Thyroid For Dummies, UK Edition

Alan L. Rubin, MD has over thirty years' experience treating thyroid conditions and is the co-author of Diabetes For Dummies. Dr. Sarah Brewer is the co-author of Arthritis For Dummies, a health writer and broadcaster, and a former Health Journalist of the Year.

• Introduction 1About This Book 2Conventions Used in This Book 2What You Don’t Have to Read 2Assumptions 3How This Book Is Organised 3Part I: Understanding Your Thyroid 3Part II: Treating Thyroid Problems 3Part III: Managing Your Thyroid 3Part IV: Considering Special Aspects of Thyroid Health 4Part V: The Part of Tens 4Part VI: Appendices 4Icons Used in This Book 4Where to Go from Here 5Part I: Understanding the Thyroid 7Chapter 1: Bigging It Up: The Huge Role of a Little Gland 9Discovering the Extent of the Problem 10Identifying an Unhappy Thyroid 11Recognising Who’s at Risk 11Realising the Importance of a Healthy Thyroid 12Treating What Ails You 12Understanding the Consequences of Delaying Treatment 14Giving Your Thyroid a Hand: Healthy Lifestyle Choices 14Paying Special Attention: Pregnant Women, Children, and Older People 15Staying Informed 16Chapter 2: Feeling Fragile: The Emotional Effects of Thyroid Problems 17Exploring How an Underactive Thyroid Slows Your Thoughts 18Seeing How an Overactive Thyroid Can Trigger Anxiety 19Fighting Depression 20Finding out if your thyroid is causing depression 21Using thyroid hormone to treat depression 22Chapter 3: Discovering How Your Thyroid Works 25Locating the Thyroid 26Producing Thyroid Hormones 28Identifying the importance of iodine 29Regulating thyroid hormones 29Moving thyroid hormones around 30Understanding the Function of Thyroid Hormones 31General functions 32Specific functions 33Chapter 4: Testing Your Thyroid 37Checking Blood Levels of Thyroid Hormones 38Total thyroxine 38Resin T3 uptake 40Free thyroxine index 40Free thyroxine (FT4) 41Free triiodothyronine (FT3) 42Thyroid-stimulating hormone (TSH) 42Taking Non-Hormonal Blood Tests 43Thyroid autoantibodies 44Serum thyroglobulin 45Determining the Size, Shape, and Content of Your Thyroid 46Radioactive iodine uptake and scan 46Thyroid ultrasound 48Fine needle aspiration biopsy (FNAB) 49Part II: Treating Thyroid Problems 51Chapter 5: Dealing with an Underactive Thyroid 53Living with Autoimmune Thyroiditis 54The extent of the problem 54Symptoms of chronic thyroiditis 55Approach to treatment 55Identifying Hypothyroidism 56Signs and symptoms of hypothyroidism 56Confusing conditions 57Pinpointing the Causes of Hypothyroidism 58Removal of the thyroid 58Absence of brain hormones 58Foods that cause hypothyroidism 59Drugs that cause hypothyroidism 59Coexisting autoimmune diseases 60Diagnosing Severe Hypothyroidism 61Treating Hypothyroidism 61Taking the right hormones 61Getting the right amount 63Testing hormone levels 64Chapter 6: Taming an Overactive Thyroid 65Picturing Hyperthyroidism 66Listing the Signs and Symptoms of Hyperthyroidism 66The body generally 67The thyroid 67The skin and hair 67The heart 68The nervous system and muscles 68The reproductive system 68The stomach and intestines 68The urinary system 68The eyes 69Confirming a Diagnosis of Hyperthyroidism 69Determining Whether Graves’ Disease Is the Culprit 70Causes of Graves’ disease 70Signs and symptoms specific to Graves’ disease 71Recognising Other Causes of Hyperthyroidism 73Choosing the Best Treatment for Graves’ Disease 74Thyroid surgery 75Radioactive iodine treatment 76Antithyroid pills 77Other helpful medications 79Treating Other Causes of Hyperthyroidism 79Surviving Thyroid Storm 80Chapter 7: Getting the Low-Down on Thyroid Nodules 81Discovering a Thyroid Nodule 82Evaluating Cancer Risks 83Securing a Diagnosis 83The fine needle aspiration cytology 84The thyroid ultrasound scan 85Treating Cancerous Nodules 86Dealing with Nodules That Are Non-Cancerous 86Hot nodules 87Benign cysts 87Warm or cold nodules 87Ignoring Small Nodules 87Chapter 8: Coping with Thyroid Cancer 89Determining What Causes Thyroid Cancer 90Identifying the Types of Thyroid Cancer 91Papillary thyroid cancer 92Follicular thyroid cancer 93Medullary thyroid cancer 93Undifferentiated (anaplastic) thyroid cancer 95Staging Thyroid Cancer 96Treating Thyroid Cancer 97Papillary thyroid cancer 98Follicular thyroid cancer 99Medullary thyroid cancer 99Undifferentiated (anaplastic) thyroid cancer 100Following Up Cancer Treatment 100Chapter 9: Learning about Multinodular Goitres 101Exploring How a Multinodular Goitre Grows Up 101Choosing to Treat It or Ignore It 103Making a Diagnosis 104Treating a Multinodular Goitre 105Part III: Managing Your Thyroid 107Chapter 10: Taking Care with Drugs That Affect Your Thyroid 109Revealing the Drug–Food–Thyroid Connection 109Identifying the Effects of Specific Substances 112Initiating or aggravating hypothyroidism 113Creating false test results 117Causing an increase in thyroid activity 118Preventing Harmful Drug Interactions 119Discovering Whether You’re at Risk 119Chapter 11: Spotting Thyroid Infections and Inflammation 123Putting a Face on Subacute Thyroiditis 123Causes and effects 124Laboratory findings 125Treatment options 126Coping with Postpartum and Silent Thyroiditis 127Understanding the disease 127Interpreting lab results 128Getting treatment 128Identifying Acute Thyroiditis 129Describing the disease 129Confirming the diagnosis with lab tests 130Treating acute thyroiditis 130Diagnosing a Rare Form of Thyroiditis 131Chapter 12: Overcoming Iodine Deficiency Disease 133Realising the Vastness of the Problem 134Facing the Consequences of Iodine Lack 135Pregnancy 135Infancy 136Childhood 136Adulthood 136Endemic Cretinism 137Looking at the geographic distribution 138Contributing factors 139Goitre: The body’s defence 140Neurologic cretinism 141Myxoedematous cretinism 141Managing the Problem of Iodine Deficiency 142A sprinkle of salt 143An injection of oil 144A slice of bread or cup of water 145Drawbacks of Iodisation 145Chapter 13: Going In: Surgery on the Thyroid Gland 147Deciding When Surgery Is Necessary 147Talking Things Over 149Preparing for Surgery 149What Happens During Surgery 150Surgical obstacles 151Extent of surgery 152Considering a New Approach 154Possible Complications 155Recuperating After the Operation 155Chapter 14: Exciting New Approaches in Thyroid Treatment 157Preventing Ill Effects of Large Doses of Iodine 157Finding Out More about Hypothyroidism 158Treating (or not treating) subclinical hypothyroidism 158Finding the right dose of hormone 159Determining the prevalence of hypothyroidism 160Linking heart disease and hypothyroidism 160Dealing with Hyperthyroidism 161Measuring calcium levels 162Controlling weight gain 162Revolutionising thyroid surgery 163Gathering clues to hyperthyroid eye disease 163Treating Goitres and Nodules 164Performing surgery after ethanol injections 164Shrinking goitres 164Developing New Approaches in Thyroid Cancer 165Understanding the impact of radioiodine exposure 165Blocking oestrogen slows tumour growth 166Predicting thyroid cancer 166Detecting residual thyroid cancer 166Following up thyroid cancer treatment 167Knowing what to expect from medullary thyroid cancer 168Using recombinant TSH to treat thyroid cancer 169Testing calcium levels after cancer surgery 170Tackling Iodine Deficiency Disease 170Recognising the importance of selenium 170Using iodised oil for goitres 171Increasing the intelligence of babies born to hypothyroid mothers 171Chapter 15: Living with Thyroid Problems: Diet and Exercise 173Guaranteeing Your Best Nutrition 173Maintaining a Healthy Weight 174Calculating your body mass index 175Measuring your waist size 176Losing excess weight 177Selecting a variety of foods 177Choosing your fats wisely 182Checking out your cholesterol 182Moderating your sugar intake 184Sifting the salt 184Drinking alcohol in moderation 185Going Organic 186Thinking about food safety 186Clarifying the Thyroid–Weight Connection 187Does my metabolism slow when I lose weight? 187If I’m treated for hyperthyroidism, am I doomed to gain weight? 187Considering Iodine in Your Diet 189Getting enough iodine in a vegetarian diet 189Exercising for Your Thyroid 190Recognising the natural consequences of ageing 190Working out with hypothyroidism 191Exercising with hyperthyroidism 192Meeting your minimal exercise needs 193Introducing Leptin: The New Hormone on the Block 194Understanding the functions of leptin 194Interacting with thyroid hormone 195Chapter 16: Helping Yourself: Herbs and Homeopathy 197Finding a Reputable Practitioner 198Digging into Medicinal Herbs 199Bladderwrack 199Bugleweed 200Korean ginseng 200Motherwort 200Oats 201Siberian ginseng 201Turmeric 201Valerian 201Understanding Homeopathy 202Discovering homeopathic remedies 202Taking a remedy 203Arsenicum album 203Iodum 204Belladonna 204Natrum Mur 204Part IV: Special Considerations in Thyroid Health 205Chapter 17: Examining the Genetic Link to Thyroid Disease 207Genetics for Beginners 207A monk and his pea plants 208Talk the talk 209The great divide 209Genes, chromosomes, and the traits they create 210The secret lives of genes 211Shall I form a liver or a brain? 213The Origins of Genetic Thyroid Diseases 214Inheriting a disease through a single gene 214Inheriting a disease through multiple genes 216Inheriting a chromosome abnormality 217The Future of Managing Hereditary Thyroid Disease 218Genetic engineering 218The ethics of germline gene therapy 219Chapter 18: Controlling Thyroid Disease during Pregnancy 221Looking at Normal Thyroid during Pregnancy 222Pregnancy and Hypothyroidism 223Decreased fertility 223Iodine deficiency 224Autoimmune hypothyroidism 224Hyperthyroidism in Pregnancy 225Postpartum Graves’ disease 229Gestational transient thyrotoxicosis 229Hydatidiform mole and choriocarcinoma 231Finding New Thyroid Nodules during Pregnancy 231Chapter 19: Developing Thyroid Conditions in Childhood 233Understanding the Onset of Thyroid Function 233Screening the Newborn 235Coping with Hypothyroidism in Children 236Transient congenital hypothyroidism 237Congenital hypothyroidism 237Acquired hypothyroidism 239Dealing with Hyperthyroidism in Children 241Signs and symptoms 241Laboratory confirmation 243Treatment 243Diagnosing Goitres in Children 245Linking Nodules and Cancer in Children 245Chapter 20: Maturing: Thyroid Disease in Later Life 247Assessing the Extent of the Problem 248Understanding Sources of Confusion in Diagnosis 249Acknowledging other diseases 249Taking medications 250Discovering Hypothyroidism in Older People 250Deciphering signs and symptoms 251Getting laboratory confirmation 252Trying thyroid hormone for subclinical patients 252Taking treatment slowly 253Managing Hyperthyroidism in Older People 253Sorting through confusing signs and symptoms 254Securing a diagnosis 255Checking Out Thyroid Nodules in Older People 256Part V: The Part of Tens 257Chapter 21: Ten Myths about Thyroid Health 259I’m Hypothyroid, So I Can’t Lose Weight 259I’m Hyperthyroid, So I Can’t Gain Weight 260Breastfeeding and Antithyroid Pills Don’t Mix 261Brand Name Thyroid Hormone Pills Are Best 261I Have to Take Thyroid Medication for Life 262Natural Thyroid Hormones Are Better Than Synthetic Hormones 263Thyroid Disease Is Catching 264Iodine Deficiency Is a Medical Problem 264The Higher My Autoantibody Levels, the Worse My Thyroid Disease 265Clinical Symptoms Are More Reliable Than Blood Tests 266Chapter 22: Ten Ways to Maximise Thyroid Health 269Screening at Appropriate Intervals 270Checking Thyroid Function As Your Body Changes 270Performing a ‘Neck Check’ 271Getting Enough Iodine to Satisfy Your Thyroid 272Stopping Thyroid Medication, If Possible 272Using Both Types of Thyroid Hormone 272Preventing the Regrowth of Thyroid Cancer 273Anticipating Drug Interactions 274Protecting Your Thyroid from Radiation 275Keeping Up-to-Date with Thyroid Discoveries 275Part VI: Appendixes 277Appendix A: Glossary of Key Terms 279Appendix B: Sources of More Information 283Index 285