Diagnosis and treatment
Sometimes it may be difficult to diagnose thyroid disease, because the symptoms are very similar to those that can appear during pregnancy or manifest themselves as a person gets older. Your doctor may use different methods to decide whether you have a thyroid disorder or not.
- Physical examination
- Radiological examination (Ultrasound)
- Laboratory tests
Physical examination is a safe and painless method during which the doctor checks your neck with his hands to look for signs of swelling or tumor. This is done in the doctor’s office. If there is no suspicion for a disease, this examination is sufficient.
However, if the doctor suspects anything, he can run some blood tests to evaluate the levels of hormones in your blood. Blood test will show if there is a functional disorder or other diseases like
- thyroiditis
- Graves’ disease
- Hashimoto’s thyroiditis
- goiter
- nodules
- cancer
Generally, the doctor will check the level of TSH, thyroid stimulating hormone, in your blood. Low level of TSH may be a sign of hyperthyroidism, while high level of TSH may be caused by hypothyroidism.
If TSH comes in abnormal levels, you may need to check other hormones. High levels of thyroxine will help the doctor to diagnose you with hyperthyroidism and low levels of thyroxine will confirm your hypothyroidism. This hormone is also checked to monitor your treatment outcomes.
Triiodthyronine helps to understand the severity of hyperthyroidism. The doctor may also check for your antibodies, calcitonin or thyroglobulin levels.
Blood tests are very important but they are not sufficient for final diagnosis.
Other techniques like medical imaging are used. Ultrasound examination is the most common method used to check the size of your thyroid, look for structural changes of the gland as well as find neoplasms or nodules.
Another method of diagnosis is biopsy. This is a procedure where the doctor takes a sample from your thyroid which is sent to the laboratory for cellular/histological examination. Nowadays, the doctors perform a fine needle aspiration biopsy under ultrasound guidance. This is a safe and painless procedure and with high reliability.
Remember that “blind biopsies” used in the past are now prohibited.
Treatment
The doctor chooses a treatment aimed at repairing or improving the normal function of your thyroid gland. The best treatment option is planned based on the type of disease and underlying causes.
In hyperthyroidism the treatment options may include antithyroid medication, radioactive iodine therapy, which are aimed at suppressing the production of hormones, or beta blockers, which are for treating the symptoms.
There is also a procedure called thyroidectomy, which is surgical removal of the thyroid gland. In this case, you will need to take hormone replacement medication during your lifetime. It is a synthetic hormone, which is also prescribed during hypothyroidism. Surgery used to be the only option in the past, however nowadays, with the development of technologies, there are many alternative options. Such alternative methods can be found in the field of Interventional Radiology, which is a medical discipline that uses minimally invasive techniques, like ablation.
Both options have strict indications, so your doctor will choose the best treatment option based on your final diagnosis.