Doctor, tell me more about my Thyroid Gland...
Information about thyroid
What is Your Thyroid Gland?
Your thyroid gland is one of the endocrine glands, which make hormones to
regulate physiological functions in your body. The thyroid gland manufactures
thyroid hormone, which regulates the rate at which your body carries on its
necessary functions. Other endocrine glands are the pancreas, the pituitary, the
adrenal glands, the parathyroid glands, the testes, and the ovaries.
The thyroid gland is located in the middle of the lower neck, below the
larynx (voice box) and just above your clavicles (collarbones). It is shaped
like a "bow tie," having two halves (lobes): a right lobe and a left lobe joined
by an "isthmus". You can't always feel a normal thyroid gland.
When Is a Thyroid Gland Abnormal?
Diseases of the thyroid gland are very common, affecting millions of
Americans. The most common diseases are an over- or under-active gland. These
conditions are called hyperthyroidism (e.g., Grave's disease) and
hypothyroidism. Sometimes the thyroid gland can become enlarged from
over-activity (as in Grave's disease) or from under-activity (as in
hypothyroidism). An enlarged thyroid gland is often called a "goiter." Sometimes
an inflammation of the thyroid gland (Hashimoto's disease) will cause
enlargement of the gland.
Patients may develop "lumps" or "masses" in their thyroid glands. They may
appear gradually or very rapidly. Patients who had radiation therapy to the head
or neck as children for acne, adenoids, or other reasons are more prone to
develop thyroid malignancy. A doctor should evaluate all thyroid "lumps"
How Does Your Doctor Make the Diagnosis?
The diagnosis of a thyroid abnormality in function or a thyroid mass is made
by taking a medical history and a physical examination. Specifically, your
doctor will examine your neck and ask you to lift up your chin to make your
thyroid gland more prominent. You may be asked to swallow during the
examination, which helps to feel the thyroid and any mass in it. Other tests
your doctor may order include:
- An ultrasound examination of your neck and thyroid
- Blood tests of thyroid function
- A radioactive thyroid scan
- A fine needle aspiration biopsy
- A chest X-ray
- A CT or MRI scan
Fine Needle Aspiration
If a lump in your thyroid is diagnosed, your doctor may recommend a fine
needle aspiration biopsy. This is a safe, relatively painless procedure. A
hypodermic needle is passed into the lump, and samples of tissues are taken.
Often several passes with the needle are required. There is little pain
afterward and very few complications from the procedure occur. This test gives
the doctor more information on the nature of the lump in your thyroid gland and
specifically will help to differentiate a benign from a malignant thyroid
Treatment of Thyroid Disease
Abnormalities of thyroid function (hyper or hypothyroidism) are usually
treated medically. If there is insufficient production of thyroid hormone, this
may be given in a form of a thyroid hormone pill taken daily. Hyperthyroidism is
treated mostly by medical means, but occasionally it may require the surgical
removal of the thyroid gland.
If there is a lump of the thyroid or a diffused enlargement (goiter), your
doctor will propose a treatment plan based on the examination and your test
results. Most thyroid "lumps" are benign. Often they may be treated with thyroid
hormone, and this is called "suppression" therapy. The object of this treatment
is to attempt shrinkage of the mass over time, usually three-six months. If the
lump continues to grow during treatment when you are taking the medication, most
doctors will recommend removal of the affected lump.
If the fine needle aspiration is reported as suspicious for or suggestive of
cancer, then thyroid surgery is required.
What Is Thyroid Surgery?
Thyroid surgery is an operation to remove part or all of the thyroid gland.
It is performed in the hospital, and general anesthesia is usually required.
Usually the operation removes the lobe of the thyroid gland containing the lump
and possibly the isthmus. A frozen section (an immediate microscopic reading)
may or may not be used to determine if the rest of the thyroid gland should be
removed. Sometimes, based on the result of the frozen section, the surgeon may
decide to stop and remove no more thyroid tissue, or proceed to remove the
entire thyroid gland, and/or other tissue in the neck. This is a decision
usually made in the operating room by the surgeon, based on findings at the time
of surgery. Your surgeon will discuss these options with you preoperatively.
After surgery, you may have a drain (a tiny piece of plastic tubing), which
prevents fluid from building up in the wound. This is removed after the fluid
accumulation is minimal. Most patients are discharged one to three days after
surgery. Complications after thyroid surgery are rare. They include bleeding, a
hoarse voice, difficulty swallowing, numbness of the skin on the neck, and low
blood calcium. Most complications go away after a few weeks. Patients who have
all of their thyroid gland removed have a higher risk of low blood calcium
Patients who have thyroid surgery may be required to take thyroid medication
to replace thyroid hormones after surgery. Some patients may need to take
calcium replacement if their blood calcium is low. This will depend on how much
thyroid gland remains, and what was found during surgery. If you have any
questions about thyroid surgery, ask your doctor and he or she will answer them
© 2004 AAO-HNS/AAO-HNSF
Please read our disclaimer. Any information provided on this Web site should not be considered medical advice or a substitute for a consultation with Dr. Hector N. Hernandez or other healthcare professional. If you have a medical problem, contact us for diagnosis and treatment.