What is the Thyroid?

If someone were to ask you where your thyroid gland is, or what it does, would you know? If you’re like most Americans, probably not, but this small but very important organ regulates every aspect of your metabolism, from your heart rate to how quickly you burn calories. Shaped like a bowtie, the thyroid gland is located in the middle of the lower neck, below the larynx and just above your collarbones. The thyroid is one of the endocrine glands, which are responsible for the body processes that happen slowly, such as cell growth. UAMS endocrinologist Dr. Don Bodenner says the thyroid gland makes and releases two hormones into the bloodstream, T3 and T4, which all cells in the body need to work properly. These hormones control how fast the body uses up energy and are key factors in the growth of children. The thyroid acts much like a thermostat in a home, producing enough of these hormones to keep the body from overheating or from getting too cold.

Where is the Thyroid?

A small, bowtie-shaped gland weighing less than an ounce, the thyroid gland is located at the base of the neck. Because it is so small, the thyroid is barely noticeable unless it becomes enlarged to the point that it becomes visible. This enlargement is known as a goiter. While not generally uncomfortable, goiter can interfere with swallowing or breathing. Before the early part of the 20th century, the most common cause of goiter was a shortage of iodine in the diet in areas where the soil was deficient in iodine. Without enough dietary iodine, the thyroid can't make and release enough of the essential iodine-containing hormone. Goiter became less common in the United States after iodized salt was introduced in the 1920s. In addition, iodine naturally occurs in some foods, such as water, dairy products and seafood, or may get into some foods during processing. Treatment for goiter depends on the size of the enlargement, associated symptoms and its underlying cause.

What is Thyroid Cancer?

The thyroid gland, located at the base of the neck, has two lobes, one on the right and one on the left. A lump at the front of the neck may be a sign of thyroid cancer, one of the least deadly forms of cancer. Thyroid cancer occurs more often in people between the ages of 25 and 65 years and is more common in women than men. Some of the possible signs of thyroid cancer include a lump in the neck, hoarseness, trouble swallowing or a cough that continues and is not related to a cold. Some types of thyroid cancer grow faster than others. The chance of recovery depends on the type of cancer, whether it is in the thyroid only or has spread to other parts of the body, and the patient’s age and overall health. The methods of treatment for thyroid cancer usually include surgery and radioactive iodine treatment. A multidisciplinary approach to treating this form of cancer typically involves a surgeon, an endocrinologist, a pathologist and a nuclear medicine physician.

Graves' Disease, Having an Overactive Thyroid.

Graves' disease is the most common form of hyperthyroidism, or overactive thyroid. It occurs when the body’s immune system mistakenly attacks the thyroid gland and causes it to overproduce the hormone called thyroxine. This abnormal immune response can also affect the tissue behind the eyes as well as the skin, usually on the lower legs and feet. When you have too much thyroid hormone in your system, your body's metabolism rate can increase by 60 percent to 100 percent because thyroxine regulates your cells' metabolism. A higher metabolism can lead to a number of health problems, such as an irregular heartbeat or anxiety. Graves' disease is rarely life-threatening, according to UAMS endocrinologist Dr. Don Bodenner. Although it may develop at any age and in men or women, Graves' disease is more common in women and usually begins after age 20. Treatment options include antithyroid drugs, radioactive iodine and surgically removing the thyroid.

MIRP

Despite a similarity in name and location, the parathyroid glands and the thyroid gland have very different functions. The thyroid helps regulate metabolism while the parathyroid glands produce a hormone that helps maintain the proper balance of calcium and phosphorus in your body. In hyperparathyroidism, the parathyroid glands produce too much of the hormone, resulting in problems with the bones, nervous system and muscles. Surgery to remove the parathyroid glands traditionally involved a long, noticeable incision but a new technique, known as minimally invasive radioguided parathyroidectomy, or MIRP, offers a safer and less invasive approach. According to UAMS’ Dr. Brendan Stack, the procedure uses a radioisotope to help locate the abnormal gland at the time of the surgery. The operation can usually be performed through a one-inch incision in the neck. The new outpatient procedure causes less trauma to tissue and little scarring.

APNs

An Advanced Nurse Practitioner (APN) is a registered nurse who has completed a nurse practitioner educational program and holds national certification as a nurse practitioner from a board-approved certifying body.

APNs can both diagnose and treat a variety of health problems, capable of making appropriate referrals to other health-care professionals and community resources on behalf of patients and families. They are also trained to promote healthy lifestyles through education and counseling. Alisha Bell, an APN assigned to the UAMS Thyroid Clinic (right), has the skills to diagnose thyroid disorders, parathyroid disorders, and osteoporosis. Her duties include monitoring osteoporosis therapy and assessing thyroid ultrasound and diagnostic tests. She is also responsible for monitoring the progress of thyroid cancer patients using dynamic testing. Her role in patient education involves both patients and caregivers, essential in ultimately treating thyroid-related illnesses.