your thyroid surgeon has, the less likely you are to have complications. One study conducted by the neoplastic diseases unit at Duke University in 2017 reported that patients treated by surgeons who performed fewer than 25 thyroid removal surgeries per year were as much as 1.5 times more likely to have complications. A review of post-surgical records showed that doctors who did six to 10 thyroid surgeries per year had a 42 percent greater risk of complications than those who performed more than 25 annually.
A 2016 study published in JAMA Otolaryngology-Neck Surgery also found that patients whose thyroid surgery is performed by high-volume surgeons had a lower risk of complications than patients who are operated on by low-volume surgeons . The risk of complications was 7.7 percent and 15.8 percent, respectively.
As a result, many experts recommend that you only consider surgeons who perform no fewer than 50 surgeries per year this is especially true if you have thyroid cancer, as the surgeon must remove all of the cancerous tissue.
The problem, of course, is that there are far fewer surgeons who meet this criterion than you might imagine.
On average, 6 percent of thyroid surgeries result in complications. Complications can include bleeding and damage to the laryngeal nerve that can make it difficult to speak, breathe, and swallow.
Choosing To Stop Treatment Or Choosing No Treatment At All
For some people, when treatments have been tried and are no longer controlling the cancer, it could be time to weigh the benefits and risks of continuing to try new treatments. Whether or not you continue treatment, there are still things you can do to help maintain or improve your quality of life.
Some people, especially if the cancer is advanced, might not want to be treated at all. There are many reasons you might decide not to get cancer treatment, but its important to talk to your doctors and you make that decision. Remember that even if you choose not to treat the cancer, you can still get supportive care to help with pain or other symptoms.
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Thyroid Nodules Or Cysts
Thyroid nodules or cysts are solid or fluid-filled lumps that form within the thyroid. Most are not serious and dont cause symptoms. Some thyroid nodules can become large enough to be visible and make swallowing or breathing difficult. Only a small number of nodules are cancerous and most are slow growing and effectively treated. Even if you dont have symptoms, your doctor may suggest routine imaging to monitor thyroid nodules or cysts.
Thyroid disorders are common and quite manageable. With appropriate medical treatment, most people with a thyroid disorder live a healthy life.
Radiologists: Imaging And Diagnosis
Radiologists play an important role in the diagnosis and treatment of thyroid nodules. They use imaging techniques such as ultrasound, CT scans, and MRI to evaluate the size, shape, and location of the nodules. This information can help determine if the nodule is cancerous or benign. Radiologists can also provide guidance on which type of surgery may be necessary to remove the nodule. Working with a radiologist for thyroid nodule care can help ensure that you receive an accurate diagnosis and treatment for your condition.
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When To Be More Proactive
Although most thyroid nodules are benign, some can harbor thyroid cancer. And some types of thyroid cancer are more aggressive than others. You should be more proactive in seeing an endocrinologist if you have any of the following symptoms:
- A lump in your neck that appears to be growing
- Swelling or pain in the neck
- Persistent cough
- Trouble breathing or swallowing
Also see an endocrinologist if you have been diagnosed with a thyroid nodule and have any of the following risk factors for thyroid cancer:
- An immediate family member who was diagnosed with thyroid cancer
- Any kind of radiation exposure, especially to the head and neck area
Will I Be Able To Lead A Normal Life After Surgery
Yes. Once you have recovered from the effects of thyroid surgery, you will usually be able to do anything that you could do prior to surgery. Some patients become hypothyroid following thyroid surgery, requiring treatment with thyroid hormone . This is especially true if you had your whole thyroid gland removed. Generally, you will be started on thyroid hormone the day after surgery, even if there are plans for treatment with radioactive iodine.
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Choosing A Healthcare Provider
Once you know what type of healthcare provider you wish to see, there are several things to consider before you make your appointment. This is an important decision for several reasons. Not only is thyroid disease something that often requires long-term care, but it isn’t always easy to treatand working to find an effective treatment can make a difference in outcomes.
The First Step Find The Right Type Of Doctor
If you have any thyroid condition then you know just how frustrating it can be trying to get your doctor to see eye to eye with you.
While doctors have undergone training to help people with various types of problems, it isnt always the case that whatever doctor you are seeing is the best option for you.
And, as a thyroid patient, you may not be aware that there are MANY options available to you.
You dont have to stick with your primary care doctor or your endocrinologist, especially if they dont seem to be helping you.
There are doctors that specialize in other areas of medicine that are often better at treating hormone imbalances such as thyroid problems.
So if your doctor really isnt willing to work with you or isnt interested in hearing about your problems, you do NOT need to settle.
But before you run out and swap doctors, lets talk a look at the various options available.
In this article you will learn:
- How conventional doctors differ from integrative doctors
- How various types of doctors can help treat and manage thyroid problems
- Why some doctors are better at managing thyroid problems compared to others
- When you should look outside of the traditional insurance based model
- How naturopaths, chiropractors, and health coaches can help you feel better
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Are There Other Means Of Treatment
Surgery is definitely indicated to remove nodules suspicious for thyroid cancer. In the absence of a possibility of thyroid cancer, there may be nonsurgical options for therapy depending on your diagnosis. You should discuss other options for treatment with your physician who has expertise in thyroid diseases.
What Is The Role Of Primary Care Doctors
A primary care doctor is your GP or the first doctor you consult when you start seeing symptoms. This doctor will be responsible for ordering tests to investigate symptoms you present with and may make a referral to an endocrinologist to confirm their suspicions of the disease.
Often, your primary care physician will work with the endocrinologists to help you create a management strategy to minimize the effect of your disease on your way of life and overall health.
Once your management strategy has been reviewed by the endocrinologist, you will likely maintain treatment with your primary care physician. This is to save you money, as your primary care physician will probably be less expensive than the specialist endocrinologist.
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When To See A Thyroid Specialist
Tamara Wexler, MD, PhD, an endocrinologist at NYU Langone Health in New York City recommends seeing an endocrinologist at least once when youre first diagnosed with hypothyroidism to review your condition, your test results, and your treatment plan. After one or two visits, you may not need to keep seeing him or her regularly, she says. Thats when your primary care doctor can usually take over.
Other times it’s smart to see an endocrinologist are when:
Symptoms of hypothyroidism dont get better despite treatment. If you’ve been taking medication to replace your thyroid hormone for a while but your symptoms persist, you might want to see an endocrinologist for a second opinion, says Cathy Doria-Medina, MD, an endocrinologist with HealthCare Partners Medical Group in Torrance, California. Some people with hypothyroidism have a more difficult time finding the concentration of thyroid hormone medication that works best for them. In these situations, a specialist often can help, she says.
You have a thyroid nodule or lump. Your thyroid gland is located in the front of your neck, just below your voice box. If you have a lump, nodule, or other growth on your thyroid, an endocrinologist should examine it. Most are harmless , but once in a while a more serious change is happening. Five percent of thyroid nodules are cancerous, according to the Cleveland Clinic. And sometimes though its rare thyroid nodules actually cause hypothyroidism.
How Does A Healthcare Provider Check Your Thyroid
Healthcare providers check your thyroid with blood tests and imaging. Blood tests look at levels of:
- Autoantibodies, which indicate Hashimoto’s or Graves’ disease
Imaging tests, especially for hyperthyroidism, may include an ultrasound, thyroid scan, or a radioactive iodine uptake test to identify thyroid nodules and see how active the gland is.
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Where Can I Find An Endocrinologist
You can ask your doctor or you can visit the healthdirect service finder. The Endocrine Society ofAustralia has a directory that allows you to search for endocrinologists based on location or the endocrinologists area of expertise.
Youll need a referral from your doctor to see an endocrinologist. You may also need to wait a while before seeing an endocrinologist, as specialists sometimes have long waiting times before you can get an appointment.
When you make a booking, you can ask how much the visit will cost, and how much you will get back from Medicare.
Generally, visits to specialists arent covered by private health funds.
What Can I Expect Once I Decide To Proceed With Surgery
Once you have met with the surgeon and decided to proceed with surgery, you will be scheduled for your pre-operative evaluation You should have nothing to eat or drink after midnight on the day before surgery and should leave valuables and jewelry at home.
The surgery usually takes 2-2½ hours, after which time you will slowly wake up in the recovery room. Surgery may be performed through a standard incision in the neck or may be done through a smaller incision with the aid of a video camera . Under special circumstances, thyroid surgery can be performed with the assistance of a robot through a distant incision in either the axilla or the back of the neck. There may be a surgical drain in the incision in your neck and your throat may be sore because of the breathing tube placed during the operation. Once you are fully awake, you will be allowed to have something light to eat and drink. Many patients having thyroid operations, especially after hemithyroidectomy, are able to go home the same day after a period of observation in the hospital. Some patients will be admitted to the hospital overnight and discharged the next morning.
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How Much Of My Thyroid Gland Needs To Be Removed
Your surgeon should explain the planned thyroid operation, such as lobectomy or total thyroidectomy, and the reasons why such a procedure is recommended.
For patients with papillary or follicular thyroid cancer, many, but not all, surgeons recommend total or neartotal thyroidectomy when they believe that subsequent treatment with radioactive iodine might be necessary. For patients with larger or more invasive cancers and for patients with medullary thyroid cancer, local lymph node dissection may be necessary to remove possibly involved lymph node metastases.
A hemithyroidectomy may be recommended for overactive solitary nodules or for benign onesided nodules that are causing local symptoms such as compression, hoarseness, shortness of breath or difficulty swallowing. A total or near total thyroidectomy may be recommended for patients with Graves Disease or for patients with large multinodular goiters.