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Are Thyroid Issues Serious? (podcast)

Thyroid disease is serious but can easily be diagnosed and treated

Dr. Matthew Levine, a Scripps endocrinologist, discusses thyroid issues in San Diego Health podcast.

Dr. Matthew Levine, Endocrinology, Scripps Clinic

Thyroid disease is serious but can easily be diagnosed and treated

The thyroid gland is located in your neck just below your Adam’s apple and produces a hormone that affects physical energy, temperature, mood, and other important bodily functions.


Sometimes the thyroid gland can produce either too much or too little of the hormone leading to problems, or nodules can develop within the gland, and unfortunately the likelihood of these happening increases with age. 

 

In this episode of San Diego Health, host Susan Taylor and guest Matthew Levine, MD, an endocrinologist at Scripps Clinic Anderson Medical Pavilion in La Jolla and Scripps Clinic Carmel Valley, discuss the signs that your thyroid is overactive or underactive, how thyroid issues are diagnosed, what causes hypothyroidism and hyperthyroidism, and treatment options.

Listen to the episode on causes and treaments for thyroid issues

Listen to the episode on causes and treaments for thyroid issues

Podcast highlights

How do you know if your thyroid gland is functioning properly? (0:52)

It can be easily diagnosed by blood tests, which your primary care physician or a specialist can order. This is useful to make the diagnosis if there are symptoms.

What are the signs and symptoms of a thyroid problem? (1:11)

They are very nonspecific unfortunately. They can run the gamut from feeling fatigued, sluggish, cold and weak, if the thyroid is underactive. If it’s overactive, it is kind of the opposite, including feeling revved up, jittery, anxious, having rapid heart rate or sweating.

Who is most affected by thyroid issues? (1:34)

Women are typically more affected by thyroid disease, whether it’s underactive or overactive thyroid glands, than men. We do see plenty of male patients as well. Thyroid issues are always more common the older one gets.

How common are thyroid issues? (1:49)

They are much more common as people get older. Hypothyroidism or an underactive thyroid is more common than hyperthyroidism or an overactive thyroid.


Hypothyroidism can be seen in up to about 10% of individuals. Hyperthyroidism can be seen in up to as many as 5% of individuals.


Thyroid nodules or growth on the thyroid are more common as people get older.

What causes the thyroid to function abnormally? (2:19)

Usually when the thyroid is functioning abnormally, it’s because of an autoimmune condition. These are conditions that run in families and tend to be more common in women than in men.


There are other reasons why the thyroid can malfunction as well, but collectively they make up maybe 5% of all cases of underactivity.


Globally in under-industrialized countries, iodine deficiency is still the biggest reason for the thyroid to be underactive. But here in the United States, it’s typically autoimmunity.

How is thyroid disease treated? (3:22)

If the thyroid is underactive, or if somebody has hypothyroidism, the treatment is typically to replace the missing or deficient hormone. Thyroid hormone replacement is a simple pill that patients can take daily.


If the thyroid is overactive, or if somebody has hyperthyroidism, the treatment can sometimes be a little more complex depending on what the exact reason for the overactivity is.


But depending on the reason, the treatment could also be as simple as taking a pill daily or can be a little bit more definitive, such as a radioactive treatment to knock out or ablate the thyroid. It could even involve surgery to remove the thyroid gland.

What causes abnormal growth of nodules in the thyroid gland? (4:09)

Many things can cause growths or nodules in the thyroid, including being female, genetics. Often it can run in families. There’s a link to estrogen. Age can cause them as well.


Most growths on the thyroid are benign. About 10% reflect cancer.


We use an ultrasound machine to diagnose, evaluate and monitor thyroid nodules on patients.

What are symptoms of an abnormal growth of nodules in the thyroid gland? (4:53)

Often there are no symptoms. These nodules usually are picked up incidentally. Sometimes they can be picked up when a physician is feeling the neck during a general physical exam.


Other times, people are in radiology and they have X-rays or other imaging studies done for unrelated reasons.


When they’re diagnosed or when they’re noted, usually they’re sent to us for evaluation. The vast majority are benign. But we have ways to track and monitor those nodules to make sure they’re not changing over time, or we can do a biopsy if we feel that’s needed to make sure that they’re benign and not cancerous.

Who is most at risk for thyroid nodule issues? (5:36)

Women seem to be more predisposed to developing thyroid nodules than men. We see plenty of male patients as well.

Is age a risk factor for thyroid nodule issues? (5:51)

Thyroid disease tends to be more common as people get older. We see plenty of younger age individuals with nodules as well, but certainly most of our patients are in their 40s, 50s, 60s, or even older than that.

What are the signs and symptoms and treatment for thyroid cancer? (6:07)

Thyroid cancer is not like other cancers that are much more complicated or involved in their treatment. Typically, there is no chemotherapy or radiation therapy treatments involved. The treatment for thyroid cancer often is surgery to remove part or all of the thyroid gland. There is a push toward leaving it alone and monitoring it if we feel that a thyroid cancer is small enough or low risk enough.


Sometimes the treatment can be a little more complicated than that, but much more curable than many other types of cancers are.

When should you see your doctor about your thyroid gland? (7:01)

The sign and symptoms can be elusive or nonspecific. Fatigue, for example, can be caused by a whole host of other possibilities. Muscle aches or weakness may be caused by a host of possibilities.


If somebody has emerging symptoms that are outside of what they would usually feel emerging over time, that’s a good reason to see your physician and inquire as to whether those symptoms could be related to thyroid disease.


The diagnosis is easily made on the basis of blood tests or if somebody feels an abnormality in their neck.


The thyroid gland sits on top of the airway underneath where the Adam’s apple might be. If somebody feels enlargement in that area, or squeezing symptoms, or breathing or swallowing difficulty, that could be an indication that there’s a growth or growths developing on the thyroid gland. That certainly would warrant a visit to your physician to have a neck exam performed and ask about whether they could have thyroid disease.


Thyroid disease, even though the symptoms can be nonspecific and caused by other possibilities, is very common, very easily recognized and very easily treated. It is not something that we want to miss because it is something that can be easily diagnosed. It would be a shame for somebody to have symptoms and not get evaluated.

Lightly edited for clarity.

Watch the San Diego video on thyroid problems

Watch the San Diego Health video with host Susan Taylor and Dr. Levine discussing causes and treatments for thyroid disease.