
	Medical Edge


	About

	Television

	Radio

	Newspaper

		Participating Newspapers

	Magazine

	Contact


	About Mayo Clinic

	Make an Appointment at Mayo Clinic

Medical Edge Newspaper Column from Mayo Clinic

MOST CAUSES OF AN ENLARGED THYROID ARE BENIGN

DEAR MAYO CLINIC: What problems are associated with an enlarged thyroid?

ANSWER: The thyroid gland, a small butterfly-shaped gland just below your Adam’s apple, is responsible for producing thyroid hormone. Many aspects of metabolism — including heart rate, body temperature and the speed at which you burn calories — are regulated by thyroid hormone. When faced with a thyroid problem, your physician has two concerns:

— Thyroid gland size. Normally weighing just an ounce, the thyroid may become enlarged for several reasons — some serious, some not.

Most causes of an enlarged thyroid are benign. Thyroid cancer does not commonly cause the entire gland to become enlarged. Because of its location near the windpipe and esophagus, an enlarged thyroid could create difficulties with coughing, hoarseness, breathing or swallowing.

For people older than 65, benign nodules on the thyroid often cause the enlargement. Although most nodules are benign, your physician may elect to perform a simple biopsy to ensure there is no reason for concern.

If symptoms are bothersome or worrisome, nodules can be surgically removed or, in some cases, treated with radioactive iodine. This therapy is taken orally and destroys thyroid cells, reducing thyroid size. This approach is safe, but may result in an underactive thyroid, necessitating hormone replacement therapy.

If you have symptoms of an enlarged thyroid, work with your doctor to confirm a diagnosis and determine if treatment is needed. Even when the gland is enlarged, it could still be working properly. If symptoms aren’t bothersome, your doctor may suggest a wait-and-see approach.

— Thyroid function. The gland can overproduce or underproduce hormones. Both can cause health concerns. Underproduction or overproduction of hormones could be related to an enlarged thyroid or inflammation of the thyroid. Blood tests can confirm the diagnosis.

Treatment could include hormone replacement for an underactive thyroid or medication including radioactive iodine to normalize hormone levels for an overactive thyroid. If the thyroid is inflamed, aspirin or corticosteroid medications may help.

— Michael Whitaker, M.D., FRCPC, Endocrinology, Mayo Clinic, Scottsdale, Ariz.

Additional Resources:
Thyroid Disorders
Appointment Information

READERS: When someone you love dies, your grief can’t be planned or mapped out. Grieving is a unique and natural experience because of your unique relationship with the person who died.

Grief can encompass many physical symptoms — an upset stomach, a tightening in the throat, actual pain around the heart, headaches, difficulty breathing, exhaustion, an inability to concentrate and forgetfulness. Some people describe grief as numbness, or feeling like the wind has been knocked out of them. Feelings of anxiety, fear and anger — even anger toward the deceased — aren’t uncommon.

Grief can last one year, two years or even longer. In that time, you may find things go well for a while, and then with no warning, you may be overtaken by a wave of grief.

Here are suggestions on ways to deal with grief:

— Share your story: It’s important to put your feelings into words. A close friend or family member who can act as a sounding board is invaluable as you struggle to sort through feelings. Don’t be afraid to let the tears flow. Crying can release sadness along with anger, guilt, loneliness and exhaustion.

— Put words to paper: Keep a journal. Write letters to your deceased loved one — share regrets, things you wanted to say that never got said, how you feel, what you miss.

— Join a support group: Talking with others who understand and share the experience of grief can be a healing gift to you.

— Be kind to yourself: Grief affects your mind, body and soul. Do what you can to care for yourself with a healthy diet, exercise and adequate sleep.

— Seek professional help if needed: If the intense, disabling part of grief lasts longer than two months, talk with your doctor. You could be dealing with depression or post-traumatic stress disorder. In addition, seek professional help if you resort to using excessive amounts of drugs or alcohol to deal with your grief.

- - -

Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.