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What You Need To Know About Thyroid Ultrasonography and Its Importance 

By Endocrinology

Thyroid ultrasound is a diagnostic imaging technique that uses high-frequency sound waves to create an image of the thyroid. It is a gland located in your neck that secretes hormones that help control heart rate, blood pressure, body temperature, breathing, digestion, and weight. It is used to help identify swelling or enlargement of the gland.

Why Do I Need Ultrasonography?

The ultrasound identifies the cause of swelling or enlargement of the thyroid-gland. The ultrasound can help determine whether the gland enlarges due to a fluid-filled cyst or inflammation. Also, it helps to identify nodules, abnormal masses, and other thyroid-abnormalities. It would be best to visit any of our facilities in tampa, to consult a qualified doctor. Our medical personnel can perform ultrasounds, biopsies, and lab services. Also, we treat complex metabolic conditions like diabetes and obesity. For obesity, we have a comprehensive weight loss program.

Role of Ultrasonography in Thyroid-Disease

The ultrasound works to:

  • diagnose and monitor treatment of thyroid-cancer or goiter – makes it possible to detect and manage abnormal growth in the gland (a nodule, tumor, cyst).
  • Help diagnose another condition that affects the gland, such as infection or inflammation.

What Are the Risks of an Ultrasound?

No radiation remains in a person’s body from the ultrasound procedure. Risks associated with exposure to high-intensity sound waves during an ultrasound include:

  • No radiation remains in a person’s body from an ultrasound exam.
  • There are no known long-term risks associated with diagnostic levels of ultrasound.
  • Pain, brief discomfort, or mild irritation where the transducer is placed on your neck, if a person has inflamed tissues due to thyroiditis
  • Bruising at the site of the ultrasound

Preparing for the Ultrasound

Your endocrinologist will explain the procedure and offer you the chance to ask questions about the possible risks and benefits.

You should let them know if you:

  • have a pacemaker or any other implanted medical devices
  • have concerns about anesthesia (numbing medication) and want to discuss the options with your anesthesiologist

What Should Tell My Doctor?

Explain any allergies, including drug allergies you have. Let them know if you have anything that might interfere with imaging, such as metal objects in your body. Discuss past surgeries and procedures. Tell them about medications you take, including prescription and over-the-counter medicine, herbs, vitamins, and supplements. Diagnostic tests may be recommended to help determine the cause of a thyroid disorder.

What Do I Need To Do?

You will be asked to sign a consent form that permits the procedure. Read the form carefully and ask questions if anything is not clear. Tell them about your past and current health history, including recent illnesses, accidents, or trauma. Let them know if you have had any anesthesia in the past and how long it has been since you had surgery or anesthesia. Also, inform the physician if you are pregnant or suspect that you may be pregnant. You can refuse treatment at any time during this process by saying “no” or refusing to sign the consent form.

How Is Ultrasonography Conducted?

The ultrasound is done in a doctor’s office or an outpatient center. If necessary, the doctor may do the test as an outpatient at a hospital or ambulatory clinic. The free-standing facility works for high-risk patients with difficult imaging studies or more complex procedures. The sonographer applies a conductive gel to the transducer and then presses it against your skin. You may feel pressure as they move it or discomfort when applying the gel, but the procedure is typically not painful for most people. Do not eat anything for four hours before having this test performed. Make sure you drink plenty of fluids before the test. Wear comfortable clothing for your exam. You may be asked to wear a gown.

The Different Types of Ultrasounds

Several types of thyroid-ultrasounds may be done based on your specific medical needs, including:

  • Thyroid-sonogram – if your health care provider suspects you have a nodule or abnormal growth in the thyroid-gland. A sonogram can also help detect fluid around the thyroid-gland (cyst or goiter).
  • Follicular imaging – sometimes done if you have hyperthyroidism.
  • Thyroid-vascular imaging – helps the endocrinologist assess the vascular supply to the thyroid-gland. A thyroid-vascular ultrasound may check for abnormal blood flow in or near the thyroid-gland.

Who Will Help You Understand Thyroid-Ultrasound Results?

A radiologist interprets your thyroid-ultrasound. This is a doctor who specializes in giving and interpreting diagnostic imaging studies. They will send their written report to your physician or health care provider within 24 hours of completing the test.

Normal: The ultrasound shows a smooth, soft gland without any nodules, cysts, or asymmetry and normal vascular pattern and compressibility.

Unusual: The ultrasound reveals the gland’s nodules, cysts, or asymmetry and an abnormal vascular pattern.

How You Will Get Your Results

Your health care provider will contact you with your test results within 24 hours. If needed, you will be scheduled for further testing or additional procedures at that time. If you have a follow-up appointment with your healthcare provider, be sure to tell the staff that you had an ultrasound and when. Now that you understand ultrasonography and our services you can visit our facilities in Tampa, Florida for more information. We have many offices around this area for your convenience. Contact us. We will be more than happy to talk to you.

 

The dangers of thyroid scans and radio line treatment for pregnant women

By Endocrinology

The thyroid gland lives in the front of the neck. A diseased gland may become inflamed and swollen. Because an enlarged gland can impede breathing and swallowing, getting tested as soon as you notice any change in the gland is critical.

Signs There May Be A Problem With Your Endocrine System

Symptoms of a diseased gland can include a variety of conditions.

You may notice

  • a change in your weight for no reason
  • a change in your skin condition
  • a change in your mood, from feeling agitated to feeling depressed
  • constantly feeling worn out
  • always being too hot or too cold
  • an irregular menstrual cycle

If you are feeling tired and your period stops, the first assumption is that you may be pregnant. In addition to getting a pregnancy test, you will probably also want to get your gland checked so you can get in front of any illness or imbalances that need to be addressed quickly.

How an Endocrinologist Checks Your Glands

When you go in for a hormone test, you can expect to undergo a blood draw. This gland secretes the hormones thyroxine (T4) and triiodothyronine (T3). This illness can impact your body weight and your menstrual cycle, but it can also impact the regularity of your heartbeat.

In the event that your gland is overactive or underactive, you will need to have the gland itself scanned. Because the easiest way to look at the gland is to highlight the tissue with a radioactive product, your fertility status will need to be checked first. If you are currently breastfeeding, pregnant, or planning a pregnancy, you are not a good candidate for any radioactive product.

The Scan Procedure

The scan procedure requires that you receive a radionuclide. Once ingested or injected, this radionuclide will embed itself in your gland so the gland will show up in a nuclear scan.

The risk to a woman who is pregnant is that there is a possibility that the radionuclide will cross the placental barrier. While changing up the dosages and extending the scan time can reduce the risk of breaching the placental barrier, avoiding this treatment unless absolutely necessary is wisest.

Radio Line Treatment

In the event that your gland is found to be diseased, cancerous, overactive or underactive, you may need to have radioiodine treatment to destroy the gland to avoid more serious disease in the future.

Radioiodine treatment is taken as a liquid or a capsule. The process of killing off the thyroid gland can take up to six months, so it is critical that you discuss your fertility plans with your endocrinologist before you undergo this treatment. The radioactive material will stay in your tissues for an extended time and may pass through the placental barrier should you become pregnant. This therapy is also not recommended for a woman who is breastfeeding.

Pregnancy Risks

One of the biggest risks in determining the best treatment for glandular disease is the chance of missing an undetected pregnancy in the earliest stages. When discussing your symptoms with your physician, carefully review your calendar to make certain there is no risk of an early stage pregnancy. Your Tampa endocrinologist can help you schedule a test to be absolutely certain.

For adolescent women under the care of a parent, the ability to have a frank conversation with your physician may be a worry. If your physician recommends the test as a matter of course, take it so you can be sure.

Other Glandular Connections

It is also possible that a problem with your thyroid is connected to other glandular concerns. The pituitary gland tells the other gland to release T3 and T4. When T3 rates go up, the pituitary gland is informed that it needs to back off stimulating hormone production. Any breakdown in that communication loop can lead to too much or too little hormone production.

One step further up the line is the hypothalamus. The hypothalamus is not a gland, but is the core of your brainstem. This primitive region of the brain is closely tied to the function of your responses to emotional stress, such as the panic response or the fight or flight response.

In the event that the hypothalamus is not functioning well, or the pituitary gland is not transmitting the right data, this critical gland could appear to the cause of the problem. A blood test will probably not be enough to track down the source of your condition.

In the event that your hormone levels are not within normal levels, you will need to get additional testing done. If you are of child-bearing age, take the opportunity to get a pregnancy test to avoid the risk of transmitting radiation across the placental barrier to the fetus.

The Role of Cytology Adequacy Assessment

By Endocrinology

Cytology adequacy assessment is the process of determining if a specimen meets the requirements defined by law for adequate cellularity. If a specimen does not meet these requirements, it may be rejected and/or re-examined.

Adequate cellularity consists of two components: appropriate numbers of cells for adequate interpretation and the presence of both squamous epithelial cells (SCC) and endocervical cells. The first assessment is made using the microscopic evaluation, while the second can only be ascertained by taking a cytology brush specimen from an area that has not been previously sampled.

This article will include what cytology adequacy assessment is, why cytology inadequacy assessment occurs, and some examples of this in practice.

What is Cytology Adequacy Assessment?

Adequacy assessment is the process of determining if a specimen meets the requirements defined by law for adequate cellularity. If a specimen does not meet these requirements, it may be rejected and/or requalified. Adequate cellularity has two components: appropriate numbers of cells for adequate interpretation and the presence of both squamous epithelial cells (SCC) and endocervical cells.

The first assessment is made using the microscopic evaluation, while the second can only be ascertained by taking a cytology brush specimen from an area that has not been previously sampled. This article will include what cytology adequacy assessment is, why cytology inadequacy assessment occurs, and some examples of this in practice.

Cytology Adequacy Assessment for the Thyroid

Cytology adequacy assessment is used in various ways for all types of fine-needle aspiration biopsies, including some which are not yet standardized, such as thyroid FNAB performed by an endocrinologist. The use of cytology adequacy assessment is most commonly associated with the evaluation for malignancy, where any tumor cells present must be adequately sampled to allow the pathologist to make an accurate diagnosis. Small amounts of neoplastic cells or relatively poor cellularity may preclude an adequate sample from being taken. Cytologic adequacy assessment is also used when there is a question of contamination.

Contamination can be present in a FNAB when there are cells that appear to be benign on cytology but could represent a hematogenous spread of malignant cells from another site. In this case, further evaluation (fine needle aspiration or open biopsy) is warranted to evaluate for the presence of cancer. However, in some instances, it could also occur due to inadequate specimen cellularity if the sample has not been taken high enough into the gland. This results in an interpretation that does not accurately reflect the true tumor extent, and treatment decisions may be based on incorrect information leading to unnecessary surgeries or radiation therapy.

Cytology adequacy assessment is performed by looking at both endocervical and squamous epithelial cells. Therefore, the specimen should include both cells from the uterine cervix and thyroid gland for evaluation of adequacy. In addition to looking at the adequacy of cellularity, one must also evaluate the extent of sampling concerning needle tract length (the distance between initial puncture site and final location where tissue is collected) within the gland as well as the position of needle tip when collecting sample.

How is the Procedure Performed?

To evaluate for adequacy, the cytologist in Tampa must assess the amount of aspirate collected and the number of cells present in an adequate sample. The technologist will note if there was an adequate amount of fluid obtained and also count how many cells are present on a slide at low power. If the amount of fluid is inadequate, another cell block may be prepared from the same area and submitted for evaluation.

The second assessment involves the interpretation of endocervical cells as well as squamous epithelial cells (SCC). Looking for both SCC and cervical epithelium allows identification of non-epithelial contaminants within FNAB specimens, which could be misdiagnosed as malignancies. Looking specifically for SCC has been shown to be more accurate than looking at all squamous epithelial cells, as SCC makes up only about 20% of the total squamous population.

The presence of cervical endocervical and glandular tissue is also important for the evaluation of adequacy in cervical cancer biopsies, though some institutions evaluate adequacy using cellularity alone.

Limitations:

There are limitations with cytology adequacy assessment which include the fact that it can only be used for evaluable specimens. Therefore not all patients will have their specimen reviewed by a pathologist trained or experienced in stringent criteria required for adequate criteria. In addition, this review is not performed in every institution, and there exists variation between different medical facilities on the interpretation of; adequate, adequate with modification, or inadequate categories. The adequacy rating also does not take into account the presence of nodules which may have significant risk for malignancy, and therefore additional evaluation and follow-up would be needed for patients with these findings.

If low cellularity is present in a suspected malignant FNAB, it is likely due to sampling error as opposed to a true tumor defect. However, if SCCs are identified, this could indicate a hematogenous spread of neoplastic cells from cervical or upper aerodigestive tract sites. Furthermore, cytology adequacy assessment cannot assess adequacy using frozen sectioned tissue, so it does not give an accurate interpretation of sampled areas when dealing with patients who had previously undergone surgery.

In summary, cytology adequacy assessment is a tool used to evaluate whether the sample was collected high enough in the gland, whether it was collected long enough (the needle tract), and how many cells were adequate for interpretation of diagnosis and clinical management.

No single assessment criterion or rating system can completely replace the pathologist’s visual examination of adequacy during the evaluation of FNAB specimens. However, having this information available as an adjunct to clinical and radiologic features as well as pathology allows for a complete review. The physician should also be made aware that no guidelines have been established for frozen section adequacy, but some studies have shown that cytology adequacy assessment using frozen sections gives similar evaluations to those obtained from formalin-fixed tissues.

Reference:

Bomeli, S. R., LeBeau, S. O., & Ferris, R. L. (2010, April). Evaluation of a thyroid nodule. Otolaryngologic clinics of North America. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2879398/.

Male vs. Female TSH Levels

By Uncategorized

A TSH test is typically administered to test the function of the thyroid gland. Both an underactive and overactive thyroid can cause uncomfortable symptoms. Thyroid stimulating hormone (TSH) is produced in the pituitary gland and is responsible for releasing certain hormones into the blood.

When To Get Tested
Symptoms of hyper and hypothyroidism can vary from person to person. The symptoms vary greatly and some may seem inconsequential or unrelated. This is one of the reasons an endocrinologist will order testing.

Hypothyroidism can cause:
-dry hair
-weight gain
-puffiness in the face
-low sex drive
-skin issues
-hair loss
-depression

Hyperthyroidism can cause:
-bulging eyes
-weight loss
-anxiety
-goiter
-increased energy
-mood changes

In Tampa, an endocrinologist can measure TSH levels to see what treatment and dosage will work best for the individual. Trying to diagnose the problem without a medical professional is both difficult and potentially risky. If you are experiencing these symptoms, getting checked out is the first step.

A thyroid stimulating hormone test is done by drawing blood. No former preparation is necessary in most cases. The test will measure exactly how much thyroid hormone is in the blood to help the doctor understand how your thyroid is functioning. Certain medications can affect thyroid function such as lithium. If you are on lithium, make sure to tell your endocrinologist beforehand.

A thyroid that is properly functioning will help with the digestive process, metabolism, body temperature, brain function and muscle control. Without proper levels of TSH, the body and mind can feel sluggish.

TSH Levels: Male vs. Female
TSH levels are different depending on sex and age. In general, women have a higher concentration of TSH than in men. The secretion of thyroid hormone may differ for women, but not men.

High levels of TSH usually fall between .4 and 4.0 milliunits per liter. This can vary depending on the laboratory. TSH levels that are higher than this typically show a patient with underactive thyroid. This can indicate hypothyroidism and possibly the presence of an autoimmune disease.

Low levels of TSH suggest hyperthyroidism. This means the thyroid is producing excessive amounts of thyroid hormone. Levels that are below .5 are likely considered below the average range of a healthy functioning thyroid.

Optimal TSH levels may vary depending on the person. TSH levels during pregnancy can affect the development of the fetus. Since both hypothyroidism and hyperthyroidism can occur in pregnant women, the treatment for optimal TSH levels must be prescribed by an endocrinologist that understands the full medical history.

Stress, medications, diet and stage of life can all impact TSH levels. Depending on lifestyle and life stage, these levels may be out of range, but still healthy. For instance, an 80 year old woman may have an 8.8 level while a 30 year old woman may have a TSH level of 4.1 Both of these levels are healthy for their sex and age.

For adults aged 18-50 years old, the normal TSH levels should fall approximately between .5 and 4/1.
For adults 51-70 years old, TSH levels should fall between .5 and 4.5.
For older adults aged 71-90, TSH levels should fall between .4 and 5.2.

Women who are experiencing their period, giving birth, or going through menopause may experience higher TSH levels. Both high and low TSH levels can have a negative impact on men’s fertility.

Ideal TSH levels help regulate energy. Both men and women with altered TSH levels can experience changes in mood and activity level. For those with higher TSH levels, depression is more likely to occur. While thyroid conditions are typically more common in women, men can experience both hyperthyroidism and hypothyroidism.

Thyroid testing is recommended on a regular basis even for those who do not show symptoms of hypo or hyperthyroidism. For those who have a family history of thyroid conditions, this is especially important. Many types of thyroid conditions including thyroid cancer and Hashimoto’s disease can have a genetic component.

What To Do If TSH Levels Are Irregular
Irregular TSH levels can be medically treated with the help of an endocrinologist in Tampa. By seeking medical help, a proper test can be conducted to measure hormone levels. Depending on age, sex, and life stage, the type of treatment may vary.

Most thyroid conditions are treated with thyroid-replacement medication. This type of medicine is designed to stabilize TSH levels for optimal functioning. Because it is affecting your hormones, TSH levels will need to be checked on a regular basis.

Most patients schedule endocrinologist appointments approximately twice a year. In the beginning, most patients will see their doctors more frequently to make sure the medication is at the right dose. While doses may vary depending on the person, a trained medical professional can tell you exactly the levels you need for your body.

How to Safely Consume Thyroid Hormone Pills

By Uncategorized
If you’ve been diagnosed with an improperly functioning thyroid gland, you will likely be prescribed thyroid hormone treatment by your healthcare provider, according to the American Thyroid Association. In addition, patients with thyroid cancer may need this type of hormone treatment as a form of suppression therapy in which this treatment would prevent any more growth of thyroid tissue and would prevent cancer recurrence.

What is Thyroid Hormone Replacement Therapy?

Hypothyroidism means a person’s thyroid gland is unable to make enough of its hormone to reach acceptable levels for the human body. This can be caused by a non-functioning thyroid or pituitary gland. Hypothyroidism is the most common need to undergo thyroid hormone replacement therapy. Taking this hormone will replace the one that is missing in your body. This medication will recreate typical thyroid functioning. Your physician will need to keep a close look at how your body is reacting since it is vital to figure out the right dosage of this hormone and ensure you are not taking too large or small of a dosage.

 

How to Take the Thyroid Hormone Safely

You will only need to take the thyroid hormone once per day because it can stay in your system for a relatively long time. This medication is meant to keep your thyroid function operating at a healthy range. It is recommended to take the thyroid hormone first thing in the morning on an empty stomach before you eat breakfast. By taking it before you eat any food, nothing will stand in the way of your body appropriately absorbing this hormone. In addition, consistency is key. Be sure to take this medication at the same time and in the same way every single day. When you are taking multiple medications, you’ll want to speak with your healthcare provider to determine the best time to take your thyroid hormone to ensure your medications do not interact with each other. For example, in such cases, it may be better to take your medications at night. The majority of thyroid problems are life-long, which means it is vital to never stop taking this medication without speaking to your physician. If you miss a dose, be sure to take that dose as soon as you remember. If you do forget for most of the day, it is also safe to take one the next morning and another the following evening.

 

Possible Interactions of the Thyroid Hormone with Other Medications

People who are taking medications along with this hormone often need a higher or lower dose of the thyroid hormone. The type of medications that interact with this hormonal treatment include estrogen, birth control drugs, testosterone, and anti-seizure pills as well as medication for treating depression. These medications as well as others can prevent the full absorption of the thyroid hormone. Any drugs that have calcium, specific antacids, soy, and iron as well as cholesterol-lowering pills can affect the absorption of this hormone. If you have been prescribed to take a thyroid hormone daily, it is vital to keep your physician aware of all other pills you are taking including supplements. The dosage that a doctor prescribes is also based on the patient’s weight, age, and additional medical diseases or circumstances. Your TSH levels will be checked and you will undergo a full physical examination before you are prescribed thyroid hormones. In addition, your doctor will want you to stay on the same name brand of medication to avoid any changes or fluctuations in how your body responds to the medicine. However, if a change must occur, be sure that your physician is aware and rechecks your thyroid function. In case your pharmacist changes the brand name of your prescription, be sure to tell your physician.

 

Finding the Best Doctors for Thyroid Hormone Replacement Therapy

It is vital to ensure you receive the best treatment possible for hypothyroidism or thyroid cancer. Having a trusted specialist handling your medical care will ensure your safety and improved thyroid functioning. Any endocrinologist at our Tampa Office is qualified to help you treat your hypothyroidism and prescribe the right medications. For example, both Carlos Fumero, MD, FACE, and Pedro Troya, MD, FACE, ECNU, are board certified in endocrinology. Via the American Association of Clinical Endocrinologists, Troya was able to receive his ECNU certification. Dr. Fumero was able to complete his education in internal medicine and endocrinology from the University of South Florida College of Medicine. Along with choosing the right specialist for your medical care, you’ll need to be completely transparent and share what other medications you are taking with your healthcare provider. If you believe you may have problems with your thyroid, be sure to reach out to the Bay Area Endocrinology Associates by calling 813-876-3636.

Is Your Thyroid Causing Your Health Problems?

By Uncategorized

When you don’t feel well, it can be hard to keep up with life’s demands. Many people deal with near constant fatigue as well as depression and mood swings without ever really knowing what is causing it. You might be surprised to know that your thyroid could potentially be causing these problems. If you’re experiencing these and other symptoms (which will be discussed later), it may be time to visit your Tampa endocrinologist in order to find out what is happening with your thyroid. Keep reading if you’re curious to learn more about thyroid levels and how they can impact your overall health.

Free T3 and Free T4 Thyroid Levels Explained
It might sound confusing at first, but the levels of certain hormones in your blood can be directly linked to the overall health of your thyroid. This in turn can have a major impact on how you feel and how your body performs on a daily basis. Free T3 measures a hormone called Triiodothyronine. It is one of the hormones most secreted by your thyroid and is responsible for much of your thyroid function. A simple blood test can measure the levels of Free T3, thus helping medical professionals determine the overall health of your thyroid. This test may be ordered if a doctor suspects that you have a condition called hyperthyroidism (an overactive thyroid). It’s also used to monitor the health of a person who is currently undergoing treatment for certain thyroid conditions. Typically, a normal level of Free T3 ranges from 0.2 to 0.5 ng/DL. By the same token, Free T4 measures another important hormone, thyroxine. Abnormal levels of Free T4 may indicate either hyperthyroidism or hypothyroidism. In short, this means that your thyroid may be either too active or not active enough. Typically, doctors will measure your Thyroid Stimulating Hormone, or TSH, with a blood test. Normal levels of TSH range from 0.5 to 5.0 mIU/L. When this hormone is not within a normal range, Free T4 is typically checked almost immediately. Anything below 0.9 ng/DL is considered abnormally low. Conversely, levels above 2.3 ng/DL are considered to be too high.

Reverse T3 Thyroid Levels
This particular aspect measures the amount of inactive T3 in your blood. If the levels are not within normal ranges, which should be anywhere from 10- 24 ng/DL or lower, a number of symptoms can persist. These symptoms include fatigue that doesn’t go away, depression with mood swings, hair loss and weight gain. It’s also common to experience chills or feel cold more often than not. Some individuals also have a slow pulse rate that is accompanied by heart palpitations and an abnormally low blood pressure.

Finding Solutions Through a Routine Medical Exam
Fortunately, a thyroid that is working too much or not enough can typically be corrected. When you visit Dr. Pedro I. Troya at Bay Area Endocrinology Associates, you know that you are in good hands. The first thing that you can count on is providing a comprehensive medical history so you can be treated properly. That is followed up with blood work in order to determine your thyroid function. Special attention is paid to Free T3, Free T4 and Reverse T3 levels. If an abnormality is found, it’s usually something as simple as taking some medication to regulate thyroid function. If something more serious is found, you know that you are working with someone who will put your needs first.

Common Thyroid Conditions
In many cases, the thyroid is simply producing too much or not enough of a particular hormone. As previously mentioned, this is something that can usually be corrected by taking medication. More serious cases may involve an underlying medical condition. For example, thyroid problems are sometimes caused by cancerous tumors. The good news is that when these tumors are caught early, the problem can typically be corrected through surgery that involves removal of the thyroid. Patients who undergo this surgery are then placed on medication to help provide normal levels of the same hormones that the thyroid is originally responsible for producing. This is done to help maintain your overall health. While many individuals are fearful of a thyroid cancer diagnosis, it is actually one of the most treatable forms of cancer and is usually something that can be dealt with quite successfully when caught early. The idea is to treat it before it has the chance to spread to other parts of the body.

Putting Your Health In the Right Hands
Obviously, you don’t want to put your health in the hands of just anyone. You need someone that you can trust. Medicine is a complex subject and even the best physicians may miss something if they don’t specialize in certain practices. That is why it is so important to see us at Bay Area Endocrinology Associates. Dr. Troya specializes in thyroid disorders. As such, you are making the decision to put your health in the hands of someone who may be able to provide more options for you, depending on your diagnosis. It’s also important to have that peace of mind that comes with knowing that you are in the hands of someone who is both skilled and extremely knowledgeable about the particular issues that you are experiencing.

If you are struggling with any of the symptoms mentioned herein, you owe it to yourself to get an exam and find out why. Thyroid issues can be complicated. Many of the symptoms associated with an overactive thyroid are also associated with one that is underactive. As such, it’s not really possible to gain a full understanding of what is happening until you do some blood work that can provide you with concrete answers to your questions. That gives you a more direct idea of what to do next in order to correct the problem so you can start feeling your best again. If you are experiencing any symptoms such as constant fatigue, chills, sudden mood swings or heart palpitations, make an appointment with us today.

Thyroid Hormone Replacement: Is Natural Better?

By Uncategorized

When the thyroid gland malfunctions, expert medical care and treatment are required to identify the exact problem, restore normal function and alleviate symptoms. This often involves the use of replacement therapy for certain hormones produced by the thyroid gland. There is a great deal of controversy regarding the use of natural hormone replacement products as compared to synthetic pharmaceutical ones. This article will discuss thyroid function, its hormones and whether natural thyroid hormone is superior to synthetic versions.

In a clever ploy, the advertising industry often tries to convey that a natural item or substance is fundamentally better than its synthetic counterpart. In some cases, this may be true. An apple is certainly more healthful than an apple fritter, which is full of refined sugar, artificial preservatives, empty calories and unhealthy fats. However, this comparison is often not valid for substances naturally produced by the human body for the human body. Hormones are very specific substances produced by the body to direct important processes necessary for life. For example, insulin is a hormone that allows blood sugar to enter cells, where it is needed for energy.

Thyroid Function and Hormones
The thyroid produces hormones, too. It’s a butterfly-shaped organ located in the frontal neck area. It requires the mineral, iodine, to function normally. Iodine can be hard to obtain from diet alone, unless you consume a lot of seafood and kelp. That’s why table salt is often iodized. This helps to provide dietary iodine. A deficiency of iodine can cause a thyroid condition called goiter, in which the gland becomes so enlarged that it visually protrudes out from the neck.

The thyroid produces two main hormones, triiodothyronine, called T3, and thyroxine, called T4. These hormones affect the entire body, including such functions as:

  • Metabolism
  • Heartbeat
  • Body temperature
  • Intestinal function
  • Muscle function
  • Directing the replacement of new cells

When the thyroid produces too little hormone, it’s called hypothyroidism. When it produces too much, it’s called hyperthyroidism. This article will focus on hypothyroidism. In this condition, replacement of the thyroid hormone, thyroxin, is necessary.

The thyroid doesn’t produce hormones on its own. Two structures in the brain, the hypothalamus and the pituitary, monitor hormone levels in the blood and tell the thyroid to produce more or less hormone, whichever is needed to maintain optimal levels for health. The medication prescribed to treat hypothyroidism is called levothyroxine. It’s the generic name for many brand names. It’s the synthetic version of the body’s own thyroxine, or T4. When the thyroid doesn’t produce enough thyroxine, symptoms can include:

  • Fatigue
  • Weight gain
  • Difficulty thinking clearly
  • Feeling cold
  • Muscle cramps and weakness
  • Depression

Problems with Natural Thyroid Preparations
Before prescribing any kind of thyroid hormone, your doctor must first do a thorough analysis of the hormone levels present in your bloodstream. This is the only way to determine how severe your deficiency is, or if one even exists at all. From there, your doctor can prescribe the correct strength of levothyroxine to restore your hormone levels to a normal range. Taking too much thyroid hormone, whether from a natural or synthetic source, can be dangerous. What is called a natural thyroid supplement is actually the dried, powdered thyroid glands obtained from animals, usually pigs. These preparations have several problems:

  • They are not purified to a single active ingredient
  • They contain proteins and other substances not natural to humans
  • They are not precisely calibrated for dose or comparison to human thyroxine
  • They are associated with a higher incidence of heart dysfunctions

There is also a great difference in the ratio of T3 to T4 produced in pigs when compared to humans. The ratio in pigs is 4:1. In humans, it is 14:1. Far from being natural, this vast difference in the ratio of thyroid hormone production in pigs and humans is concerning, to say the least. Pharmaceutical levothyroxine is exactly the same as the hormone thyroxine as produced by the human body. Moreover, it comes in many strengths, allowing your doctor to adjust your hormone levels very precisely and as needed. There is no guesswork. At Bay Area Endocrinology Associates, we are experts in the treatment of any kind of disorder of the thyroid.
Thyroid preparations from pigs are only very approximately comparable in dosage to pharmaceutical levothyroxine. When dealing with very delicate hormone levels and balances, this really isn’t good enough in most cases. However, here at Bay Area Endocrinology, we understand that some patients may prefer this natural thyroid supplement to levothyroxine. While we don’t condone thyroid preparations obtained from pigs, we also always listen to our patients. We don’t profess to know everything. We know that not all patients will respond the same way to any given therapy, so we are always open to patient suggestions regarding their own care. If you think you may have thyroid problems, you may need to see a Tampa thyroid doctor.

Bay Area Endocrinology Associates
We offer treatment services for many metabolic conditions, including diabetes. We have a medical weight loss program for obesity, and we also do corrective hormone therapy for Low T, or low testosterone levels in men. We have several convenient locations in Tampa. We always warmly welcome new patients.

How Thyroid Ultrasonography is Used for Your Care

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What is Thyroid Ultrasonography?

Thyroid ultrasonography is a common procedure that is available in Tampa to diagnose various thyroid conditions. Ultrasonography uses ultrasound waves to create a detailed image of the glands in your neck. The ultrasound procedure is non-invasive, meaning that no incisions or anesthesia are needed, and it is performed on an outpatient basis, so you can go home immediately after the ultrasound. Ultrasound for thyroid conditions works by emitting sound waves through your skin using a special device. Once the sound waves reach your thyroid, they bounce back to the device. The data is compiled by a computer to create an image on a monitor.

Benefits of Thyroid Ultrasonography

Endocrinologists recommend thyroid ultrasonography for many patients in Tampa because the technology is well-proven and provides several benefits, both for the clinician and patient. Your endocrinologist explains why the test is being recommended for your care. Some of the benefits of a thyroid ultrasound test are:

  • Non-invasive and no needles required
  • Images are produced in real-time
  • Covered by most insurances
  • Displays information that is not available through other tests, such as x-rays
  • Guides treatment recommendations
  • Detects nodules that interfere with thyroid function and efficacy of treatments

When is Thyroid Ultrasonography Recommended?

Your endocrinologist may recommend a thyroid ultrasonography test if nodules or lumps are detected during a physical examination. Occasionally, thyroid ultrasound is recommended if you are not responding as expected to treatment. The test may reveal that the lump is attached to your thyroid or other structures in your neck. Once your endocrinologist finds the nodule, the ultrasound allows for an in-depth evaluation of the size, shape, location, and other characteristics that help guide the direction of treatment. Your endocrinologist may also use thyroid ultrasonography to monitor a lump on your thyroid to determine if the nodule is growing.

Detecting Thyroid Cancer with Ultrasound

Thyroid ultrasonography is also recommended when your endocrinologist suspects cancer of the thyroid. Cancer is a term that intimidates many people in Tampa, yet not all cancers are life-threatening or at risk of spreading to other areas of the body. If your endocrinologist suspects, cancer, details will be provided about the possible type of cancer and how it may affect your health.

Preparing for Your Thyroid Ultrasound in Tampa

Preparing for your ultrasound is easy. First, ask your endocrinologist any questions and share your concerns openly. You want to feel relaxed during the ultrasound. Make sure to dress comfortably so that you are able to lay down and stay still during the test. You will need to remove any jewelry prior to the procedure, so you may want to limit what you wear to the appointment. Lotions and other skincare products may interfere with the procedure and will be removed prior to the test.

Thyroid Ultrasonography Procedure

You will lay down on an examination table for your thyroid ultrasonography. A gel is applied to your neck area to help the ultrasound device move smoothly across your skin. The handpiece is moved very slowly to ensure that your endocrinologist sees the necessary level of detail. The device may be moved around the same area several times to get a good visual representation. You may be able to see the monitor during the test, and the technician may describe what you are seeing. After the ultrasound is complete, your neck is cleaned to remove the gel, and you are free to go home.

Thyroid Ultrasound for Biopsies

Your Tampa endocrinologist may recommend a biopsy of the nodule around your thyroid to determine if it is benign or malignant. The biopsy may be performed during the exploratory ultrasound or as a separate procedure. The ultrasound is used to guide the position of the needle that is used to collect tissue from the nodule. The area is numbed with local or topical anesthesia before the needle is inserted. The sample is sent to a lab for evaluation, and results are sent to your endocrinologist.

Results of Your Thyroid Ultrasonography Test

The results of your thyroid ultrasonography are used for the diagnostic and treatment process. Your Tampa endocrinologist reviews the results and schedules a follow-up appointment to discuss the findings. The discussion will include a detailed explanation about the findings, significance to your overall health, and appropriate treatment options. In some cases, nodules and lumps do not require immediate interventions. Rather, your endocrinologist may recommend periodic thyroid ultrasound tests to monitor the lump if the test determines that the nodule is not significantly interfering with thyroid function. In other cases, the nodule may need to be removed. In rare cases, thyroid function is severely disrupted by nodules, and the entire thyroid may need to be removed. If the thyroid ultrasound and biopsy revealed that the growth is cancerous, your endocrinologist works with you to develop a treatment plan that may include a referral to an oncologist.

How the HCB Diet Works

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The HCG diet is an extremely low-calorie weight loss plan that’s combined with injections of human chorionic gonadotropin. It was developed by physician Albert Simeons in the mid-1950s as a way to rapidly lose weight. HCG is found in high levels in women in the early stages of pregnancy.

How the HCB Diet Works

To properly follow the HCG diet, you need to start on the hormones and consume a lot of calories for two to three days. Then you drop to 500 calories a day, and only at lunch and dinner. You stay on the 500 calories a day restriction for 3 to 6 weeks.

There are indications that the HCG diet would work without the hormone shots; at 500 calories a day for 3 to 6 weeks, you’re going to lose weight, and by eating only lunch and dinner, you’re on an intermittent fasting program whether you intend it or not.

What You’re Allowed to Eat

Foods allowed on the HCG diet include

  • Limited Fruits, including oranges, red grapefruit, apples, and some berries
  • High Roughage Veggies, including lettuce, cabbage, cucumbers, and tomatoes
  • Lean Meats, including white poultry meat and seafood, as well as lean ground beef

Nutritional experts express concern about the HCG diet and the extremely low-calorie allowance. The health risks of trying to function on 500 calories a day include

  • dizziness
  • nausea
  • constipation
  • exhaustion

Additionally, dropping your caloric intake so severely can put you at risk for a starvation response, and this will cause muscle as well as fat loss.

Boomerang Gains

When you put your body into a crisis mode with an extremely low-calorie diet, you set yourself up for the boomerang effect. Yes, you may drop pounds on the HCG diet, but they may include a lot of water and muscle as well as fat.

Worse, your body believes that there is a food crisis in the process, and makes preparations to put as many incoming calories it gets to good use; that is, rebuilding your fat stores. Once you’re eating normally again, you may find that your energy level stays low while your weight goes up as your body protects itself. Your body doesn’t really understand what happened to the fat stores and will do what it takes to get them back.

Thus, as soon as you start eating again, even if you’re only eating enough to stay healthy and not gain weight, you will likely add some fat back. Some dieters give up at this point and return to their former eating habits, regaining all they’ve lost and even more over time.

HCG and Thyroid Function

A physician monitoring your thyroid function if you’re struggling to lose weight will likely encourage you not to participate in the HCG diet. If you’re planning to take in so few calories, you’re functionally resetting your thyroid to fuel your body on an inadequate number of calories.

Your thyroid functions like the thermostat for your metabolism. If you choose a starvation diet, your thyroid turns down the temperature to conserve enough fuel to keep your body going. Your hands will be cold. You’ll be tired. Your gut will likely be a mess. Coming off the diet, your thyroid will keep your metabolism low as your body plans for the next round of starvation.

Kidney Function and Weight Gain

If your endocrinologist is currently treating you for hypothyroidism and weight gain, it’s important that you understand the link between weight gain and kidney function.

The thyroid as the thermostat analogy is important here. If your cleansing organs, such as the kidneys, the liver, and the lower intestines are dialing back due to hormonal imbalances or starvation dieting, your cleansing organs will function more sluggishly. Weight gain around the torso, general malaise, and constipation may be the result.

The eventual damage done by the HCG diet to your entire body may take time to show up. That being said, a lot of this damage is forever. Limited kidney and liver function will alter your quality of life for years to come, and a sluggish gut becomes a sick gut over time, possibly leading to further inflammation, ulcers, and other dangerous conditions.

Make a smart long-term choice in your health. Protect your metabolism, your cleansing organs, and your gut from the damage that can be caused by starvation diets. Work to support your body with good nutrition and effective exercise as you take pounds off logically for best results, now and in the future.

Contact Us

There are logical and safe ways to lose weight, and a full endocrinological workup is key to making the right choice for you. The professionals at Bay Area Endocrinology Associates of Tampa have multiple locations to see you in person and offer telemedicine appointments as well.

Thyroid Treatment and Care During Pregnancy

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Whether your thyroid is underactive (hypothyroid) or overactive (hyperthyroid), getting it back in balance can take time. If your thyroid cannot be managed, your physician may choose to destroy it with radioactive iodine, or RAI. RAI is also used to kill off any remaining thyroid cells after treatment and surgery for thyroid cancer.

Why RAI Works

Any iodine you ingest passes through the thyroid, so any radioactive particles will likely lodge there and not travel through the rest of your body. For a woman who is past child-bearing age, this treatment is a protective decision that removes the risk of any returning thyroid cancer.

When RAI Should Be Avoided

Women who are pregnant or who are planning to become pregnant should not receive RAI therapy. As noted above, iodine is initially processed by the thyroid upon entering the body. Both men and women who receive large doses of radiation risk infertility. Women who undergo this treatment may face an irregular menstrual cycle after their RAI therapy. The dangers of thyroid scans and radio line treatment for pregnant women, or those planning to become pregnant, become more severe. Undergoing this therapy may concentrate the iodine in your thyroid tissue, but the radioactivity impacts your entire body. Ovulation schedules can be disrupted, and the eggs within the ovaries at the time of treatment will have suffered radiation exposure.

RAI Therapy Risks for Pregnant Women

Thyroid issues during pregnancy are not uncommon. Pregnant women should have their thyroid checked repeatedly throughout their pregnancy, and if any abnormalities are noted, medications to modify the thyroid output will need to be administered. Hyperthyroidism especially increases the risk for both mother and baby, including preterm delivery, stillbirth, miscarriage, and maternal cardiac failure. Symptoms of hyperthyroidism include swelling of your thyroid gland, irritability, shakiness, weight loss, and weakness. If you find that you have inflammation or swelling of the thyroid or feel agitated at any point in your pregnancy, it’s critical that you seek medical attention.

How to Avoid These Risks

Make sure that your OB/GYN is made aware of any thyroid conditions you’ve suffered in the past. Get a referral to an endocrinologist who can check your thyroid health before you attempt to conceive if possible, and especially once you know you are pregnant. Managing the condition from the start will greatly reduce the risks for you and your baby. Catching thyroid production abnormalities early will allow you to get on the right medications before the hormonal cascade of pregnancy muddies your tests. No matter what the ultimate course of treatment is, it’s critical that you also get your thyroid checked after you deliver; there are many thyroid conditions that fade after the physical stress of pregnancy has passed.

Diagnosis When Pregnant

Rates of thyroid cancer are on the rise, and more women than men get the disease. It’s not surprising that thyroid cancers are detected during pregnancy; after all, an increase in thyroid activity is likely to bring any palpable cancers to prominence. If you are pregnant and diagnosed with thyroid cancer, experts recommend waiting until after your delivery to operate. If that’s not possible, it’s recommended that you undergo surgical thyroidectomy after 22 weeks. RAI treatment should never be administered to someone who is pregnant or breastfeeding.

Protect Your Thyroid

If you have a family history of any type of thyroid illness, from Hashimoto’s to Graves’ Disease, strive to consume a diet that will protect your thyroid as much as possible. Whenever possible, avoid processed foods, or fried foods with high oil content. A diet high in antioxidants is a great way to protect your entire body from toxins, so take care to include

  • berries
  • cruciferous vegetables
  • yogurt

Seafood and shellfish are both rated highly as a way to keep your iodine intake at a healthy level. However, seafood is often restricted when you’re pregnant. Make sure that your physician and your Tampa OB/Gyn are aware of your family history of thyroid concerns and that your prenatal supplements include plenty of thyroid support to keep your endocrine system working effectively for the safety of you and your baby.

Should you receive a diagnosis of thyroid cancer or unusual thyroid activity while you’re pregnant or during your childbearing years, discuss your plans and your concerns with your physician. Your thyroid illness may not require RAI to completely destroy any remaining thyroid tissue should you need surgery. If you’re at a higher risk of cancer spreading without RAI, plan with your partner to avoid pregnancy for the recommended time after RAI to make sure that the radioactive materials have completely cleared from your system. It may take time for your ovulation cycle to return to normal, so give yourself time before you attempt conception.

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