The thyroid is a butterfly-shaped gland at the front of the neck, and thyroid disorders affect this gland. Your thyroid is important for regulating many metabolic processes, and thyroid disorders can affect its function or structure. Your thyroid is used to produce vital hormones, and a feedback mechanism regulates its function.
If you have low thyroid hormone levels, the hypothalamus produces a hormone called thyrotropin, and this causes the pituitary gland to release a hormone called thyroid-stimulating hormone or TSH. Problems with the hypothalamus and pituitary gland can also affect the function of your thyroid. Our internists NYC physicians are among the top hypothyroidism treatment and hormone imbalance specialists in the country.
Specific types of thyroid disorders include:
- Thyroid nodules
What Is Hypothyroidism?
Hypothyroidism is a condition caused when the thyroid gland doesn’t produce enough thyroid hormone.
Hypothyroidism can cause symptoms that include:
- Feeling cold
- Fluid retention
- Poor concentration
- Dry skin
- Muscle and joint aches
Hypothyroidism may be caused by Hashimoto’s thyroiditis, which is an autoimmune condition, or thyroid hormone resistance.
What is Hyperthyroidism?
Hypothyroidism is where the thyroid produces an excess of hormones and is rarer than hypothyroidism. In mild cases, there may be very few symptoms, and most are related to increased metabolism.
Hyperthyroidism symptoms can include:
- Unintentional weight loss
- A faster heartbeat
- Feeling fatigued
- Concentration problems
- Increased bowel movements
- Increased sweating.
What Are Thyroid Nodules
Thyroid nodules are masses or lumps in the thyroid. They are usually cysts or benign tumors and are rarely cancerous. If the nodules are large, they can compress nearby structures.
A goiter is simply an enlargement of the thyroid gland and may be associated with hypothyroidism or hyperthyroidism, or the thyroid could have normal function.
Diagnosing Thyroid Disorders
Initially, we will need to review your medical history and conduct a physical exam, but specialized tests are required to diagnose thyroid disorders. Blood tests can measure levels of thyroid hormones, and there are specific tests that can identify antibodies against thyroid tissue.
If the thyroid is enlarged or if thyroid nodules are present, and ultrasound can often reveal calcifications or cysts and allows us to visualize the tissue in the gland.
A thyroid scan using radioactive iodine can evaluate its function because the thyroid is the only part of the body that takes up iodine. The test uses radioactively labeled iodine, and any nodules or areas producing excess hormone are sometimes called hot nodules and will show increased uptake of iodine. Cold nodules show a decreased iodine uptake and don’t produce excess hormone.
Sometimes it may be necessary to take a sample of cells or tissue from the thyroid gland for examination by a pathologist.
Fine-needle aspiration is a technique using a very thin needle to collect a sample of cells from the thyroid. A biopsy is required to collect a tissue sample. Once we have the results of your diagnostic tests, we can determine the best thyroid treatment.
Hypothyroidism Treatment in NYC
When deciding how to treat hypothyroidism, your local physicians or our best internal medicine doctors in New York will typically use medications that synthetically replace the missing thyroid hormone in hypothyroidism. The synthetic hormone, called levothyroxine, is given in pill form. The pill restores hormone levels to normal, reversing the symptoms and signs of hypothyroidism.
Levothyroxine usually has virtually no side effects, but it is important to take it regularly, and it’s best taken on an empty stomach every day. Ideally, the hormone is taken in the morning an hour before eating. If you prefer to take it in the evening, wait at least four hours after your last meal.
Most people begin to feel better soon after starting treatment. The medication can reverse any weight gain and will lower cholesterol levels that may have been elevated by the disease.
It’s most likely that you will need to take levothyroxine for life, but we will monitor you closely because the dosage may change. Initially, when you begin treatment, we may check TSH after 6 to 8 weeks. After this period, blood levels are generally checked six months later. Once we are sure we have the correct dosage, we will most likely check your TSH level each year.
Thyroid Nodules Treatments
Most thyroid nodules are benign, and the biopsy or fine-needle aspiration will allow us to make a definitive diagnosis. However, even benign thyroid nodules can still be problematic if they grow too large and affect your breathing or swallowing.
When the thyroid nodule is small and benign, we may monitor it using ultrasounds to check if the nodule is growing. Also, we will check your thyroid hormone levels periodically, and if there is any change, we can provide medication to regulate them.
Nodules that produce too much thyroid hormone can be treated with radioiodine taken in liquid or pill form. Radioiodine reduces the size of the nodule without harming other tissues. Other possible treatments include surgery and anti-thyroid medicines.
If the thyroid nodule is cancerous, it will need to be removed surgically. We may also choose to surgically remove very large nodules or ones that begin to change shape over time.
Thyroid Disorders Treatment Plan for Patients in NYC
Based on your medical history, physical exam and multiple tests (including specialized tests), our doctors can identify antibodies against thyroid tissue to diagnose thyroid disorders. In addition, blood tests can measure levels of thyroid hormone production. Once we have the results of your diagnostic tests, we can determine the best thyroid treatment.
Please make an appointment with one of our thyroid specialist in Midtown Manhattan or Upper East Side. Our primary care doctors, internal medicine and hypothyroidism treatment specialists look forward to meeting you!