thyroid

The thyroid is a butterfly shaped gland located in the neck.The American Thyroid Association estimates more than 20 million Americans have some form of thyroid disorder. Of these disorders, Hashimoto’s thyroiditis is one of the most common, believed to be the leading cause of primary hypothyroidism in North America. But it may surprise you to learn that Hashimoto’s thyroiditis, also known as chronic autoimmune thyroiditis, is actually an autoimmune disease, like type-1 diabetes or rheumatoid arthritis.

An autoimmune disorder causes your immune system – which usually fights off infections – to attack otherwise helpful parts of your body. In the case of Hashimoto’s thyroiditis, your immune system attacks your thyroid, which can cause inflammation and lead to an underactive thyroid gland.

Hashimoto’s most commonly affects older women, though it can strike either sex at any age. Risk factors include prior autoimmune diseases or a family history of thyroid problems.

The symptoms for Hashimoto’s are often vague and easily confused with other health problems. They include:

  • Fatigue
  • Increased sensitivity to cold
  • Constipation
  • Pale, dry skin
  • A puffy face
  • Hoarse voice
  • Unexplained weight gain
  • Muscle aches, tenderness and stiffness, especially in your shoulders and hips
  • Pain and stiffness in your joints and swelling in your knees or the small joints in your hands and feet
  • Muscle weakness, especially in your lower extremities
  • Excessive or prolonged menstrual bleeding (menorrhagia)
  • Depression

Fortunately, Hashimoto’s can typically be treated fairly easily with a daily pill to maintain proper thyroid hormone levels.

To determine if you have Hashimoto’s Thyroiditis—or any number of other thyroid issues—have your doctor check your blood for your Thyroid Stimulating Hormone (or TSH) levels.

Read more about the thyroid:

{ 0 comments }

It’s Oral, Head & Neck Cancer Awareness Week, so we’re revisiting this Q&A with Dr. McConnell, in which he explains why the Fukushima Nuclear Disaster is less likely have long term cancer implications for the surrounding area than did the Chernobyl disaster.

The earthquake and tsunami in Japan that occurred in March 2011 not only took the lives of hundreds of people, but also resulted in a nuclear crisis at the Fukushima nuclear power complex.  This nuclear disaster raises another major health concern: radiation induced thyroid cancer.  Dr. Robert McConnell, a co-director of the New York Thyroid Center, discusses the Fukushima nuclear crisis and associated health risks in Japan and shares his expertise in radiation induced thyroid cancer as well as his experience in treating those affected by the Chernobyl accident in 1986.

 

Why does exposure to radioactive material raise the risk of thyroid cancer?

The thyroid uses iodine to produce essential thyroid hormones.  When the thyroid is functioning properly, it absorbs iodine from food and the environment.  However, when radioactive iodine is released in the environment, the thyroid will easily take this up as well.  Nuclear reactors, like ones involved in the Japanese nuclear disaster, produce large amounts of radioactive iodine and therefore pose the risk of releasing it into the environment.  The thyroid cannot tell the difference between radioactive and nonradioactive iodine, so if it is present in the environment, the thyroid will take it in. Since the thyroid is one of the most radiosensitive organs in the body, it is particularly vulnerable to developing cancers after radiation exposure.  Young children are especially susceptible.  While high controlled doses of radioactive iodine can be used therapeutically to treat an overactive thyroid by intentionally killing the thyroid cells, uncontrolled exposure in lower doses can instead damage the thyroid. This in turn leads to an increased risk of cancer.

 

How are the Chernobyl and Fukushima crises different?

The Japanese authorities were much quicker to respond to the disaster than the authorities responsible for Chernobyl.  Although large amounts of radioactive iodine were released into the environment after the crisis in Japan, the rapid evacuation of residents of Fukushima Prefecture decreased their risk of radiation-induced thyroid cancer.  In addition, those affected by the disaster were instructed to restrict their intake of green leafy vegetables, milk and water from potentially contaminated sources.  Unfortunately, the Soviet citizens affected by Chernobyl could not benefit from a timely evacuation and were not advised to avoid possible sources of contamination.

The type of radiation exposure also separates the two incidents.  After the 1986 Chernobyl disaster, the people of Ukraine and Belarus were exposed to high concentrations of radioactive cesium, strontium and iodine.  The half life of cesium and strontium is 30 years.  This means that in 30 years, half of the original material will have degraded, while the other half remains.  Significant exposure to these materials can affect the environment for hundreds of years.  On the other hand, radioactive iodine, which was released into the environment after the Japanese crisis, has a half life of about 8 days.  Due to this short half life, radioactive iodine is virtually gone after 2 months.

In Japan, the amount of radiation release is estimated to be about 40% of that released at Chernobyl.  This estimation, combined with the various other differences between the two disasters, demonstrates that those affected by Chernobyl experienced greater radiation exposure and risks than those affected by the Japanese crisis.

 

What are the potential long term consequences in the surrounding areas of the Fukushima nuclear power complex as a result of this crisis?

The short half life of radioactive iodine ensures that the immediate affected area will be cleared of the radioactive material in about two months.  It is also unlikely that people in the surrounding areas were impacted; any residual reactive iodine would have quickly degraded and disappeared prior to having a significant effect on the environment in more distant areas.  Half life aside, overall exposure was reduced by the efficient evacuation efforts.  Populations in both immediate and distant locations relative to the nuclear accident have a reduced risk of long-term radiation risk.

 

When someone is diagnosed with thyroid cancer, what is the prognosis?

In most cases, thyroid cancer is treatable.  Papillary thyroid cancer is the most common type of radiation-induced thyroid cancer.  Many of these cases are slow to develop and therefore curable.

The New York Thyroid Center is comprised of a multidisciplinary team of experts in endocrinology, surgery, pathology, nuclear medicine and other various disciplines in medicine.  These physicians work together to diagnose each patient and determine the course of treatment.  Treatment options vary and may include surgical removal of the thyroid and removal of lymph nodes if the cancer has spread.  Radioactive iodine may also be used in some cases to destroy remaining thyroid tissue.   According to the center’s co-director, Dr. James Lee, “because thyroid cancer is typically very slow growing, it is usually curable.”  The survival rate of thyroid cancer is 99% at ten years among men under 40 and women under 45 years of age.

Links for further reading:
Columbia University’s Dr. James Lee on how to test your thyroid [VIDEO LINK]

New York Thyroid Center Establishes Unique Thyroid Biopsy Clinic

Thyroid Cancer: My Story

{ 0 comments }

Hypothyroidism vs Hyperthyroidism

April 15, 2014

TweetHypothyroidism and hyperthyroidism are two of the most common thyroid disorders, and though their names sound almost identical, the disorders themselves are very different. The easiest way to remember the difference is to recall that “hyper” means too much, like when they say someone is hyperactive, it means they have too much energy. The thyroid […]

Read the full article →

Thyroid Surgery: Common Questions and Concerns

September 16, 2013

TweetLaurie Chabot, RN Division of GI/Endocrine Surgery Laurie Chabot, RN, has worked with patients in the Division of GI/Endocrine Surgery since 2008, and prior to that, in other divisions at NYP/Columbia. She is well versed in the concerns that patients have before thyroid surgery. In this post, she shares the most common questions she discusses […]

Read the full article →

Thyroid Cancer: Treatment After Surgery

September 12, 2013

TweetSalila Kurra, MD, Co-director of the Columbia Adrenal Center Patients and families may be interested to know that treatment of thyroid cancer differs from treatment of other cancers in some unique ways. As readers may already be aware, thyroid cancer tends to be slow growing, allowing for most patients to be evaluated and treated before […]

Read the full article →

New York Thyroid Center Establishes Unique Thyroid Biopsy Clinic

September 10, 2013

TweetAmended 10/3/2013: We greatly apologize for our recent technical difficulties on our last BlogTalkRadio episode. In order to ensure all of our followers’ questions were answered, we are hosting a special rebroadcasting of “Thyroid Biopsy: What is it and when is it recommended” on October 9th at 3:30 PM/EDT. We hope you are able to […]

Read the full article →

Thyroid Cancer: My Story

September 4, 2013

Tweet  By Erica Ervin In the fall of 2011, three months after my wedding, I began to experience some strange health issues including an irregular heartbeat and panic attacks. I was just 31 at the time, and I have always exercised regularly, eaten a well balanced diet, and have been very healthy. Since we had […]

Read the full article →

Dr. James A. Lee on The Dr. Oz Show: How to Test Your Thyroid

October 21, 2010

TweetDr. James A. Lee, Chief of Endocrine/Thyroid Surgery of NewYork-Presbyterian/Columbia University Medical Center was on The Dr. Oz Show to discuss the detection of thyroid cancer. Dr. Lee says that fifteen to thirty percent of the U.S. population have thyroid nodules. Most are not cancerous. When a lump is found, a needle biopsy is performed […]

Read the full article →