Diseases nuclear medicine
Thyroid diseases include nodular changes as well dysfunctions like hyperthyroidism (overactive thyroid) or hypothyroidism (underactive thyroid). The diffuse goiter, also called struma, can also be accompanied by nodular changes.
Symptoms thyroid diseases
Thyroid diseases can have several different symptoms, depending on the kind of thyroid disease.
Often, patients suffer from a goiter (struma) with difficulties in swallowing and a tight feeling in the throat.
Hypothyroidism (underactive thyroid) can be associated with tiredness, weight gain, hair loss, constipation and depressive mood.
Hyperthyroidism (overactive thyroid) can come along with weight loss, hair loss, increased perspiration, nervousness, diarrhea and restlessness.
Causes thyroid diseases
Subject to the kind of thyroid disease, there are different causes.
Goiter (struma) can be caused by iodine deficiency or hormonal changes.
The most frequent cause of hyperthyroidism (overactive thyroid) is Hashimoto´s thyroiditis. It is an autoimmune disease that is brought about by a malfunction of the immune defense. But often the cause of hyperthyroidism cannot be clarified.
Hypothyroidism (underactive thyroid) can often be traced back to changes of the immune system. In case of Grave´s disease, the malfunctioning immune defense produces antibodies against certain thyroid receptors that facilitate the hormone production. Another cause is autonomous adenomas (benign tumors) or a diffuse anatomy of the thyroid gland. Here, the root of evil can be iodine deficiency that is overcompensated by the body, which happens more often in case of goiters that have been present for a long time.
Diagnostics thyroid diseases
Firstly, a clinical examination including manually checking the throat and soft tissue of the throat (lymph nodes) is carried out in case of presumptive thyroid diseases.
Thyroid ultrasound can help measure the size, structure and shape of the thyroid gland as well as detect nodules. A further examination of the thyroid nodules is done with scintigraphy, a medical imaging procedure of nuclear medicine that works with radioactive contrast agents. Overactive (“hot”) nodules are signs of a distinct hyperthyroidism (overactive thyroid), whereas inactive (“cold”) nodules represent defect parts of the thyroid gland. Given cold nodules of 1 cm (0.4 in) or larger, a tissue sample should be taken and send to a laboratory for further examination.
The results of a blood test can show if a patient suffers from hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid).
Every examination of the thyroid gland requires a blood test, measuring the concentration of thyroid hormones T4, T3 and TSH. T3 and T4 are connected to THS. When suffering from an overactive thyroid, TSH is suppressed but is elevated in case of an underactive thyroid. In addition to those parameters, the concentration of thyroid antibodies is assessed in order to evaluate the presence of Grave´s disease. Given suspicious nodules, the blood is also tested for two specific tumor markers (thyroglobulin, calcitonin).
Treatment thyroid diseases
The kind of treatment depends on the kind of thyroid disease.
A goiter (struma) can be treated with thyroid hormone medication (levothyroxine/L-thyroxine).
Hypothyroidism (underactive thyroid) does also require the application of thyroid hormones.
Hyperthyroidism (overactive thyroid) can be treated in three ways: antithyroid drugs (thyrostatics), radioiodine or surgery. Every therapy method has to be discussed in detail before adhering to one.
Given potentially cancerous nodes, surgery is indicated to make an accurate diagnosis.