Ruchi Mathur, MD, FRCP(C) is an Attending Physician with the Division of Endocrinology, Diabetes and Metabolism and Associate Director of Clinical Research, Recruitment and Phenotyping with the Center for Androgen Related Disorders, Department of Obstetrics and Gynecology at Cedars-Sinai Medical Center.
William C. Shiel Jr., MD, FACP, FACR received a Bachelor of Science degree with honors from the University of Notre Dame. There Dr. Shiel was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
There are really not many emergencies that we need to worry about regarding
the thyroid gland - but thyroid storm is one of the rare exceptions.
Thyroid storm is a crisis or life-threatening condition characterized by an
exaggeration of the usual physiologic response seen in hyperthyroidism. Whereas
hyperthyroidism can cause symptoms such as sweating, feeling hot, palpitations and weight loss
- symptoms of thyroid storm are more severe,
resulting in complications such as:
Hyperthyroidism is a condition in which an overactive thyroid gland is producing an excessive amount of
thyroid hormones
that circulate in the
blood. ("Hyper" means "over" in Greek). Thyrotoxicosis is a toxic condition that is caused by
an excess of thyroid hormones from any cause. Thyrotoxicosis can be caused by
an excessive intake of thyroid hormone or by overproduction of thyroid hormones by the thyroid gland. Because both physicians and patients
often use these words interchangeably, we will take some liberty by using the
term "hyperthyroidism" throughout this article.
What are thyroid hormones?
Thyroid hormones stimulate the metabolism of cells. They are produced by the
thyroid gland. The thyroid gland is located in the lower part of the neck, below the Adam's apple. The gland wraps around the
windpipe (trachea) and has a shape that is similar to a butterfly formed by two
wings (lobes) and attached by a middle part (isthmus).
The thyroid gland removes iodine from the blood (which comes
mostly from a diet of foods such as seafood, bread, and salt) and uses it to produce thyroid hormones.
The two most important thyroid hormones are thyroxine (T4) and triiodothyronine
(T3) representing 99.9% and 0.1% of thyroid hormones respectively. The hormone with the most
biological activity (for example,
the greatest effect on the body) is actually T3. Once released from the
thyroid gland into the blood, a large amount of T4 is converted to T3 - the more active
hormone that affects the metabolism of cells.
Hypothyroidism is any state in which thyroid hormone production is below normal. Normally, the
rate of thyroid hormone production is controlled by the brain at the pituitary.
Hypothyroidism is a very common condition and the symptoms of hypothyroidism are
often subtle.
Dizziness is a symptom that is often applies to a variety of sensations including lightheadedness and vertigo. Causes of dizziness include low blood pressure, heart problems, anemia, dehydration, and more. Treatment of dizziness depends on the cause.
Night sweats are severe hot flashes that occur at night and result in a drenching sweat. In order to distinguish night sweats that arise from medical causes from those that occur because one's surroundings are too warm, doctors generally refer to true night sweats as severe hot flashes occurring at night that can drench sleepwear and sheets, which are not related to an overheated environment.
There are four major types of thyroid cancer: papillary, follicular, medullary, and anaplastic thyroid cancer. Tumors on the thyroid are referred to as thyroid nodules. Symptoms of thyroid cancer include swollen lymph nodes, pain in the throat, difficulty swallowing, hoarseness, and a lump near the Adam's apple. Treatment usually involves chemotherapy, surgery, radioactive iodine, hormone treatment or external radiation and depends upon the type of thyroid cancer, the patient's age, the tumor size, and whether the cancer has metastasized.
Vitiligo is a condition in which the skin turns white due to the loss of pigment from the melanocytes, cells that produce the pigment melanin that gives the skin color.
Thyroid nodules are the most common endocrine problem in the United States. The term "thyroid nodule" refers to any abnormal growth that forms a lump in the thyroid gland. The vast majority of thyroid nodules are benign.
Premature ventricular contractions (PVCs) are premature heartbeats originating from the ventricles of the heart. PVCs are premature because they occur before the regular heartbeat. There are many causes of premature ventricular contractions to include: heart attack, high blood pressure, congestive heart failure, mitral valve prolapse, hypokalemia, hypoxia, medications, excess caffeine, drug abuse, and myocarditis.
There are many types of thyroid disease. Some occur due to the function of the thyroid itself such as hypothyroidism, hyperthyroidism, Hashimoto's thyroiditis, etc. Some causes of thyroid disease occur due to problems with the structure of the thyroid gland such as goiters, thyroid nodules, and thyroid cancer. Treatment of thyroid disease depends on the cause of the disease.
Gynecomastia, an enlargement of the gland tissue in the male breast is the caused by an imbalance of hormones. Certain medical conditions may also lead to gynecomastia such as cirrhosis, malnutrition, disorders of the male sex organs, kidney failure, thyroid disorders, and medications. Gynecomastia is generally treated with medication, and if necessary surgery.
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
Hypercalcemia is a condition in which calcium levels in the blood are elevated. Hypercalcemia is associated with other conditions such as hyperparathyroidism, lung cancer, breast cancer, kidney failure, and elevated levels of vitamin D. Symptoms of hypercalcemia include constipation, nausea, abdominal pain, kidney stones, to name a few. Treatment depends on the cause of hypercalcemia.
Grave's disease is an autoimmune disease that affects the thyroid. Some of the symptoms of Graves' disease include hand tremors, rapid heartbeat, trouble sleeping, enlarged thyroid, thinning of the skin or fine brittle hair. Causes of Graves' disease are thought to be multifactorial such as genes, gender, stress, and infection. Treatment for Graves' disease is generally medication.
Dry skin (xeroderma) may be caused by external factors, like cold temperatures, low humidity, harsh soaps, and certain medications, or internal factors, such as thyroid disease, diabetes, psoriasis, or Sjogren's syndrome. Symptoms and signs of dry skin include itching and red, cracked or flaky skin. The main treatment for dry skin is frequent, daily lubrication of the skin.
Thyroiditis is the inflammation of the thyroid gland. The inflamed thyroid gland can release an excess of thyroid hormones into the blood stream, resulting in a temporary hyperthyroid state. Some forms of thyroiditis can be diagnosed based on tenderness and enlargement of the thyroid gland. A thyroid scan sometimes is used in making the diagnosis. Thyroiditis can also be diagnosed with a biopsy of the thyroid gland.
Dry skin is a very common skin condition characterized by abnormal or excessive dryness of skin. While dry skin tends to affect males and females equally, older individuals are typically much more prone to dry skin. The skin in elderly individuals tends to have diminishing amounts of natural skin oils and lubricants. Areas such as the arms, hands, and particularly lower legs tend to be more affected by dry skin. Dry skin is also known as xeroderma.
Dry skin may be a mild, temporary condition lasting a few days to weeks. Dry skin may also become a more severe, long-term skin problem for some. Symptoms of dry skin include discomfort from skin tightness and itching. In addition, external factors such as weather can affect the severity of skin dryness. For example, cold or dry air and winter weather can worsen dry skin. Individuals whose occupations require more frequent hand-washing and sanitizing may experience dry skin more often. Dry skin may ...