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Dear Student Doctors,

JANUARY 2013 IS:

Thyroid Gland

Thyroid Disease Month

Thyroid Quick Facts

  • The thyroid is a butterfly-shaped gland located in the anterior neck, responsible for the release of hormones essential in metabolism.
  • The thyroid requires iodine for function, and as many as 20% of Americans may still be iodine deficient, despite the widespread availability of iodized salt .
  • Common problems affecting the thyroid include hypothyroidism, hyperthyroidism, thyroid cancer, thyroid nodules, thyroiditis, and autoimmune thyroid diseases.
  • As many as 30 million Americans are affected with some type of thyroid disease.
  • Although 95% of thyroid nodules are due to reasons other than cancer, all should be evaluated thoroughly.

Thyroid Disease at HIPHOP Promise Clinic

Although relatively few PC patients have diagnosed thyroid problems, thyroid disease is very frequently misdiagnosed due to its often nonspecific symptoms. Based on national rates as well as undernutrition among the PC population, thyroid disease is a significant potential risk.


Evidence-based Thyroid Disease Care

  • Screening: While TSH and other thyroid tests are not recommended in general screening, a wide array of symptoms may suggest thyroid disease. These symptoms may include:

Hyperthyroidism: Weight loss, anxiety, insomnia, chronic diarrhea, tachycardia, hypertension, sweating, heat intolerance, visual disturbances
Hypothyroidism: Weight gain, depression, fatigue, hair loss, poor cold tolerance, clammy skin, decreased libido
Thyroid cancer/nodules: Anterior neck masses, voice changes, difficulty breathing or swallowing
Goiter, or an enlargement of the thyroid in the anterior neck, may be associated with any of the above conditions, including iodine deficiency

  • Testing: All thyroid testing should start with TSH levels. Complex algorithms exist for workup of a thyroid nodule. Below is an algorithm for classifying thyroid disfunction:

Thyroid Table