Pink Prescriptions - July 2022

I Just Don’t Feel Right. Could it be my Thyroid?


 July 2022 Issue — Pink Prescriptions
I Just Don’t Feel Right. Could it be my Thyroid?

You may not be able to point to your thyroid, but it controls many activities in your body, including how fast you burn calories and how fast your heart beats—pretty important things. However, the thyroid seems to be a mystery gland that is not thought about until it begins to wreak havoc. Basically, when your thyroid is functioning properly, things we take for granted, like a good night’s sleep, regular bowel movements, controlled inner temps—not inappropriately hot or cold, are also functioning properly. Because an out-of-order thyroid can cause symptoms that are quite common, usually the thyroid is the last thing we point to as the culprit for our dis-ease and discomfort. That’s why we wanted to unlock the mystery behind this little gland in your neck that can make feeling good a real pain-in-the-neck! In order to learn more about the almighty thyroid, we asked our local experts to clue us in.

PinkRx0722 OpeliaChristopher Opella, M.D.
Beaufort Memorial Hospital

Are there any thyroid conditions that could lead to or increase my risks for cancer?
When discussing the topic of thyroid cancer, it’s important to understand there is a difference between thyroid function and actual thyroid cancer. For instance, many patients take thyroid medication due to hypothyroidism or hyperthyroidism. Hashimoto’s and Graves’ disease are autoimmune conditions that can cause hypo- or hyperthyroidism and can place the patient at higher risk for thyroid cancer.

However, most thyroid cancers actually come from nonfunctioning thyroid nodules. Nodules usually present with an enlarged thyroid or a portion of the thyroid enlarged. Most thyroid nodules do not cause symptoms other than feeling an enlarged thyroid or "lump" in your thyroid, which can cause difficulty swallowing. If you feel your thyroid is enlarged, you should seek immediate medical advice from your physician and have an examination and further testing if necessary. As with any cancer, early detection is the key.

Christopher Opella, M.D., is a board-certified family medicine physician. He recently joined Beaufort Memorial May River Primary Care in Okatie after more than two decades working as a clinician and medical director at primary care clinics and hospital emergency rooms in his native Texas.

PinkRx0722 PelligrinoYvette-Marie Pellegrino, M.D., FAAFP
Beaufort Memorial Hospital

What does the thyroid do?

The thyroid is a gland located in the front of the neck that functions as the body’s thermostat to control metabolism. It receives messages from another gland in the brain called the pituitary, which determines how much hormone it needs to regulate metabolism. When the thyroid is not working properly, the metabolic rate is either too fast or too slow.

When it is too fast (HYPER/overactive) some common symptoms are weight loss, anxiety, sweating, feeling hot, fast heart rate, diarrhea, tremor, insomnia and irregular menstrual cycles. When it is too slow (HYPO/underactive) some common symptoms are weight gain, depression, feeling cold, constipation, dry skin, hair loss, slow heart rate, fatigue and puffiness.

What are some of the most common thyroid disorders?

The most common thyroid problems are thyroiditis (inflammation) or a goiter (enlargement of the gland). Both can result in either an under- or over- active thyroid and can be caused by several factors.

Thyroiditis causes include:
• Infection: Either a bacteria or virus causes a temporary abnormality in thyroid function.
• Autoimmune thyroiditis: Your body makes antibodies that attack the thyroid. These include: Hashimoto’s (a common cause of hypothyroidism/underactive) and Graves’ disease (common cause of hyperthyroidism/overactive). In addition, postpartum thyroiditis can happen when a woman's thyroid gland becomes inflamed after having a baby.
• Drug induced thyroiditis: Thyroid levels are routinely monitored when taking certain medications that have been known to increase incidence of thyroid dysfunction.
• Radiation induced thyroiditis: Thyroid can be affected by radiation therapy for certain cancers or repeated x-ray exposure. For instance, when you get x-rays at the dentist, they cover your thyroid with a special blanket to block radiation.

The most common cause of goiters worldwide is iodine deficiency. However, in the United States, the most common causes are autoimmune thyroiditis (such as Hashimoto’s or Graves’) and multiple nodules.

Yvette-Marie Pellegrino, M.D., FAAFP, is a primary care physician at Beaufort Memorial Lady’s Island Internal Medicine. Board-certified in both family medicine and obesity medicine, Dr. Pellegrino oversees Healthy Weight, the hospital’s medically supervised weight loss program.

PinkRx0722 HHRHThyroid Health
by The Team at Hilton Head Regional Healthcare

How are Thyroid problems usually diagnosed?

Approximately 59 million Americans have a thyroid problem, but most do not know it1. Common disorders involve either too much (hyperthyroidism) or too little hormone (hypothyroidism) production by the gland. Hyperthyroidism affects more women than men and is usually diagnosed in people under the age of 402. Hypothyroidism occurs when the thyroid does not produce enough hormones and the body’s metabolism slows down.

Thyroid problems can be diagnosed following specialized blood tests, a nuclear thyroid scan, thyroid ultrasound, fine-needle aspiration of the thyroid tissue, or computerized axial tomography scan. Treatment is based on the form of thyroid problem. Medications commonly recommended for hyperthyroidism include beta-blockers, propylthiouracil, methimazole, iodide and radioactive iodine therapy. Surgery may be necessary to remove most of an overactive thyroid gland. Hypothyroidism can be treated with L-thyroxine with or without triiodothyronine.
Why is it so important not to eat or drink anything (except water) with my thyroid medication?
Some foods can bind with thyroid medication which impairs how fast the medication dissolves and is absorbed in the body. As is common with many medications, taking your thyroid medication with a full, 8-ounce glass of water is the best way to ensure complete levothyroxine absorption.

Thanks to the team at Hilton Head Regional Healthcare for providing their knowledge of thyroid health and all it encompasses. For more information about thyroid problems, talk with your doctor or visit Hilton Head Regional Healthcare provides comprehensive healthcare to the Lowcountry at four locations including Coastal Carolina Hospital, Hilton Head Hospital, the Bluffton Medical Campus and the Bluffton-Okatie Outpatient Center. Both hospitals are accredited by The Joint Commission, the nation’s oldest and largest hospital accreditation agency.

Sources: 1. Top 10 Signs That You May Have a Thyroid Problem – first paragraph 2. What Is an Overactive Thyroid? – first paragraph

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