The medical history and physical exam are important parts of the evaluation for thyroid problems. The health care practitioner will focus on eye, skin, cardiac (heart), and neurologic findings.
1.) Thyroid-Stimulating Hormone (TSH): In most cases, this is the single most useful lab test in diagnosing thyroid disease. When there is an excess of thyroid hormone in the blood, as in hyperthyroidism, the TSH is low. When there is too little thyroid hormone, as in hypothyroidism, the TSH is high.
2.) Free Thyroxine (T4): T4 is one of the thyroid hormones. High T4 may indicate hyperthyroidism. Low T4 my indicate hypothyroidism.
3.) Triodothyronine: T3 is another one of the thyroid hormones. High T3 may indicate hyperthyroidism. Low T3 may indicate hypothyroidism.
4.) TSH receptor Antibody (TSA): This antibody is present in Graves’ disease.
5.) Antithyroid Antibody (Thyroperoxidase Antibody): This antibody is present in Hashimoto’s and Graves’ disease.
6.) Nuclear Thyroid Scan: During this scan a small amount of radioactive iodine is swallowed or a similar material, 99m-technetium is injected into the blood, and then an imaging study of the thyroid is taken that reveals localization of the radioactivity. Increased uptake of the radioactive material in the thyroid gland indicates hyperthyroidism, while decreased uptake is present in hypothyroidism. This test should not be performed on women who are pregnant.
7.) Thyroid Ultrasound: Thyroid ultrasound helps to determine the size and number as well as the different types of nodules in the thyroid gland. This exam can also detect if there are enlarged parathyroid glands or lymph nodes near the thyroid gland.
8.) Fine Needle Aspiration: This test is used to see if thyroid nodules have normal cells in them. A local anesthetic may be used to numb an area on your neck. Then, a very thin needle is inserted into the thyroid to withdraw some cells and fluid is called a biopsy. The tissue is then observed under a microscope by a pathologist to look for any signs of cancer.
9.) Computerized axial Tomography (CT) Scan: A CT scan is occasionally used to look for the extent of a large goiter into the upper chest or to look for narrowing or displacement of the trachea (breathing tube) from the goiter. However, this is not a routine test for thyroid nodules or goiter.
How is Hypothyroidism treated?
Hypothyroidism is treated with medicine to supply the body with the thyroid hormones it needs to function right. The most commonly used medicine is levothyroxine. This is a man-made form of T4. It is exactly the same as the T4 that your thyroid makes. When you take T4, your body makes the T3 it needs from the T4 in the pills. A man-made form of T3, called liothyronine, is also available. Some doctors and patients prefer a combination of T4 and T3 or T3 by itself.
How is Hyperthyroidism treated?
Your doctor’s choice of treatment will depend on the cause of your hyperthyroidism and how severe your symptoms are. Treatments include Antithyroid medicines that block the thyroid disease ability to make new thyroid hormones, Radioiodine which damages or destroys the thyroid cells that make thyroid hormones, Surgery to remove most of the thyroid and Beta-blockers medicines that block the effects of thyroid hormones on the body. These medicines can be helpful in slowing your heart rate and reducing other symptoms until one of the other forms of treatment can take effect. If your thyroid is destroyed by radioiodine or removed through surgery, you must take thyroid hormone pills for the rest of your life. These pills give your body the thyroid hormones that your thyroid would normally make.
How is Goiter treated?
The treatment for goiter depends on the cause of the goiter. If your goiter is caused by not getting enough iodine, you may be given an iodine supplement to swallow and T4 hormone, if need be. Other treatments include:
1.) Radioiodine to shrink the goiter, especially if parts of the goiter are overactive
2.) Surgery to remove part or almost all of the thyroid
Diet for Hypothyroidism
Foods to be taken:
1.) Iodine is essential for the production of thyroxine so foods rich in iodine should be included like sea food and salt.
2.) Includes fiber rich foods in the diet like fruits and vegetables.
3.) Drink plenty of water
4.) Exercise daily
Foods to be avoided:
• Avoid goitrogenic foods like broccoli, cauliflower, sweet potato, mustard, radish, strawberry, peach and pear.
• Avoid alcohol, junk foods, and food rich in fat, starch and sugar
Diet for Hyperthyroidism
Foods to be taken:
1.) Eat foods high in B-vitamins and iron, such as whole grains (if no allergy), fresh vegetables
2.) Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes) and vegetables.
3.) Limit the intake of iodized salt, seafood, sea salt and some dairy product
4.) Exercise daily
Foods to be avoided in thyroid disease:
1.) Avoid refined foods, such as white bread, pasta, and sugar.
2.) Avoid meat and meat products
3.) Eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, processed foods etc.
4.) Avoid alcohol and tobacco