Thyroid for Dummies (49 page)

haemorrhaging, 83

192–193

hot, 47, 85, 87

loss of, 188

ignoring, 87–88

strengthening exercises, 190–191, 193

multinodular goitre, 101–106, 280

mutation, 281

older people with, 256

mute (lack of speech), 141

in pregnancy, 231–232

myxoedema coma, 61, 80

thyroid adenoma, 82, 242

myxoedema madness, 17

treatment options, 13, 79–80, 86–87, 164

myxoedematous cretinism, 138

ultrasound scan of, 49, 85

warm, 85, 87

• N •

non-hormonal blood tests, 44–46

non-steroidal anti-inflammatory drugs

nails, 34, 56

(NSAIDs), 39

National Health Service (NHS), 197, 198

nuclear medicine physician, 98

National Institute of Medical Herbalists

nutrition.
See also
diet; iodine deficiency

(Web site), 198

healthy eating guidelines, 174

natrum muriaticum,
204

iron, 116, 181, 272

nausea control drugs, 120

minerals, 181–182

‘neck check’, 271

protein, 178, 179

neck pain

vitamins, 33, 161, 180–181

in acute thyroiditis, 129

in multinodular goitre, 103

• O •

in subacute thyroiditis, 124, 126

in thyroiditis, 55

oatstraw, 201

negative feedback for TSH release, 30

obesity, 194

nervous cretinism, 138

octreotide (drug), 117

nervous system, 68

oedema, brawny, 56

neurologic cretinism, 141

oestrogen (hormone)

new treatment approaches

blocking to prevent tumour growth, 166

dealing with excessive iodine, 157–158

in oral contraceptives, 110

endoscopic thyroid surgery, 154–155

in pregnancy, 222

goitres and nodules, 164

in puberty, 235

for hereditary thyroid disease, 218–220

thyroxine-binding protein level affected

hyperthyroidism, 161–163

by, 30–31, 115

hypothyroidism, 158–161

total thyroxine (TT4) test affected by, 38

iodine deficiency disease, 170–171

oil, iodised, 144, 171

staying up-to-date with, 275

older people

thyroid cancer, 165–170

diagnosing thyroid disease in, 16, 247–250

NHS (National Health Service), 197, 198

hyperthyroidism in, 18, 253–255, 260

NHS Direct Online (Web site), 284

hypothyroidism in, 250–253, 259

NHS general practitioner (GP), 197

nodules in, 256

nicotinic acid (drug), 39, 115

oncogenes, 91

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oncologist (cancer specialist), 97, 98

nodules in, 231–232

Online Mendelian Inheritance in Man (Web

overview, 15–16, 221–222

site), 214, 284

radioactive iodine avoided during, 76, 228

ophthalmopathy (thyroid eye disease), 69,

thyroid function in, 222–223

71–72, 163, 284

thyroid surgery avoided during, 75

opiates, 115, 117

thyroid-binding protein, 270, 271

oral contraceptives, 110, 115, 270

pretibial myxoedema, 72–73

organic foods, 165, 186

Prodigy Knowledge (Web site), 284

organs of the body, 33–35

prohormone, 28

orphenadrine (drug), 118

propranolol (beta-blocker)

osteoporosis, 35, 253, 273

for hyperthyroidism, 79

hypothyroidism caused by, 60

• P •

for postpartum and silent thyroiditis, 128

for severe hyperthyroidism, 116

pain medication, 120

for subacute thyroiditis, 126

Panax ginseng (Korean ginseng), 200

propylthiouracil (PTU).
See also

papillary thyroid cancer, 92–93, 98, 99, 154,

antithyroid drugs

215

breastfeeding, 261

paracetamol (drug), 55

for children, 244

parathyroid glands, 60, 75, 151–152

dosage, 78

Patients Association (Web site), 284

for Graves’ disease, 226, 228

Pendred Syndrome, 215, 219

for hyperthyroidism, 77–79, 116, 261

peptic ulcer drugs, 121

hypothyroidism caused by, 60

pernicous anaemia, 60

as iodine blocker, 114

perphenazine (drug), 115

side effects, 78–79

PET scan, 167

for subacute thyroiditis, 120

phaeochromocytoma (adrenal gland

for thyroid storm, 80

tumour), 94, 117

white blood cell count, 78

phenobarbital (drug), 116

protein

phenothiazines (drug), 38, 115

sources and servings, 179

phenotype, 209, 214–215

thyroid hormones carried by, 31, 212–213

phentolamine (drug), 117

thyroid-binding, 110, 111, 114–115,

phenytoin (epilepsy drug), 39, 116, 118

270–271

phosphorus, 181

psychoactive drugs, 121

pituitary gland, 30, 58–59, 140–141

PTU.
See
propylthiouracil

pituitary tumour, 42, 43, 62

Pub Med (Web site), 171

Plummer’s disease (toxic multinodular

puberty, 102, 195, 235, 240

goitre), 105

pyramidal lobe, 26, 281

postpartum depression, 128

pyridoxine (drug), 117

postpartum Graves’ disease, 229

postpartum thyroiditis, 127–128, 262, 281

• R •

potatoes, servings per day, 180

prednisone (adrenal steroid), 59

radioactive iodine (RAI).
See also
iodine

pregnancy.
See also
women

avoided during pregnancy, 76, 228

hyperthyroidism in, 148, 225–231

children, 76, 136, 228, 243

hypothyroidism in, 223–225

dangers to foetus, 136, 228

iodine deficiency in, 135–136, 224

follicular thyroid cancer treated with, 99

iodine needed during, 222

goitres shrunk with, 105–106

molar pregnancy, 42

Graves’ disease, 76–77, 106

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radioactive iodine
(continued)

sickle cell disease, 218–219

hot nodules, 87

silent thyroiditis, 127–128, 262, 281

for hyperthyroidism in older people, 255

silicone gel sheet, 156

hypothyroidism caused by, 77

Sjögren’s syndrome, 60

impact of exposure to, 165

skin

nodules treated with, 79–80

hyperthyroidism, 67–68

after thyroidectomy, 98

hypothyroidism, 56

whole-body scan with, 167

thyroid hormones effect on, 34

radioactive iodine uptake and scan,

thyroid skin disease, 72–73

46–48, 85

vitiligo, 67, 282

radioactive technetium, 232

sleep, 201

ranitidine (drug), 118

smoking, 71, 160, 161, 173

recessive gene, 208, 281

soda, diet, 184

recipes, reducing salt in, 185

sonogram.
See
ultrasound

recombinant chromosomes, 211

soy beans, 114, 140, 188

recombinant TSH, 169

specialist thyroid clinic, 97

recurrent laryngeal nerves (voice box), 75,

Stewart, Rod (singer), 10

152

stomach, 34, 68

reproductive system, 68

subacute thyroiditis.
See also

research, staying up-to-date with, 16, 275

hyperthyroidism

resin T3 uptake, 40, 281

causes of, 124–125

rheumatoid arthritis, 60

children with, 245

Riedel’s thyroiditis, 131–132, 281

defined, 281

rifampicin (drug), 117

diagnosing, 125–126

RNA, 212

symptoms of, 74, 123–124, 126, 129–130

Rosa Mosqueta oil, 156

treatment for, 80, 262

Royal College of Physicians of London, 90,

subclinical thyroid disease

149, 153

diagnosing, 37

Rubenstein, David (physician), 1

hypothyroidism, 158–159, 191–192, 281

in older persons, 247–248

• S •

thyroid hormone for, 252–253

substernal thyroid, 104

salicylates (drug), 118

sucralfate (drug), 117, 225

salt, iodised

sugary foods, 180, 184

daily recommended intake, 184, 272

sulfonamide drugs, 113–114

decreased use of, 134

sulphonylureas (drug), 114

drawbacks of, 145

surgery

for iodine deficiency, 143–144

calcium levels after, 170

reducing in recipes, 185

for cancerous nodules, 86

saturated fat, 182

for children, 244

scar reduction, 156

complications, 155

seafood, iodine in, 143

deciding to have, 147–148

selenium, 140, 170–171, 181

endoscopic thyroid surgery, 154–155

serum thyroglobulin, 45–46

extent of, 152–154

severe hyperthyroidism (thyroid storm),

for Graves’ disease, 75–76, 228

61, 80, 116, 282

new treatment approach, 163

sex, loss of interest in, 18, 19

for papillary thyroid cancer, 98, 154

sexual functioning, 35, 240

preparing for, 149–150

Siberian ginseng, 201

procedures, 150–151

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recuperating after, 155–156

protecting from radiation, 275

residual thyroid cancer after, 166–167

pyramidal lobe, 26, 281

risks and obstacles, 75–76, 151–152

size and shape, 48–49, 50

scar from, 156

thrill, buzzing sensation in, 67

talking with specialists, 149

thyroid hormones produced by, 28–31

total thyroidectomy, 75, 86, 153

weight of, 27

swallowing difficulties, 83, 103, 105, 131

thyroid acropachy, 72–73

systemic lupus erythematosus, 60

thyroid adenoma, 82, 242

thyroid agenesis, 237, 281

• T •

thyroid antigens, 76

thyroid autoantibodies.
See also
autoim-

T3 (triiodothyronine), 28–30, 62, 280, 282

mune thyroid disease

T3 thyrotoxicosis, 73, 80

antiperoxidase (antimicrosomal), 44, 127

T4 (thyroxine).
See also
thyroid hormone

antithyroglobulin, 44

replacement

blood tests for, 44–45

conversion to T3, 28–29, 62

defined, 44, 281

defined, 282

in Graves’ disease, 70

dosage for, 63–64

high levels of, 23, 265–266

generic brands, 62, 280

theories explaining, 46

for hypothyroidism, 61–64

thyroid-stimulating immunoglobulin

iodine in, 29

(TSI), 44

natural versus synthetic, 263–264

thyroid cancer.
See also specific types

for papillary thyroid cancer, 98

calcium levels after surgery, 170

production and release of, 28–29, 30

causes of, 90–91, 165, 246

role in pregnancy, 135–136

children with, 245–246

T4 immunoassay test, 38–40, 282

diagnosing, 83

testosterone, 31

follow-up treatment, 100, 167–168

tests.
See also
ultrasound

gene therapy for, 219

diagnosing thyroid disease, 266–267

guidelines for managing, 90

false results, 117–118

overview, 89–90

fine needle aspiration biopsy (FNAB),

predicting, 166

49–50, 84, 279

preventing regrowth, 273

free thyroxine index (FTI), 40–41, 280

residual, 166–167

radioactive iodine uptake and scan,

specialists, 97–98

46–48, 85

staging, 96–97

resin T3 uptake test, 40

surgery for, 152–154

size and shape of the thyroid, 46–50

survival rates for patients, 168

thyroid hormone levels, 37–43

symptoms of, 83, 92

thyroid-stimulating hormone (TSH), 38,

testing for, 43, 49–50

42–43

treating nodules, 86

total thyroxine (TT4), 38–40, 282

treatment options, 13, 90, 97–100, 165–170

therapist, selecting, 198–199

types of, 91–96

thickened tongue, 58–59

Thyroid Cancer Support Group – Wales

thiocyanate, 114, 281

(Web site), 284

thyroglobulin, 45–46, 166, 281

Thyroid Cancer Support UK (Web site), 284

thyroid.
See also
thyroid function

thyroid disease

locating, 26–27

delaying treatment, 14

‘neck check’, 271

diagnosing, 11, 266–267

nodules on, 11

incidence of, 10

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thyroid disease
(continued)

taking both types of thyroid hormone,

inheriting, 214–217

272–273

lifestyle, 14–15

testing levels of, 64

pregnancy, 15–16

thyroid hormones.
See also
thyroid hor-

risk groups, 11–12, 15–16

mone replacement; thyroxine

staying up-to-date on, 16, 275

circulating in the body, 30–31

symptoms of, 11, 18–19

depression treated with, 22

treatment options, 12–13

dosage, 63–64, 159–160

thyroid dysgenesis, 237, 282

drugs affecting, 113–115

Thyroid Eye Disease Charitable Trust (Web

drugs removing, 116–117

site), 284

function of, 31–35

Thyroid Eye Disease Surgery Information

iodine’s importance for, 29, 134

(Web site), 284