Thoughts on thyroid examinations?

Never seen anyone mention them here

Did you mean external palpation of the thyroid? A thyroid panel? A sestamibi scan? Frankly, having my throat pressed firmly enough to make swallowing difficult, and then being told to do so is not the most memorable part of a physical exam for me except for the annoyance factor.

Part of any complete physical exam

There is nothing especially interesting about a thyroid exam. The pressing is not really that pleasant and if you do have a condition, the doctor - endocrinologist most likely - will want to take a biopsy as well. It's done by sticking a needle into the (swollen) thyroid in your throat. No hardship to it except in the mind, since it's not really that special a place to stick a needle if you're looking for medfet fun ...

I've never had it done as part of a routine exam though. Only when i complained about a swollen thyroid was it examined and biopsied ... and believe me when I say that the medication is not good for the heart - it speeds up the heart rate and you feel as if your heart is racing, sometimes even like there is a hand inside your chest squeezing the heart - like something out of the X-Files - and that is no fun at all.

And then we won't get into the whole testosterone imbalance that often accompanies the condition.

This is one of the reasons the doctor feels on your throat.

Pretty simple exam to feel for any nodules in the neck.

Pretty simple exam to feel for any nodules in the neck.

There is only one thyroid gland and when it becomes enlarged it is more like being enlarged and thick than in the nature of being a hard nodule.

I think it's possible to confuse the typical palpation of the lymph glands that is standard in most exams with palpating the thyroid gland, even though both are located in very different areas of the neck/throat.

I can not remember ever having any doctor check my thyroid gland until I went with a specific complaint about it being very enlarged and exerting a pressure and a feeling of constriction when swallowing. Lymph glands (in the neck) on the other hand, are usually checked during most doctor's visits, especially if you come in with symptoms of the flu or other common maladies.

Actually, I am not sure where certain posters got their information from. A biopsy is never done for the thyroid without extensive testing; it would never be ordered after a simple standard physical exam, but only after x-rays or other scans, extensive bloodwork, and a very detailed history. All this including when the dr. feels some kind of nodule. It is surprising how much the thyroid actually controls - everything from heart rate to amount of hair on your body to the amount of hormones (testotsterone and estrogen included). You only get medicine if, after blood testing, it is found that you have a thyroid hormone deficiency, for example, if your pituitary gland makes too much of the hormone that tells your thyroid to slow down) or if you have too much thyroid supporting hormone (TSH), free T3, T4, etc. Blood testing discovers this. The medicine only speeds up your heart rate because it tells your thyroid to do so, and it has adverse effects IF it is the wrong dosage. Thyroid medicine is very sensitive, and even a small dosage increase or decrease can alter how you feel, so it should be closely regulated. Usually you start with a very small dose (25mcg) and go from there with periodic blood tests (every few months) until you reach a level that's "in the range".

It's true that enlargement makes your throat feel "fuller" and it's very uncomfortable. THe dr. can tell this just from feeling it, but would not know what the cause is unless they do more testing. However, there are other things that can cause the full feeling, and it's important for you to report other maladies, such as fatigue, hair loss, lethargy, very dry skin/eyes, voracious or nonexistent appetite, weight gain or loss that is completely unexplained, and so on. These are all symptoms of hypo or hyperthyroid. If you notice a combination of these, and report it to your doctor, it is likely you will first get checked, blood will be drawn and analyzed, and then you will go from there. You won't have to get a biopsy unless the dr. thinks it's thyroid cancer.

Actually, I am not sure where certain posters got their information from. A biopsy is never done for the thyroid without extensive testing; it would never be ordered after a simple standard physical exam, but only after x-rays or other scans, extensive bloodwork, and a very detailed history. .

I wouldn't call the testing extensive. I went to my family physician with my complaints, he palpated the gland and ordered bloodwork. He then referred me to an endocrinologist who had meanwhile received the bloodwork results. When I went to the endocrinologist he asked if I would have a biopsy done while I was there as I had symptoms he was familiar with and those indicated a biopsy to determine what was wrong.

I also had a feeling that in his experience some patients were very skittish, not to say terrified of having a biopsy done on the thyroid. So he probably thought of having it done at once, before I could change my mind and perhaps not show up if one were scheduled at a later date.

I felt it was appropriate and opportune to get it out of the way at once so I agreed. And it was not a big deal at all. I felt as good as nothing of the biopsy. An x-ray was done at the same time as well, so that when I came back a second time to the endocrinologist, he had all pertinent data with which to advise me and prescribe medication. It was not a long drawn out process at all.

I have struggled with my weight since adolescence. Alot of people think that thyroid is the issue when its a combination of alot of things. Only recently has a doctor actually listened to my concerns about my thyroid. My blood tests all came back within the normal range, however, it was borderline normal, but still normal enough to not do anything. It took alot of convincing for me to get him to try me on a low dose of synthroid, and even then it was only after he gave me a very complete examination (as he had done the last 2 times i was in his office) he felt and felt and felt my thyroid, having me take sips of water and swallow (which was very uncomfortable!) he finally remarked he thought he felt something, and agreed to the low dose of the synthroid.. This last time I went to his office, again a full complete exam and i told him that the synthroid seemed to be helping. I had more energy and felt better overall. He finally said "you have subclinical hypothyroidism" he may adjust my dose up, but he spent alot of time listening to my heart (almost 3 minutes)... i suppose because the med causes heart issues.

Wembleyjones, I agree with you. As you stated, many functions of the body are controlled directly or indirectly by the thyroid. It is very important and needs to be checked out by a professional but a biopsy comes way, way down the list after many other less invasive tests.

They call the thyroid the master gland, and do so for a good reason. It controls so many things in your body it's even hard to list them all here. And even things that it doesn't control it also has some effect over, including things like libido believe it or not. Some things are or can be rather serious, others not so much. A serious thing for example is that thyroid issues can cause infertility, non serious, it can cause hair loss/growth.

The thyroid gland is very complicated in a matter of speaking, and I find it highly interesting. Thyroid disease effects women more often than men. There are in fact two thyroid glands, not one as previously mentioned. There is the thyroid gland itself, and the parathyroid glands too. Para meaning "around".

As a woman who suffers from a form of thyroiditis (itis meaning inflamation of) called Hashimotos (sp?) Thyroid Disease and as a nurse, I am pretty well versed in thyroid issues. However as I mentioned before, a thyroid is pretty complicated, especially for as small as it is and I still learn things about it and my disease all the time.

To put things on a very very simple level, there are basically 3 most common types of thyroid issues. High, low, and changing. If your TSH is high, say over 4 or 5 for most lab values, then you have hypothroidism. And I believe if it is 0.2 or less then you have hyperthyroidism. Confusing I know. The values run opposite like a gauge of a needle. The lower the gauge the bigger the needle. The higher the TSH level the more hypothyroidish you are. Hypo meaning low, and hyper meaning high basically. But if you are like me you have the third type which is changing. My thyroid waxes and waines, meaning that it might be working just fine for 6 months, then suddenly it will stop working and my TSH level goes through the roof. And it continues to work then not work. So I take my meds and then my thyroid decides to start working again and then suddenly my TSH bottoms out. I have learned to be able to read my body and adjust my snythoroid medication accordingly. I do so mostly on my sleep patterns. If I am tired all the time then I need more synthroid, if I am wired and can't sleep then it's time to back off my medication. And no, I do not suggest anyone else do this. Do as I say, not as I do.

I had been having weight issues my entire life once I reached puberty. I was very hairy as well and just assumed it was because I am part German. I could sleep anyplace at anytime all the time, and my hair was very course and dry. I was also hot all the time too. All these symptoms along with a tire around my neck should have clued someone into the fact that I probably had a thyroid issue. My family history also strongly pointed to thyroid issues as every single woman on both sides of my family have had goiters or thyroid issues. Also, I have never had a period that was even close to being regular, another clear sign. I went basically undiagnosed for 30 years because everytime I was tested, my TSH, T3 and T4 was basically normal. Finally after testing and testing for multiple months in a row I had one that came back high and presto, the dx was determined. I was put on synthroid and I lost 30 pounds in less than 2 months. Amazing.

Also mentioned was how dangerous synthroid medication can be. This is also true. And remember, do as I say not as I do. I decided to double up on my synthroid medication because I wanted to feel that much better. Well by doing so it caused some issues that will never go away. It left me with permanant nerve damage in both my hands, especially my left. I have a slight tremor. At first it was a huge tremor, but it got better with time and is now only slight. But point is, never take more synthroid medication that the doctor gives you to take. Not a smart idea.

There are still a lot of studies being done with the thyroid and issues it can cause. They have recently found a link between kidney stones and thyroid disease. Interesting because I am prone to those too. Get your thyroid checked folks. Also, on another point. About 4 years ago I had a thyroid scan done and they found 3 nodes, 2 on the left and 1 on the right. The largest is 9mm. They are not palpable and they will not do a biopsy until they reach 1 cm. Also, I have read the chances of nodes being cancerous if they are there when you are young is slim. Also interesting. I have an enlarged neck, but I do not have a goiter, just an enlarged thyroid. That I am thankful for.

Mashie

I believe it is the pituitary that has the nickname "the master gland."

Interesting, I was always taught that it was the thyroid glad that was called that. You are probably right as usual, lol.

Mashie

Speaking as an endocrinologist, I have to agree that it's the pituitary gland that's called in the lay world the "master gland." since it controls most of the other glands, including the thyroid gland thru secretion of thyroid stimulating hormone (TSH). Elevated levels of TSH are usually used to define thyroid failure. It's the bodies own assessment of thyroid adequacy that increases the levels. It doesn't get much better than that. And the hypothalmus secretes thyrotropin releasisng hormone (TRH) which stimulates the pituitary to secrete TSH. One big feedback loop. But it sure screws a body up when it doesn't work right.

But it sure screws a body up when it doesn't work right.

You're telling me ... and medication never seems to put things exactly right again either ...

Hey folks lets not forget about the physical and/or emotional difficulties.

how often have you seen a person with chusings syndrom....moon face

Right or someone with Graves disease or also known as "Aunt Bea's Syndrome"? When you have bulging eyes.

Mashie