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Thyroid Status
| MEDICAL CONDITION | SUGGESTED SOLUTION | DISEASE MANAGEMENT / SCREENING GUIDELINES IN THE UNITED STATES | STATISTICS / RISK REDUCTION | |||
Thyroid status:
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You should be checked for • Size of your thyroid and lumps in the gland. You may need an ultrasound and ultrasound guided biopsy of any nodules (lumps) that are detected, to check for thyroid carcinoma. • Have your thyroid function tests checked every year (more frequent checks may be required depending on your condition and medications used). Aim for normal thyroid hormone levels. Overactive or under active thyroid status must be corrected appropriately. |
Testing for thyroid disease by measurement of serum TSH is recommended for adult’s age 35 years or older.
Certain population groups who are at a higher risk for thyroid disease includes women older than 60 years, individuals with prior radiation treatment of the thyroid gland or external radiation therapy, individuals who have had thyroid surgery or thyroid dysfunction in the past, individuals with diabetes mellitus, past history of auto-immune disease, family history of thyroid disease, or atrial fibrillation would benefit from thyroid testing. Individuals presenting with fatigue, weight gain, cold intolerance, dryness of the skin, hair loss, depression, dementia, muscle pains, edema, bradycardia, constipation, menstrual irregularity, infertility, fatigue, weight loss, heat intolerance, hyperhydrosis, nervousness, insomnia, tremors, muscle weakness, dyspnea, palpitations, atrial tachyarrhythmias, hyper defecation, irregular menstrual periods, would also benefit from thyroid testing. Thyroid testing should also be done in individuals with a goiter, diabetes mellitus, vitiligo, pernicious anemia, prematurely gray hair, and individuals taking medications such as lithium, amiodarone, iodine containing medications, kelp, following exposure to iodinated contrast agents. Individuals with a family history of thyroid disease, pernicious anemia, adrenal insufficiency, and diabetes mellitus would also benefit from testing. (Archives of Internal Medicine 2000;160:1573-1575) American Thyroid Association Guidelines For Thyroid Nodules and Cancer: Thyroid cancer occurs in 5-10% of thyroid nodules depending on age, gender, radiation exposure, family history, and other factors. (A thyroid nodule is defined as a discrete lesion with in the thyroid gland that is palpable or ultrasonographically distinct from the surrounding parenchyma). Consensus from the American Thyroid Association, American Association of Clinical Endocrinologists and Endocrine Society recommend that aggressive case finding is appropriate. |
THYROID DISEASE It is estimated that more than 200 million people have thyroid disease worldwide. According to the third United States National Health and Nutrition Examination Survey of individuals ages 12 and older, 6% of the United States population i.e. 12.2 million individuals have thyroid disease. About 9.6 million have hypothyroidism (under active thyroid) and 2.6 million individuals have hyperthyroidism (overactive thyroid). In parts of the world where there is iodine-sufficiency, thyroid nodules can be palpated in 5% of women and 1% of men. With high resolution ultrasounds, 19%-67% of individuals can be diagnosed with thyroid nodules. (American Thyroid Association Updates, Guidelines for Thyroid Nodules and Cancer) 5-10% of thyroid nodules are malignant depending on age, gender, radiation exposure, family history and other characteristics of the nodule. (American Thyroid Association Guidelines for Thyroid Nodules and Cancer: 2008.) According to estimates by the American Cancer Society, about 37,340 new cases of thyroid cancer were estimated to be diagnosed in the United States in 2008. 28,410 would occur in women and 8930 would occur in men. 1,590 deaths were expected from thyroid cancer in 2008. (Cancer Reference Information: Detailed Guide: Thyroid Cancer). |