Diagnosing and Treating Thyroid Diseases
Medical College of Wisconsin endocrinologists are experts at diagnosing and treating a wide range of thyroid gland disorders. The endocrinologist will take a complete patient history, conduct a physical exam, order tests, coordinate treatment and make additional referrals. At all stages of care, the endocrinologist maintains communication with the patient’s referring physician or nurse practitioner.
Thyroid Disorder Diagnosis
There are a number of tests used to detect thyroid disease.
Thyroid function testing is a blood test to determine the level of thyroid hormones TSH (thyroid stimulating hormone), T4 (thyroxine) and T3 (triiodothyronine). The levels of thyroglobulin and calcitonin (markers for thyroid cancer) and antibodies associated with autoimmune diseases may also be determined.
Thyroid ultrasound imaging involves exposing part of the body to high-frequency sound waves to produce pictures of the inside of the body. The sound waves are emitted from a small hand-held transducer that is passed over the thyroid. Ultrasound images show the structure and movement of the internal organs in real time.
An ultrasound exam of the thyroid is typically done to help diagnose a lump in the thyroid or a thyroid that is not functioning properly. Ultrasound can also be used to assess lymph nodes in the neck in cases of suspected thyroid cancer. The use of thyroid ultrasound facilitates an immediate answer regarding the size and characteristics of a thyroid nodule, and allows the endocrinologist to determine the need for a biopsy.
Ultrasound-guided fine needle aspiration biopsy is a method of removing a small tissue sample from a nodule using a thin, hollow needle. The placement of the needle is guided with ultrasound imaging. The tissue sample is examined in a laboratory to determine if the cells are benign or malignant (cancerous). For patients with a positive biopsy or suspicious cells, an appointment with a surgeon is arranged.
Thyroid uptake/scan is a nuclear medicine test that uses a radioactive iodine tracer to see how well the thyroid is working. A patient is given a pill that contains radioactive iodine. After the radioactive iodine has been absorbed by the thyroid (in a few hours), the scanner detects the location and intensity of the rays given off by the radioactive material. A computer displays images of the thyroid gland. This test is done to check for hyperthyroidism, thyroid cancer and thyroid nodules or other growths.
CT and MRI may be used to capture images of thyroid abnormalities and diagnose thyroid disease.
Thyrogen stimulation is a synthetic form of thyroid stimulating hormone (TSH) given to patients to assist in the diagnosis and treatment of thyroid cancer.
Thyroid Disorders Treatment
The treatment of thyroid disease depends on many factors, including the type and severity of the disorder, and patient’s age and overall health. Froedtert & the Medical College of Wisconsin endocrinologists tailor treatment to the unique needs of each patient, using a collaborative multidisciplinary team approach. Physicians who specialize in endocrinology, endocrine surgery, pathology, radiology, nuclear medicine and other areas may be involved in treatment.
Restoring thyroid hormone levels through hormone replacement is the most common treatment for hypothyroidism (underactive thyroid).
Treatments for hyperthyroidism include medication to block the production of thyroid hormone and radioactive iodine to treat an overactive thyroid.
Thyroid nodules, whether cancerous or benign, may require surgical treatment. Thyroid cancer may also be treated with radiation therapy, hormone replacement and chemotherapy.
Thyroid Disease Research
At Froedtert & the Medical College of Wisconsin, Medical College physicians and scientists continually search for new ways to diagnose and treat a wide range of diseases and disorders. In thyroid disease, current research involves:
- Looking at molecular pathways that lead to the development of thyroid cancer
- Investigating diagnostic strategies for thyroid cancer
- Conducting clinical drug trials for thyroid cancer