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.

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.

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.

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.

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.

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.

According to the American Association of Clinical Endocrinologists, over 27 million Americans have been diagnosed with a thyroid disorder. The larger percentage of this population is made up of women. It is estimated that for every ten thyroid patients, eight are women. The hypothesis formed behind this statistical data is that women experience hormonal imbalance, especially after pregnancy, which will often develop into thyroid disease. A statistical projection states that about 18% of pregnant women develop a postpartum thyroid disorder, and out of the 18%, 5% of the cases develop to a permanent thyroid disorder.

On the other hand, although men are at a lower risk of developing thyroid disorders, their numbers are certainly on the rise. To get a deeper understanding of thyroid disorders, we must first understand the functioning of the thyroid gland.

The thyroid gland is a butterfly-shaped gland located on the anterior part of the neck, just below Adam’s apple. Its function is primarily the regulation of the body’s metabolism via interaction with various organs like the liver and the pancreas. The thyroid gland produces thyroid hormones, known as triiodothyronine, also known as T3 and thyroxine, commonly known as T4. The thyroid gland also produces calcitonin, which is a hormone that regulates blood calcium levels.

Thyroid hormones are made from iodine and tyrosine. The release of thyroid hormones into the blood circulation is regulated by Thyroid Releasing Hormone (TRH), which is released from the hypothalamus in response to low blood T3 and T4 levels. Conventionally, the amount of T4 released is four times the amount of T3 released. However, the active thyroid hormone is triiodothyronine. This depicts that there is a deiodination activation reaction that converts T4 to T3.

Thyroid disorders
Thyroid disorders can be classified broadly into three: hyperthyroidism, hypothyroidism, and a malignant thyroid gland. The main indicator of thyroid malfunction is the development of goiter, which is a large mass found on the neck. Other symptoms vary depending on whether it is hypothyroidism or hyperthyroidism.

What is the relationship between thyroid activity and weight?
As earlier stated, the thyroid gland plays a vital role in the body’s metabolism. Hyperthyroidism is associated with high Basal Metabolic Rate (BMR), which may potentiate weight loss. The cause of hyperthyroidism is primarily due to the over-proliferation of the thyroid cells, which may potentiate malignancy.

Hypothyroidism is associated with a low basal metabolic rate, which may potentiate weight gain, the cause hypothyroidism due to iodine deficiency, Hashimoto’s diseases, or surgical removal of the thyroid gland. Hashimoto’s disease is an autoimmune disorder that targets and destroys the thyroid gland. Iodine is used in the production of thyroid hormones, therefore reduced intake of iodine results in reduced levels of T3 and T4.

Endocrinologists have tried coming up with theories to explain the relationship between thyroid hormone levels and weight. A study conducted on over 6000 people for six years tried to assess the correlation between the levels of thyroid-stimulating hormone (TSH) and body mass index (BMI). The results were published in the International Journal of Obesity, which revealed a direct correlation between high BMI and high TSH levels, as seen in hypothyroidism cases.

Another study was conducted in 2004 that was investigating sleep-related disorders and obesity. The study revealed that 12% of its patients had subclinical symptoms of hypothyroidism. In addition, 25% of a group of patients comprised of 72 members scheduled for a gastric bypass had subclinical symptoms of hypothyroidism. Furthermore, they discovered a direct relationship between neck circumference and BMI. However, these studies did not reveal a direct relation between TSH levels and BMI.

Although fat accumulation is the primary cause of weight gain, it is not the major culprit in the case of hypothyroidism. Weight gain in hypothyroidism is attributed to the accumulation of body fluids due to reduced kidney function. Therefore, it is quite difficult for patients with hypothyroidism to lose weight. On average, a patient with hypothyroidism can gain about 5-10 pounds or more depending on its severity.

Patients with hyperthyroidism recorded increased levels in the basal metabolic rate, which leads to significant weight loss. To maintain one’s healthy weight, it demanded that one eats food rich in calories to counter the metabolic demand. The effect on weight in hyperthyroidism is much predominant than in hypothyroidism.

What is the effect of the dramatic changes in weight due to thyroid disorders?
Drastic weight gain may have a direct impact on a person’s self-esteem, especially if they cannot point out the cause. Low self-esteem can lead to anxiety and depression. On the other hand, dramatic weight loss may be a cause of concern and anxiety. All these may potentiate mood swings, depression, and anxiety disorders.

What are the measures are taken to deal with the drastic changes in weight?

For weight loss, a patient diagnosed with hypothyroidism needs to be on thyroid hormone supplementation in the form of levothyroxine. This will increase the basal metabolic rate and improve kidney function.

It is also recommended that such patients adopt a lifestyle change by incorporating more calorie deficient foodstuffs like fruits, vegetables, and whole grain. They should be more active by engaging in regular exercises like jogging, swimming, or cardio workout. This will help keep the BMI at the average standard range and counteract the fatigue associated with hypothyroidism.

Hyperthyroidism
For patients diagnosed with hyperthyroidism, the medical intervention involves symptomatic management and the use of drugs to reduce thyroid hormone formation. In severe cases, surgical removal of the thyroid gland is recommended.
With therapy, significant weight gain will be noticed.

For more information or questions about the thyroid function and its effect, contact Bay Area Endocrinology Associates in Tampa.

Thyroid health is an important indicator of overall health. The thyroid is a small gland located at the bottom of the neck. It releases hormones that help to regulate bodily functions into the bloodstream. The thyroid is key when it comes to processes like growth and metabolism. Changes to the thyroid can cause disruptions in some bodily systems. Changes to weight, mood, and frequency of sweating can all be caused by thyroid nodules. At Bay Area Endocrinology Associates in Tampa, we see people with suspected nodules all the time.

There are plenty of symptoms for thyroid nodules. In some cases, they’re large enough to be felt or seen. When nodules are present, they may be linked to overproduction or underproduction of thyroid hormones. Overproduction is known as hyperthyroidism. Weight loss, insomnia, and weakness are all symptoms of this issue. Hypothyroidism means the underproduction of thyroid hormones. Symptoms of this disorder include dry skin, being cold all the time, trouble remembering things, and depression.

Cytology and Testing the Thyroid

For nodules that aren’t visible to the naked eye, diagnosis is done with radiological imaging tools. These include CT or computed tomography scans, and PET or positron emission tomography scans. Once a nodule has been identified, it can be further tested. This is important because some thyroid nodules are cancerous. Identifying those before cancer can metastasize and spread is a crucial step any thyroid doctor needs to take.

In order to find out what’s going on inside the thyroid nodule, doctors send patients for thyroid fine-needle aspiration biopsy. This is performed with a fine, thin needle. It’s inserted into the thyroid and draws out some cells. Cytology is the study of the structure and function of animal cells. In effect, it means that a scientist is going to look at animal cells under a microscope and make determinations about them.

The Nuts and Bolts of Cytology

There are a few different ways that scientists may prepare slides in order to evaluate the thyroid health of a particular patient. The direct smear, cytospin, and cell block are all different ways of preparing the sample to be looked at under a microscope. After putting the samples on the slides, they need to be fixed in place. They will also need to be stained so that the lab workers can see the cells properly. There are three commonly used dyes for this purpose: diff-quick, Papanicolaou and hematoxylin, and eosin or H&E. H&E is one of the most widely used stains. It makes the interior of a cell look pink, and the nucleus or center looks purple.

When the slides are ready, someone will look at them under the microscope and interpret them. This is where the term adequacy really comes into play. Adequacy refers to the characteristics of the cells in the sample. In order to determine cytology adequacy, a pathologist or cytology technologist will look at a few different factors. These include how many cells are present, what types of cells they are, the presence of colloid, and the way the cells are put together. Colloid is important. Colloid nodules are benign. This is the result that every patient and doctor wants to see coming back from the lab.

For a thyroid cytology sample to be judged as adequate, it needs to meet a standard of, basically, abundance. This can mean 5 or more groups of 10-15 well-preserved cells. Others set the standard higher. For them, adequacy can mean 8 groups of 10 or more well-preserved cells. If there’s inflammation or abundant colloid in a sample, these standards don’t apply.

Assessing an Adequate Sample

Having an adequate sample is great. That means there are enough cells present to make a judgment about what’s going on with the thyroid. When it comes to actually assess the cells, there are a few different determinations a pathologist can arrive at. Adequate samples can show signs of things like thyroiditis. In this disorder, the gland is irritated. It may be producing too much or too little hormone. Adequate samples can also show problematic, atypical cells. Adequate samples may also be judged to have only a colloid present.

There’s a possibility of a sample being interpreted as inadequate. This can mean it doesn’t have enough cells present to make a determination. Samples can also be judged as “blood obscured.” In general, physicians will let their patients know what the results were. Even when things are good, and the results indicate that growth is benign, that’s not necessarily the end of the road. Responsible physicians will want to monitor thyroid nodules. That can mean scheduling more biopsies down the road and getting more cytology adequacy assessment test results. The thyroid is one of the body’s most important structures. Monitoring its health can be key to overall well-being.

At Bay Area Endocrinology Associates, we do our own biopsies. We run our own lab tests. We know that thyroid testing is important to our patients. As endocrinologists, we take it just as seriously as they do.