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Thyroid Awareness and You: Learn About the Three Main Thyroid Conditions Impacting Americans

January 28, 2019

It’s estimated that more than 20 million Americans have a thyroid condition, and up to 60 percent of them aren’t aware of it. That is over 7 percent of the U.S. population.

The three most common thyroid conditions are hypothyroidism, thyroid nodular disease and hyperthyroidism. Learn more about these conditions from Jefferson Health’s Endocrinologist Dr. Anthony J. Cannon below:

Hypothyroidism, or thyroid failure, occurs when the thyroid gland doesn’t produce enough thyroid hormone, slowing down the metabolism. Hashimoto’s disease, an autoimmune disease in which antibodies destroy the thyroid directly, is the most common cause. Hypothyroidism can present subtly, so it’s easily missed.

  • Symptoms: May include sluggishness, slow heart rate, constipation and weight gain. Contrary to popular belief, an underactive thyroid doesn’t always lead to weight gain. It takes a very profound hypothyroidism to cause fluid retentiveness. When the kidneys can’t clear salt and water so well, you get puffy.
  • Treatment: The primary treatment is thyroid hormone replacement.

Thyroid nodular disease may coexist in a patient with hypothyroidism. A thyroid tumor is called a nodule and can be benign or malignant. With more radiography tests being done for the head and neck, more thyroid nodules are being found. Any thyroid nodule that is noticed incidentally or by palpation (a provider feels it during a neck evaluation) generally has a five percent risk for cancer.

  • Symptoms: Thyroid nodules don’t present with symptoms, unless they’re the underlying cause of hyperthyroidism.
  • Treatment: A nodule is diagnosed through a thyroid ultrasound and a fine needle aspiration biopsy (FNAB). A benign nodule is followed conservatively, and if it enlarges over time, another FNAB will be conducted, or it will be considered for surgical removal. If the nodule causes hyperthyroidism, it will be treated with anti-thyroid medication, and in some cases, surgical resection (partial removal). The typical treatment for a malignant nodule, or thyroid cancer, is surgery and post-operative radioiodine treatment, followed by hormone replacement.

*How serious is thyroid cancer?

The No. 1 thyroid cancer, papillary thyroid cancer, spreads slowly and may spread to the lungs or liver if not detected early enough. However, this is uncommon. And while thyroid cancer cases are increasing, life expectancy has not changed. The majority of people, after 10 years of treatment, are cured. The life expectancy for papillary thyroid cancer is 25 years.

Hyperthyroidism causes the thyroid to release excessive amounts of thyroid hormone. While this condition is sometimes caused by over functioning thyroid nodules, Graves’ disease is the No. 1 cause in the country. Graves’ disease is an autoimmune disease in which antibodies over stimulate and indirectly destroy the thyroid.

  • Symptoms: May include dysphoria (a feeling of unease and sometimes depression), increased heart rate, fatigue, weight loss and trouble sleeping. Most people like this weight loss, but it is a dangerous, physiological weight loss. They’re losing muscle before they lose fat.
  • Treatment: The most common treatment for hyperthyroidism is anti-thyroid medication. The thyroid is the only gland in the body that absorbs iodine and incorporates it into a hormone; this medicine decreases the percentage of iodine that can be absorbed. Basically, we slow down the thyroid by shortening its fuel supply. Other treatments are radioiodine (I-131) therapy and surgical removal, if necessary.

The endocrinology team at Jefferson Health in New Jersey provides personalized, compassionate care to improve the lives of patients living with endocrine-related disorders. For more information on endocrinology services offered, click here. To read Dr. Cannon's Thyroid Awareness Month Q&A, click here