What You Need To Know About Your Thyroid

January is National Thyroid Awareness Month. The thyroid gland is a butterfly shaped organ located in the base of your neck. It releases hormones that control metabolism— or the way your body uses energy.

What is thyroid disease?

Any condition that affects the normal function of the thyroid gland, causing too little or too much production of thyroid hormone. Thyroid disease can also include enlargement of the gland, called a goiter, or development of lumps in the gland, called thyroid nodules.

Why is the thyroid important?

It produces thyroid hormones that are critical in controlling the body’s metabolism by impacting every organ. Thyroid hormones help the body use energy, stay warm, and keep the brain, heart, muscles, and other organs functioning properly.

What is a thyroid nodule and how common are they?

It is an abnormal growth of thyroid cells causing a lump in the thyroid gland. They are common and increase with age.

 Why is it important for African-Americans to have thyroid nodules detected and biopsies early?

The majority of thyroid nodules are benign and do not cause symptoms; however, some thyroid nodules contain cancer. While thyroid cancer rates are similar in Blacks compared to whites; however, we are more likely to have larger tumors that have a less favorable pathology; lower 5-year survival, and higher overall thyroidectomy complication rates. It is therefore crucial to have nodules detected earlier before they enlarge from cancer, which can spread to lymph nodes in the neck.

Can thyroid disease be prevented?

Most thyroid disease in the United States (both hypothyroidism and hyperthyroidism) is caused by autoimmune disease where the body makes proteins against its own thyroid cells, either destroying them (as in hypothyroidism) or stimulating them (as in hyperthyroidism/graves’ disease). We do not yet know how to prevent the development of antibodies against the thyroid.

 Is thyroid disease hereditary?

Some autoimmune diseases of the thyroid, like Hashimoto’s thyroiditis and graves’ disease does run in families. Certain types of thyroid cancer can run in families as well.

 What are different types of thyroid disease and their symptoms?

There are two primary categories of thyroid disease.

  • hypothyroidism, where the thyroid gland is underactive and not making enough thyroid hormone—so everything slows down. Symptoms include feeling cold, fatigue, dry skin, forgetfulness and depression, and constipation.
  • hyperthyroidism, where the thyroid gland is overactive and making too much thyroid hormone—so everything speeds up. Symptoms include racing heart, nervousness and irritability, sweatiness, tremors, anxiety, warm skin, difficulty sleeping, thinning of hair and skin, muscle weakness, weight loss, and menstrual irregularities.

 How often should you get your thyroid checked?

Everyone should have their thyroid physically examined by a physician once/year and have a tsh checked. This hormone stimulates the thyroid gland and if it is too low or too high, it can be an indication of thyroid disease.

If thyroid disease goes undetected what other health issues can it cause?

Severe hypothyroidism can cause severe swelling, impaired mental function, electrolyte abnormalities, hypothermia (low body temperature), and an extremely low heart rate.

Severe hyperthyroidism can cause severe weight loss and muscle wasting, heart failure, and life-threatening abnormal heart rhythms.

Both extreme conditions require hospitalization and immediate treatment.

 Does most insurance cover the cost for treatment?

Insurance covers thyroid hormone replacement for individuals with hypothyroidism (underactive thyroid). Insurance also covers the treatments for hyperthyroidism (overactive thyroid)—medications, radioactive iodine treatment, and/or surgery.

 What causes a goiter?

In the United States, the most common cause is Hashimoto’s thyroiditis, which causes autoimmune destruction of the thyroid gland, resulting in hypothyroidism. Another common cause is Graves’ disease, another autoimmune condition in which the body produces a protein (antibody) that stimulates the thyroid gland and causes it to enlarge and produce too much hormone, resulting in hypothyroidism.

Dr. Sherita Hill Golden is the Hugh P. McCormick Family Professor of Endocrinology and Metabolism and Executive Vice-Chair of the Department of Medicine at the Johns Hopkins University School of Medicine. 

She holds joint appointments in the Welch Center for Prevention, Epidemiology, and Clinical Research, in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health, and in the Armstrong Institute for Patient Safety and Quality. 

She was Director of the Johns Hopkins Hospital Inpatient Glucose Management Program from 2003-2018.  In the community, Dr. Golden is a proud member of Delta Sigma Theta Sorority, Inc. and Co-Directs the Health Ministry with her husband at Clearview Baptist Church in Woodlawn, MD.





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