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Thyroid Disease News
Aug. 18, 2022 — In single pollutant models and within a 20-year period, 10 out of 29 reviewed pesticides were associated with thyroid cancer, including several of the most widely used ones in the U.S. These included ...
Aug. 12, 2022 — The targeted therapy pralsetinib was well-tolerated and demonstrated high response rates in patients with RET gene fusions, regardless of tumor ...
July 6, 2022 — Older people with hypothyroidism, also called underactive thyroid, may be at increased risk of developing dementia, according to a new study. The risk of developing dementia was even higher for ...
June 28, 2022 — The current system of chemical risk assessment is inadequate and underestimates levels of flame retardants and other pollutants needed to cause harmful health effects, according to a recent ...
May 20, 2022 — Two recent discoveries may help lead to new ways to treat patients with Allan-Herndon-Dudley syndrome (AHDS), a brain development disorder that causes severe intellectual disability and problems with ...
Feb. 8, 2022 — Toxic goiter affects the brain more than was previously known, a new study shows, and involves volume changes occurring in central parts of the brain. These findings are described as a key advance ...
Jan. 6, 2022 — Thyroid hormone levels during pregnancy may predict preschool boys' emotional and behavioral problems, according to a new ...
Jan. 5, 2021 — Maternal health, in-utero, and perinatal exposures and risk of thyroid cancer in ...
What Is Thyroid Cancer? Symptoms, Causes, Diagnosis, Treatment, And Prevention
About 99 percent of people with thyroid cancer survive for at least 5 years after being diagnosed with the disease, according to NCI.
Part of the reason for this high survival rate is that thyroid cancer is usually caught early, before it has had a chance to spread beyond the throat, according to one analysis.
In fact, about 68 percent of thyroid cancer diagnoses occur when the cancer is still confined to the thyroid, according to the Annals of Surgical Oncology.
There are several different options for treating thyroid cancer. The most effective treatment will depend on the stage and type of thyroid cancer you have.
Thyroid Cancer SurgerySurgery is the primary treatment for thyroid cancer (except for some cases of anaplastic carcinoma, an aggressive type of thyroid cancer that often spreads to other areas of the body), according to ACS.
If the cancer is only in one lobe of your thyroid gland, your surgeon may opt for a lobectomy.
In this procedure, the surgeon makes an incision in your neck to expose the thyroid, then cuts out the affected lobe — often along with the strip of tissue that connects the two lobes.
The most common thyroid cancer surgery, however, is a thyroidectomy, in which the entire gland is removed.
Your surgeon may also remove the lymph nodes in the back of your neck if your thyroid cancer has spread to them.
Thyroid cancer surgery may cause the following side effects:
Also, after undergoing a thyroidectomy, you will have to take daily thyroid hormone pills.
Radiation TherapyRadiation therapy may be used in combination with surgery to destroy any cancer cells still left in the body.
In this procedure, which is often used if the cancer has spread beyond the thyroid gland, doctors treat the area with high-energy X-rays or another type of radiation, using either an external machine or an internally placed device.
Radiation therapy may cause the following side effects:
Alternatively, your doctor may use a special radiation technique called radioactive iodine (RAI) therapy.
This therapy makes use of the fact that the thyroid gland naturally absorbs nearly all of the iodine in your body, including radioactive forms of iodine, according to ACS.
When you swallow RAI capsules or fluids, your thyroid tissues — including cancer cells that have spread to other parts of the body — absorb the RAI, which destroys the cells.
Possible side effects of RAI therapy include temporary:
A few different treatments for thyroid cancer involve taking medications.
In thyroid hormone therapy, drugs are used to stop the body from producing thyroid-stimulating hormone.
This helps slow the growth of thyroid cancer and prevent the cancer from returning after treatment.
As with other types of cancer, chemotherapy is often used to treat thyroid cancer that has spread to other areas of the body.
However, most chemotherapy drugs affect other rapidly dividing cells in the body that aren't cancerous, leading to a number of side effects, including hair loss, diarrhea, and fatigue.
A newer kind of chemotherapy — targeted therapy — uses drugs that interfere with specific molecules that cancer cells need to grow, according to ACS.
Though less damaging to the body than regular chemotherapy, targeted therapy drugs may cause side effects, which range from fatigue and high blood pressure to heart and liver problems.
Learn More About Thyroid Nodules
Overdiagnosis: Hypothyroidism
As part of our series on conditions that may be overdiagnosed, GP Dr Peter Bagshaw considers whether we over-diagnose hypothyroidism and should instead consider other causes
BackgroundTiredness is a common symptom, so it is not surprising that many patients would like a simple solution. While tiredness is one of the symptoms of hypothyroidism, there are many other causes to consider.
In recent years, social media have amplified the idea that undiagnosed thyroid disorders are common causes of tiredness and low energy. There is an even broader trend to blame medics for not taking tiredness seriously.
Actual prevalenceHypothyroidism is found in 1-2% of the UK population and in more than 5% of people over 60. Women are five to 10 times more likely to be affected than men.1 NICE states that 'subclinical hypothyroidism may have been overestimated in older people', with age-related physiological increase in TSH levels being misinterpreted as thyroid disease.'1
Common featuresFatigue, weight gain, cold intolerance, dry skin and hair, muscle and joint pain, constipation, depression and mood changes, memory and cognitive problems, menstrual irregularities and elevated cholesterol levels are all classic features of hypothyroidism. Often only a few of these symptoms are present. Subclinical hypothyroidism (defined as raised TSH but normal T3/T4) may be asymptomatic.
Reasons for overdiagnosisSymptoms of hypothyroidism are common. One Swiss study found prevalence of fatigue was 21.9% in the general population.2 Patients' research, or even well-meaning friends, may identify hypothyroidism as a potential cause. Hypothyroidism is also easier to address than lifestyle or mental health causes.
The chances of an abnormal thyroid blood test in this group is high. Subclinical hypothyroidism affects 5–10% of the population.3 Often these abnormalities are transient and return to normal when repeated, but patients will often latch onto the transient abnormality as the cause of their symptoms.
Supporting the patient's next stepsIf both TSH is raised and free thyroxine (FT4) is reduced, the diagnosis is likely to be correct and we should start treatment. Given the high incidence of tiredness from other causes, it is important to explain that correcting thyroid function may not always abolish symptoms.
The situation is very different when the patient has a raised TSH and normal (or not measured) FT4. Given the relative incidence of asymptomatic subclinical hypothyroidism, rushing to treatment is not advised. NICE recommends if patients are not pregnant, to repeat TFTs after three to six months to exclude other causes of a transiently raised TSH and to confirm the diagnosis.1
Broader issuesBorderline hypothyroidism is the subject of controversy. Several studies point out that treating subclinical hypothyroidism, which can revert to normal spontaneously, has no clinical benefits.4 Some criticise 'over-reliance on a single laboratory parameter, TSH'.5 However, relying on patient wellbeing, as some studies recommend, can be difficult when many patients report feeling better if they run slightly hyperthyroid. In addition, support groups debate the relative benefits of levothyroxine, liothyronine or desiccated thyroid extract. GPs may be asked to advise on these.
Overall, we should try to stick to NICE guidance: a mildly abnormal TSH alone is unlikely to be the cause of the patient's symptoms. Holding off treatment and repeating TSH and FT4 six weeks later may not make us popular with our patients, but it is the right thing to do, and may reduce harmful overtreatment.
Dr Peter Bagshaw is a GP in Minehead, Somerset
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