Ruchi Mathur, MD, FRCP(C) is an Attending Physician with the Division of Endocrinology, Diabetes and Metabolism and Associate Director of Clinical Research, Recruitment and Phenotyping with the Center for Androgen Related Disorders, Department of Obstetrics and Gynecology at Cedars-Sinai Medical Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
A thyroid scan can provide information on
the size and shape of the gland as well as the overall activity of the gland (is
the whole thyroid gland overactive or underactive?).
For example, thyroid scanning is used to determine how
active thyroid tissue is in manufacturing
thyroid hormone. This
feature can determine whether inflammation of the thyroid
gland (thyroiditis) is present. It can also detect the presence and degree of
overactivity of the gland (hyperthyroidism ). In this case the scan reveals
increased iodine uptake by the whole gland.
In addition, a thyroid scan can provide information on
specific areas within the thyroid gland and can help to determine whether any
localized areas are hyperfunctioning or under functioning compared to the rest
of the gland. In these cases spots appear on the image
corresponding to areas that take up iodine differently from the rest of the
gland.
Thyroid scanning is especially helpful in evaluating
thyroid nodules,
particularly after a fine needle
aspiration biopsy has failed
to provide a diagnosis. A scan will reveal whether a thyroid nodule is
"functioning" or "nonfunctioning". Doctors refer to hyper functioning nodules of
the thyroid (those that are actively taking up iodine to produce thyroid hormone
more so
than surrounding thyroid tissue) as "hot" nodules, and these hyperfunctioning
areas are seen on the image of the thyroid gland. A nonfunctioning nodule does
not take up iodine and produces a localized "cold" area on the image of the
thyroid gland.
In addition, thyroid scanning can be done to help
determine if thyroid cancer has spread beyond the bed of the thyroid in the neck. For this
purpose, usually a whole body thyroid scan is performed.
Hypothyroidism is any state in which thyroid hormone production is below normal. Normally, the
rate of thyroid hormone production is controlled by the brain at the pituitary.
Hypothyroidism is a very common condition and the symptoms of hypothyroidism are
often subtle.
Hyperthyroidism is an excess of thyroid hormone resulting from an overactive thyroid gland. Symptoms can include increased heart rate, weight
loss, depression, and cognitive slowing. Treatment is by medication, the use of
radioactive iodine, thyroid surgery, or reducing the dose of thyroid hormone.
There are four major types of thyroid cancer: papillary, follicular, medullary, and anaplastic thyroid cancer. Tumors on the thyroid are referred to as thyroid nodules. Symptoms of thyroid cancer include swollen lymph nodes, pain in the throat, difficulty swallowing, hoarseness, and a lump near the Adam's apple. Treatment usually involves chemotherapy, surgery, radioactive iodine, hormone treatment or external radiation and depends upon the type of thyroid cancer, the patient's age, the tumor size, and whether the cancer has metastasized.
Hashimoto's thyroiditis is the most common cause of hypothyroidism in the US. This conditions is caused by inflammation of the thyroid gland. Symptoms may include: fatigue, weight gain, cold intolerance, excessive sleepiness, dry or coarse hair, difficulty swallowing, a lump in the front of the throat, and many more. Treatment is usually hypothyroid medication.
Thyroid nodules are the most common endocrine problem in the United States. The term "thyroid nodule" refers to any abnormal growth that forms a lump in the thyroid gland. The vast majority of thyroid nodules are benign.
There are many types of thyroid disease. Some occur due to the function of the thyroid itself such as hypothyroidism, hyperthyroidism, Hashimoto's thyroiditis, etc. Some causes of thyroid disease occur due to problems with the structure of the thyroid gland such as goiters, thyroid nodules, and thyroid cancer. Treatment of thyroid disease depends on the cause of the disease.
Graves' disease is an autoimmune disease that affects the thyroid. Some of the symptoms of Graves' disease include hand tremors, rapid heartbeat, trouble sleeping, enlarged thyroid, thinning of the skin or fine brittle hair. Causes of Graves' disease are thought to be multifactorial such as genes, gender, stress, and infection. Treatment for Graves' disease is generally medication.
Thyroiditis is the inflammation of the thyroid gland. The inflamed thyroid gland can release an excess of thyroid hormones into the blood stream, resulting in a temporary hyperthyroid state. Some forms of thyroiditis can be diagnosed based on tenderness and enlargement of the thyroid gland. A thyroid scan sometimes is used in making the diagnosis. Thyroiditis can also be diagnosed with a biopsy of the thyroid gland.
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