May 25th, was World Thyroid Day! This is a day that has been recognized by many Thyroid societies throughout the world. If you are wondering why this is becoming such a big deal, well sit back and buckle up, you are going for a ride down what is becoming a growing concern.
Let’s start with the fact that thyroid cancer is the most common cancer in the endocrine system. Currently, we are seeing new cases of thyroid cancer at 13.9 per 100,000 men and women per year. This is one of the fastest growing cancers in the world. As with all cancers, early detection is one of the best ways to make sure that the cancer never has a chance to grow. Let’s look at ways to screen your thyroid.
Always make sure that you start with Physical exam. The physical exam is where a physician will feel areas at the front of your neck 2-3 inches below your jaw, under the thyroid cartilage in your throat (the adam’s apple for men) and just above your sternum. This is a simple exam that can be done in a couple of minutes, you may be asked to swallow while the location is being felt. Your physician is looking for enlargement, swelling and any abnormal bumps in your thyroid. These are all signs that the thyroid is having tissue changes and would definitely require further investigation with lab work and imaging.
Now, let’s talk about that lab work. This is where you will need several tests looked at that do not happen all the time with basic thyroid screening. The most common thyroid blood test is your Thyroid-stimulating hormone (TSH). This will be higher if thyroid is not working as well and lower when the thyroid is over working. The TSH level is an indicator of dysfunction or disease states of the thyroid and can be normal in thyroid cancer. The next labs will be for thyroid hormones (T3 and T4). Thyroid hormone levels can be checked for a sense of thyroid gland function. The thyroid hormones also usually normal with thyroid cancer, will be high in hyperthyroid states and low in hypothyroid states. Some other tests to have done will be Thyroglobulin levels, a protein from the thyroid that should not be too high in the blood. It is elevated in some forms of thyroid cancers (papillary and follicular types), not in other forms, so it is not a definitive test. You can also have Thyroglobulin antibodies (TgAb) checked, in about 30% of cancers TgAb can show up positive with thyroid cancer. Calcitonin is an additional marker to have checked that is common in medullary thyroid cancer, where thyroglobulin was more common in papillary and follicular thyroid cancers. This is where running the appropriate labs can be helpful for detection of thyroid cancer early.
The next screening that you need to make sure to get, just in case the physical exam and labs do not show the cancer is imaging. The first and more common imaging is a Thyroid U/S, this is the selfie that we are talking about. This is a simple procedure where a wand like device is used to look at the shape, size, structure and tissue consistency of your thyroid. This also detects nodules, cysts and lymph nodes. So, this is really important to get done. It is a common yearly imaging that should happen when you have any dysfunction or disease states of your thyroid.
Now, if for some reason nodules are found from all the screening mentioned above, you should have a Fine Needle Aspiration (FNA) biopsy performed that can help determine if it is benign, malignant, suspicious or indeterminate. Depending on the results, appropriate follow up care will be determined. In certain cases, a CT scan will be recommended to check the surrounding tissues, that are not seen with the imaging mentioned so far. Also, Nuclear imaging can be done with radioactive iodine to determine if a nodule is active or not. This helps to determine if the nodule detected is more of a threat.
Now that you have a brief overview of screening to be done for Thyroid cancer and World Thyroid Day just passing by us yesterday, make sure that if you have suspicious bumps seen in the front of your neck, get the appropriate care to evaluate them. Let’s be proactive and stop thyroid cancer from growing!
A naturopathic physician, Dr. Rezaie earned his medical degree from the Southwest College of Naturopathic Medicine and a master’s degree in molecular biology from the University of Texas at San Antonio. He applies his comprehensive understanding of the body’s biochemistry to employ safe and effective therapies toward fine-tuning neurochemistry and balancing hormones of the endocrine system. Dr. Rezaie incorporates nutrition, acupuncture and homeopathy to address concerns regarding stress, sleep and chronic conditions. Bringing additional backgrounds in physical medicine, strength and conditioning, as well as PRP/prolotherapy, Dr. Rezaie enhances the healing process of structural issues to regain prior fitness and reach new fitness levels. He is a motivated practitioner who exemplifies optimization, and challenges all individuals to take power over their health.