You're
at the doctor's getting your routine annual physical. Everything's
going fine then all of a sudden, the doctor exclaims "I think
I found a lump on your neck, it's probably nothing.
But
why don't we go ahead and order a TSH?" You shudder. TSH? What's
that? TSH stands for Thyroid Stimulating Hormone. It's a screening
marker test for thyroid disease, which affects millions of Americans,
many of whom are not aware they have it.
Your
Thyroid Gland
Your
thyroid gland is located at the base of your throat, and among
its functions includes regulating your metabolic rate. It consists
of two lobes and surrounds your "Adam's apple". It secretes
hormones that affect our weight and determine whether we are
hot or cold.
It
also directly affects our organs such as the heart. When there
is an imbalance of how much thyroid hormone is produced, we
can either fall in one of two ways: overproduction or underproduction.
Thyroid stimulating hormone is responsible for coordinating
these hormones.
Hyperthyroidism:
Overproduction
Hyperthyroidism
is the result of an overactive thyroid gland, and symptoms include
a fast and irregular heart rate, nervousness, anxiety, weight
loss, and a fine tremor. President George Bush and his wife
Barbara (and even their dog!) were diagnosed with this condition,
the common cause of which is known as Graves'
disease.
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Thyroid
Stimulating Hormone (TSH) Test
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Your
doctor has ordered a TSH. What is it? Will it hurt?
What do you have to do?
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A
TSH test is a blood test performed to evaluate the
function of your thyroid gland. It measures the
amount of thyroid stimulating hormone (TSH) in your
blood. A change in the amount of TSH in the blood
indicates a malfunctioning of the thyroid gland.
You'll
be sent to a laboratory where a technician will
draw a small amount of blood; you may feel a pinprick,
but other than that, the test won't hurt. You don't
have to do anything to prepare for the test. Just
let your doctor know what medications you have been
taking, including any over-the-counter (OTC) drugs
such as aspirin, as some may interfere with the
test results. You can eat or drink before the test;
there are no food restrictions.
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We
believe Graves' disease occurs because our immune system is
somehow altered into stimulating the production of more thyroid
hormone. If not controlled, a condition known as exophthalmos
may develop. This is when the eyes seem to bulge out from their
sockets.
Treatment
can include radioactive iodine, which suppresses the thyroid
gland. Medications that can slow the heart rate may also be
used. Finally, surgery to remove part of the dysfunctional thyroid
gland can also have a successful result.
Hypothyroidism:
Underproduction
Hypothyroidism
(caused by a underproducing thyroid gland) is generally more
common than hyperthyroidism, especially in middle-aged women.
Hashimoto's disease is the most common form of primary hypothyroidism,
with symptoms including lethargy, cold intolerance, fatigue,
and hair loss. Viral and bacterial infections can also affect
the thyroid gland, but usually temporarily.
People
can also get nodules in their thyroid, which are mostly benign,
although a physician will need to make sure that it's not cancer,
usually by performing a thyroid scan or biopsy. A family history
of thyroid cancer or previous neck irradiation will also increase
your risk of hypothyroidism. Although generally benign, over
time, hypothyroidism, if left untreated can develop into a condition
called myxedema, which can result in fatigue, and eventual coma.
If
you have hypothyroidism, most likely, your doctor will start
you on synthetic thyroid hormone pills that you may need to
continue for the rest of your life. Periodic blood work will
be done to make sure the thyroid is functioning properly.
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