The thyroid gland: Love it or hate it
Dr. Ong,
I experienced sweating, palpitation and being easily irritable a few months ago. I didn’t think anything was wrong with me until I was said to have a goiter. I am taking Tapazole for my “hyperthyroid.” Can you tell me about my condition? — Alona
Alona, your thyroid problem brings up a lot of bittersweet memories for me in handling cases similar to yours. Before I tell you why, let’s start off with a simple test on how well you know your thyroid gland. Get three points correct and that’s average. Get all five points, then you must be a genius in health topics. Superb! Let’s try this…
1. Where is the thyroid gland located?
a. In front of the neck
b. In the stomach
c. In the brain
d. Above the kidneys
2. What is the shape of the thyroid gland?
a. Like a cross
b. Like a butterfly
c. Round or oval-shaped
d. Like a snake
3. How much does the thyroid gland weigh?
a. Half pound
b. 2 ounces
c. Less than an ounce
d. 4 ounces
4. The thyroid gland controls what parts of the body?
a. All cells
b. Your body’s metabolism
c. How you feel
d. All of the above
5. Which doctor specializes in diseases of the thyroid gland?
a. Endocrinologist
b. Oncologists
c. Neurologist
d. Gastroenterologist
Answers: 1. a) Your thyroid gland sits in front of the neck just above the collarbones. 2. b) It is butterfly in shape. 3. c) It weighs less than an ounce. 4. d)The thyroid produces two types of hormones, the T3 and the T4, which determines how fast the body’s organs should be running, how you feel and thus controls all cells. 5. a) Endocrinologists are the thyroid experts.
Why is the thyroid gland important?
For three reasons: 1) thyroid disorders are so common, 2) these diseases are easily missed by doctors, and 3) the thyroid controls your whole body.
Women are affected much more than men. In fact, one out of eight women (12.5 percent of the female population) will develop a thyroid problem in their lifetime. Well, that’s millions of Filipinos.
The thyroid gland acts like the captain of the ship. It is like the accelerator of the car, making the body work slower or faster depending on the hormones it produces, the so called body’s metabolism.
Because of these reasons, we should all be thankful to (and thus love) our thyroid glands. However, should this tiny organ falter for whatever reason, we could have a medical disaster in our hands, something patients and doctors should know about.
Is Your Thyroid Overactive?
The thyroid gland is like Robin Williams. They’re good impersonators and can mimic any disease. If your thyroid is overacting, I mean overactive, you could have a wide variety of symptoms like palpitation, sweating, diarrhea, nervousness, tremors, insomnia, irregular menses and loss of weight. This disease is called hyperthyroidism or Graves’ Disease. If this is not diagnosed early, the eyes can bulge out, the heart fail, and the patient can die.
Diseases of the thyroid are so easily missed. Sometimes it’s just a slight increase in heart rate or a little feeling of being hot. If you have menopausal symptoms and are still less than 50, you need to have your thyroid checked.
If your wife is always irritable lately and nagging you more than usual, it could be her thyroid. If your wife seems jumpy, angry and ‘shouty’ most of the time, it could be her thyroid. If she accuses you of philandering or insists that you’re looking at other women, it could be her thyroid. On second thought, it could be you.
Is Your Thyroid Underactive?
Going to the opposite problem, if the thyroid is underactive, we call this hypothyroidism. Again, this is a nightmare for doctors to diagnose unless they have a morning mantra saying, “Thyroid gland. Thyroid gland.”
Look how difficult it is to diagnose. The complaints of people with hypothyroidism are practically the complaints of worriers and every other patient we see. They experience fatigue (everybody complains of fatigue), poor memory (who doesn’t forget), constipation (elderly people are uniformly constipated), high cholesterol (tricky, tricky, the elevated cholesterol is not due to lechon but the hidden thyroid gland), loss of hair, dry skin, weight gain, aching muscles and joint pains.
Well, I rest my case. It will take a genius to diagnose hypothyroidism on the first try. The symptoms are so difficult to predict that it could be anything really. And if a doctor misses the diagnosis, it could prove disastrous in the long run.
Disasters with the Thyroid Gland
As doctors, we find it terribly frustrating and irritating to miss a diagnosis. No one is perfect. And doctors, being human, can’t get a perfect test score every time. And thyroid diseases are the Achilles’ heel of medical diagnosis.
Many doctors have been stumped from unusual patient complaints only to find out that the thyroid gland (just staring at them mockingly in the clinic) is the nasty culprit. Each doctor can probably remember a time they had missed this great mimicker.
That’s why I hate it. I hate thyroid disease so much I want to remember it every time a patient comes to me talking gibberish and seemingly making things up.
A real problem occurred in 1991 during Operation Desert Storm. President George H.W. Bush (the elder one) was so adamant about bombing
Would deaths have been prevented?
I don’t know how many misunderstandings, fights and divorces could have come from an overactive thyroid gland but I’ll bet there’s a good number.
Testing the thyroid gland
It’s easy to test the thyroids. We just request a blood test, called thyroid function tests that include Free T3, Free T4 and TSH levels. So why don’t we just test everyone? Well, because it costs close to a thousand pesos to test.
We interpret the results as follows. If T3 and T4 are high and TSH is low, then you’ve got hyperthyroidism (fast or overactive thyroid). Your thyroid hormones, T3 and T4, are high, thus your TSH is inhibited. Urgent treatment is necessary with drugs like Tapazole or PTU. I feel good when I catch these diseases.
For the opposite case of having a low T3 and T4 with a high TSH, then this means you’ve got hypothyroidism (slow or underactive thyroid). The thyroid hormones in the body are low and patients feel slow. Treatment is thyroid hormone replacement, like Levothyroxine (Eltroxin), given for life.
Another useful test is the thyroid scan, which detects thyroid nodules and possible cancers. Your endocrinologist will tell you which other tests you need.
It’s the thyroid gland!
Our brains easily remember either of two things: those we love and those we hate. Thinking of the thyroid gland makes me squirm. It’s like thinking of the wrong answer I got in a previous test. I should remember. I should remember. All together now: “We should always remember to check the thyroid glands.” Care to check your Free T3, Free T4, and TSH, anyone?
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E-mail me at drwillieong@gmail.com
