Having some health issues but not sure why? It could be linked to your thyroid. Here we look at some conditions associated with the thyroid hormone and why it’s worth getting screened, even if you don’t have any symptoms.
What exactly is a thyroid gland?
It’s a gland that performs one function: to make the hormone, thyroxine.
“My patients often ask me what thyroxine does, but really the question is, ‘what doesn’t it do?’” says DR DENNIS LIM, an oncology surgeon with expertise in head and neck surgery. “It’s involved in every metabolic function in the body. If you don’t produce thyroxine and do not replace it, you will die.”
So, what can go wrong?
The thyroid can stop producing thyroxine (a condition called hypothyroidism) or it can produce too much (hyperthyroidism). The former can be treated with a daily thyroxine tablet. The latter is the more common disease of the gland, and symptoms include sweating, muscular weakness and loss of weight despite a good appetite. Medication or radioactive iodine can be given to destroy the thyroid, and the patient can supplement with daily thyroxine tablets. Alternatively, 75 percent of the gland can be removed, though it’s a less common treatment nowadays.
“Many people think ‘thyroid problem’ and their immediate assumption is the gland as the troublemaker, not the actual hormone that’s being produced,” says Dr Lim. “The truth is, the function of the thyroid gland is easily replaced so, if need be, it can be taken out and thyroxine can be supplemented with a small daily tablet.”
Got a lump on your throat?
Even if the thyroid gland is functioning normally, nodules can present as solid or fluid-filled lumps within the gland. They are very common, says Dr Lim; in fact, it’s been estimated that up to 50 percent of people older than 60 have them, if you look hard enough.
Often, these nodules are asymptomatic. Most people don’t even realise they have them until their facialist at the spa points it out, or a man’s collar starts feeling too tight, says Dr Lim.
Luckily, the vast majority (beyond 95 percent) of nodules are benign, and most don’t need intervention. While nodules with higher suspicion may need biopsy or surgery, nodules that have low likelihood of malignancy may only need monitoring and some follow-up.
“If it’s not cancerous but the lump is big enough to be bothersome, we can take it out; otherwise, I’d advise the patient against surgery,”says Dr Lim.
Screening for thyroid cancer
With many more health screening packages offering thyroid screening these days, more nodules are being caught by incidental screenings. That is, of course, great news for those with thyroid cancer.
Though thyroid cancer is easy to treat and slow to progress, it’s still vital to know that you have it in the first place so you can take action. For instance, the gland can be removed with minimally invasive surgery.
While there isn’t a formal screening recommendation for thyroid nodules, Dr Lim says screening for them certainly can’t hurt; after all, there is risk to thyroid ultrasound.
“Just like a mammogram for a breast lump, ultrasound scan is very safe, consistent and informative in the management of thyroid nodules. A unified system of reporting called Thyroid Imaging Reporting and Data System (TI-RADS) is often used to pick up suspicious nodules for further evaluation.”
“Check whether it’s available in your screening package, and if it is, do it,” advises Dr Lim.
To book an appointment, call 6836 5167 or email enquiry@dennislim.com.sg.
Dennis Lim Surgery
#11-09 Mount Elizabeth Medical Centre
3 Mount Elizabeth
dennislim.com.sg
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