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St. Maarten Medical Center
Internal Medicine
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The thyroid gland is located at the base of your neck in front of your trachea (or windpipe). The thyroid gland makes, stores, and releases two hormones— T4 (thyroxine) and T3 (triiodothyronine).
Certain disorders can cause the thyroid gland to make too much or too little hormone.
Thyroid hormones control your metabolism, which is the rate at which every part of your body works. When your thyroid gland is working the way it should, your metabolism stays at a steady pace—not too fast and not too slow.
The thyroid gland is controlled by the pituitary gland (a gland in your brain). The pituitary gland makes thyroid stimulating hormone (TSH). TSH tells the thyroid gland to make more hormone if needed.
Thyroid disease is diagnosed by your symptoms, an exam, and tests. Symptoms of thyroid disease can be much like symptoms of other health problems.
Your doctor will examine your neck while you swallow. The thyroid gland moves when you swallow. This makes it easier for your doctor to feel. Your doctor also may examine your skin and eyes and check your weight, temperature, heart rate and blood pressure.
The following tests may be used to help find the exact cause of a thyroid problem:
During a thyroid scan, you drink a small amount of radioactive iodine. A special camera then detects the areas of the thyroid gland that absorb the radioactive iodine.
This test is not available on St. Maarten. Instead, tests for antibodies are done in the blood.
Hypothyroidism occurs when the thyroid gland does not make enough of the thyroid hormones to maintain your normal body metabolism.
The most common cause of hypothyroidism is a disorder known as thyroiditis—an inflammation of the thyroid gland. The most common type of thyroiditis is called Hashimoto disease.
In this disease, the immune system— your body’s natural defense against disease— mistakes cells in the thyroid gland for harmful invaders. Your body sends out white blood cells to destroy the thyroid gland. The pituitary gland then releases TSH to tell the thyroid gland to make more thyroid hormone. This demand on the thyroid gland can cause it to enlarge. This enlargement is called a goiter.
The symptoms of hypothyroidism are slow to develop. Common symptoms of hypothyroidism include the following:
In most cases, hypothyroidism is treated with medication that contains thyroid hormone. The dosage of the medication is increased slowly until a normal level of thyroid hormone has been reached in the blood.
Hyperthyroidism results when the thyroid gland makes too much thyroid hormone. This causes your metabolism to speed up.
The most common cause of hyperthyroidism is a disorder known as Graves disease. It most often affects women between the ages of 20 years and 40 years. A late sign of Graves disease is often a wide-eyed stare or bulging eyes. Hyperthyroidism also may result from medication. Taking too much thyroid hormone when being treated for hypothyroidism can lead to symptoms of an overactive thyroid.
Common symptoms of hyperthyroidism include the following:
Anti-thyroid medication can be used to reduce the amount of thyroid hormone your body is making. Medications known as betablockers control rapid heart beat.
In some cases, surgery may be needed to remove the thyroid gland. Alternative treatment can be given by administration of radioactive iodine.