A number of relatively vague symptoms can be the result of a problem with your thyroid, which is a gland located in the middle of the neck that controls metabolism. An overactive thyroid can cause you to lose weight, have elevated blood pressure and heart rate, or experience a tremor, while an underactive thyroid can result in fatigue and weight gain.
Sometimes, a thyroid problem can be identified by noticing a lump in the middle of the lower neck.
“Generally, thyroid dysfunction is initially managed by a primary care physician or an endocrinologist,” said Dr. Nathan Schreiber, a Marshfield Clinic otolaryngologist. “An otolaryngologist typically gets involved when surgery is needed.”
Is it a thyroid issue?
Schreiber said lab tests for thyroid hormone levels can help determine whether your symptoms are thyroid related or not. In some cases, an ultrasound exam to evaluate the structure of the thyroid is needed, primarily when a nodule in the thyroid is identified.
“The symptoms of thyroid dysfunction are often vague,” Schreiber said. “And a lot of different conditions can cause many of these symptoms. In many cases, when the thyroid is underactive, a replacement hormone can be given as a daily pill, which is usually a very successful treatment.”
Removing the thyroid
There are a few scenarios where the thyroid may need to be removed.
“If you develop thyroid nodules that are concerning for cancer or compressing the airway or esophagus, thyroid surgery may be considered,” Schreiber said. “Graves disease, which is an autoimmune condition that causes the thyroid to produce too much hormone, can also be treated with surgery, typically if treatment with medication fails to be effective.”
Depending on the situation, half of the thyroid or the entire thyroid may be removed. Thyroid surgery is typically performed under general anesthesia, commonly as an outpatient procedure or in some cases with overnight observation.
After thyroid surgery, Schreiber wants patients to “take it easy” for about two weeks.
“We want you to avoid strenuous activity, and then after that you can pretty much go about your daily activities normally,” he said.
After the thyroid is removed
If the thyroid was removed because of cancer, post-surgical treatment may include taking radioactive iodine to reduce the chance of the cancer coming back and is usually very successful. To replace thyroid function, providers may give their patient a daily replacement hormone pill. If only half the thyroid is removed, you may not need the replacement hormone, but need to be closely monitored.
If you’re concerned you may have a thyroid health problem, a good place to start is by having a discussion with your primary care provider.