A gland located in the lower portion of the neck, the thyroid's primary function is to secrete hormones responsible for controlling the rate of chemical reactions of the body. A malfunctioning or abnormal thyroid will often produce symptoms suggestive of other disorders, such as depression, PMS, anxiety and elevated cholesterol. Misdiagnosis often leads to prescribed medication that further disrupts the hormonal balance and only worsens the symptoms. According to "Differential Diagnosis and Management for the Chiropractor," the vast majority of patients with abnormal thyroid function are diagnosed with hypothyroidism or hyperthyroidism.
Patient Assessment
It is extremely important to determine if the patient has already been diagnosed with an abnormal thyroid or is currently undergoing thyroid treatment. Patients will often complain of intolerance to heat and cold, fatigue, tremors and irritability.
Secondary signs of hypo and hyperthyroidism must be noted to properly diagnose and treat the patient. Those with an underactive gland or hypothyroidism often present with a slower heart rate, weight gain, intolerance to cold, drier skin, constipation, and goiter, an enlargement of the thyroid. Hyperthyroidism or a more overactive thyroid shows signs of weight loss, nervousness, perspiration, elevated heart rate and blood pressure, and goiter.
Laboratory Testing
A standardized thyroid function test is often requested for patients with abnormal thyroid activity. Three hormones--thyroid stimulating hormone, triiodothyronine and thyroxine--are closely evaluated to determine the proper diagnosis.
"Bottom Line's Prescription Alternatives" estimated that thyroxine comprises approximately 90 percent of the thyroid gland secretions, with triiodothyronin being a direct derivative of thyroxine. By monitoring these levels, you can determine the hypo or hyperactivity of the thyroid gland.
Thyroid stimulating hormone is a hormone produced in the brain and is responsible for regulating how much thyroid hormone is produced and released into the body. If the thyroid is hypo-active, a signal from the brain tells the gland to increase production, and it does so by increasing how much thyroid stimulating hormone is secreted into the blood. An elevated level of thyroid stimulating hormone is a clear indicator that the patient has a hypothyroid.
Treatment of Hyperthyroidism
Hyperthyroidism is treated by the administration of radioactive iodine. Due in part to the iodine-fortified foods people consume, uptake of the radioactive iodine may be as low as 1 percent. It is very important not to administer radioactive iodine to pregnant women to protect against possible cancer-promoting capabilities or alter genetic composition. Surgery is usually performed on patients younger than 21 who cannot be subject to radioactive iodine, are hypersensitive or have other health-related issues.
Treatment of Hypothyroidism
Hormone replacement therapy is the typical means of treating hypothyroidism. Patients are given a synthetic form of thyroxine, which the thyroid gland has been insufficiently producing. Noticeable improvement can usually be seen in two to three weeks, with most symptoms disappearing after a couple months.
Who to See for an Abnormal Thyroid
Always seek medical attention if you suspect an abnormal thyroid. Upon consulting your family physician, you will most likely be referred to an endocrinologist, who is highly trained and specializes in endocrine disorder, including thyroid disease.
References
- "The Merck Manual"; Fourteenth Edition; 1984
- "Bottom Line's Prescription Alternatives"; Earl L. Mindell, Rph, PhD; 2003
- "Differential Diagnosis and Management for the Chiropractor"; Second Edition; Thomas A. Souza; 2001
