Section one
Goiter and Hyperthyroid - my personal experience story
Ultrasound
Comparison - results
before and after thyroid treatment
Misc. bits of thyroid information
Frequently Asked Thyroid Questions
Section two
Miscellaneous information about this website
Section three
Email
Copyright ©1998 -
2006
molly b. All Rights Reserved
Molly b.'s Thyroid FAQ Page 4
15. Q. What is a thyroid cyst? How is it treated?
A. A thyroid cyst is a fluid filled nodule ( growth ) on the thyroid gland. A cyst can be drained - aspirated - in the specialist's office, but will sometimes grow again. A cyst is rarely cancerous. It may only require observation over a period of time, for any signs of increase in size, especially if the thyroid gland is functioning normally. Blood tests of thyroid function might also be done occasionally. My sister had a thyroid cyst removed in a surgical procedure, because it was interfering with her breathing, but she had normal thyroid levels. I believe the need for surgery because of this is a very rare occurance. The specialist felt that the cyst I have is part of the multinodular goiter, and doesn't require any further testing or separate treatment.
16. Q. A scan has revealed that I have a single nodule on my thyroid. The word cancer scares me. I'm going to have more tests, but I'd like some information about thyroid cancer.
A. If nodules are working okay they are called 'hot' nodules and are very common. If a nodule shows up on the test as 'cold', or not working right, this might require a small biopsy, usually done in the doctor's office to rule out the possibility of cancer. If the results are unclear or if cancer is present, a nodule would be removed surgically. If the nodule is hot, it will probably not be cancerous, and even a cold nodule doesn't always mean cancer.
There is a good chance that you do not have thyroid cancer, since it is rare. Even if cancer is found, the survival rate for the most common type of thyroid cancer is very good, compared to many other types of cancer. Most cases can be treated with very successful results.
17. Q. What is a goiter? Is a toxic goiter a serious problem?
A. A goiter is an enlarged thyroid gland but not a growth on the thyroid. It is possible to have a goiter and normal thyroid functioning. An enlarged thyroid may be present during pregnancy or puberty, and would not necessarily require any treatment.
A nontoxic goiter is an enlarged thyroid which is not over-producing thyroid hormone.
A toxic nodule is a growth on the thyroid which is over-producing thyroid hormone.
A toxic multinodular goiter is an enlarged thyroid which has many overactive nodules that are producing too much thyroid hormone.
The word 'toxic' used in this way is a medical term that just describes the activity of a goiter or nodule. If doctors were to use a word such as 'busy' instead of 'toxic' it wouldn't sound quite so terrible to us patients!
Before table salt was iodized there was a type of goiter commonly found in areas where the soil, and therefore vegetables and fruit, lacked iodine. This is seldom seen in North America today since most of us use regular table salt. Iodine from salt and other foods is used by the thyroid gland to make thyroid hormone.
18. Q. Why is synthetic thyroid hormone replacement prescribed to nearly everyone these days, instead of a natural one?
A. The original medication for hypothyroid patients, desiccated thyroid hormone, was made from dried beef and pork thyroid glands. It was a combination of T3(triiodothyronine) and T4 (levothyroxine).
T3 leaves the body quickly, so truly effective therapy would require taking pills several times a day, to keep the levels in the blood consistent. A person would be hyperthyroid between pills, as the blood levels of T3 rapidly increased and then rapidly decreased from the time of taking one pill until it was time to take the next.
It was discovered that T4 levels in the blood increase very gradually and then decrease very gradually.
Pharmaceutical labs developed synthetic thyroid hormone, which uses T4, because T4 is slower acting. No more 'hyperthyroid rushes' as our grandmothers had with desiccated thyroid hormone. The dose per pill is also more accurate because it's chemically manufactured. The amount your body receives daily is important, so most doctors now prescribe the synthetic.Vegetarians should be especially pleased about this!
19. Q. What is radioactive iodine? Is it the same stuff they give a person who receives cancer treatment ( chemotherapy )? Are there any side effects from RAI?
A. Radio iodine is a substance taken up mostly by the thyroid gland. It damages the thyroid cells so that they can no longer over produce thyroid hormone. Over production of thyroid hormone causes hyperthyroidism. After RAI, the thyroid cells lose their ability to grow and their function is decreased. The treatment has been used for over 40 years.
The radiation is similar to that used during any standard medical or dental x-ray. These, too, are examples of external radiation exposure.
Chemotherapy, used in cancer treatment, is not the same thing. Its purpose, its effects and the side effects are very different from radio iodine therapy.
Because the thyroid gland absorbs all of the RAI, none is taken up into any other parts of the body. Only the thyroid is affected. The radionuclide half-life is 8 days, which means that its presence will be reduced by one-half every 8 days. For the first few days, a person gives off small amounts of radiation - although they don't glow in the dark:) This is why precautions are necessary, such as using your own towels, sleeping alone for a few nights, and not staying within close range of others, especially small children or pregnant women, for more than a few minutes at a time, from 2 to 5 days after treatment. The number of days varies according to the amount you receive. The doctor and lab staff explain precautions and the time involved according to your personal treatment.
RAI can take up to 6 months to work and may require a second treatment. The amount of RAI administered needs to be enough to work on the individual's thyroid gland. Surgery is effective a bit sooner and does have a better chance of success. There's less guesswork involved since the surgeon removes the necessary amount of thyroid gland during the operation. Surgery requires a few days stay in the hospital, so anyone who thinks the precautions necessary with RAI are inconvenient should keep this in mind. RAI is administered in one quick trip to the lab and you are able to go home immediately after with no hospitalization needed.
I had RAI in early December/97 and there haven't been any noticeable side effects - other than no longer being hyperthyroid:) The specialist and lab tech explained that the dose of radiation is not enough to make a person ill, either at the time of treatment, or in later life. I had to stay several feet away from other people - not remain in close contact for more than a few minutes at a time - and use disposable utensils and dishes for 5 days afterward. Laundry had to be done separately from the family's. The sink and toilet had to be rinsed/flushed several times after use.
I was determined to have surgery at first, since my mother had successful surgery in the 1970's, but the specialist said she would like to try RAI because it's non-invasive. I'd prefer effectiveness and not want to base a decision solely on whether or not a treatment is 'non-invasive'! I feel that the high rate of malpractice suits in the U.S. may be a possible reason that RAI is the preferred treatment method in most cases nowadays.
As of November 2006, I'm still on 0.05 mg of Synthroid as I have been since April 1998. TSH test results have all been normal.
