What Can Cause Changes in the Thyroid?
Changes in the thyroid that may need to be examined with ultrasound include:
- Swelling or inflammation
- Neck redness
Autoimmune conditions such as Graves disease or Hashimoto's Thyroiditis can cause the thyroid gland to enlarge. As injury atrophies the gland over time, it becomes smaller. If the gland is actively inflamed, followed by an abrupt change in function, swelling, or neck redness, blood tests may show a sudden overproduction of hormones or antibodies to the gland or its receptors. This condition is known as toxic thyroiditis, which can be dangerous if essential functions such as heart rate or temperature are involved.
Sometimes a solitary thyroid nodule develops and affects only one area of the thyroid. This process usually requires an ultrasound of the thyroid gland.
What to Expect During a Thyroid Ultrasound
Ultrasound of the thyroid uses a small hand-held transducer or wand that emits sound waves produced by special crystals sent to and from the transducer to the thyroid gland. Sound waves reflected back to the crystals in the transducer are displayed as X-ray images of the gland for a specialized radiologist to interpret. This process is also sometimes referred to as a sonogram of the thyroid.
Unlike almost all other radiology centers, a radiologist at The Women's Imaging Center directly oversees the procedure and personally examines you if there is a thyroid abnormality or concern. A thyroid ultrasound will include:
We look at the overall size of the thyroid gland, the texture, nearby neck lymph nodes, and whether there are any nodules.
We look at the thyroid vessels to gain information on the thyroid gland's health.
Although most thyroid nodules appear benign (noncancerous), some have suspicious characteristics such as an irregular shape or suspicious calcifications requiring a thyroid needle biopsy.
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Frequently Asked Questions About Thyroid Ultrasound
A doctor may order a thyroid ultrasound to evaluate any physical changes of the thyroid gland such as an enlargement or difficulty swallowing.
A thyroid ultrasound will show any masses or subtle changes in the thyroid gland that could be associated with benign (non-cancerous) versus malignant (cancerous) nodules. Most nodules of the thyroid are benign.
Depending on the size, shape, and characteristics of the nodule, a biopsy might be indicated called a Fine Needle Aspiration. Most nodules will require a follow-up ultrasound within a short interval versus a biopsy.
Under ultrasound guidance, a very small needle is introduced into the thyroid gland after numbing the area. It feels like a light pressure for a few minutes while obtaining the cells. The sample is then interpreted by the pathologist.
The blood test will interpret the function of the thyroid gland while the Ultrasound evaluates the anatomy.
The function of the thyroid can be assessed by measuring the specific hormones secreted by the thyroid gland called thyroxine (T4) and triiodothyronine (T3) or by measuring the feedback signal from the pituitary gland (the brain of the thyroid), called Thyroid Stimulating Hormone (TSH).
Iodine is a necessary building block for the thyroid. Another substance produced by the gland called Calcitonin signals the correct amount of calcium in the blood and affects bone metabolism.
Hypothyroidism is when the thyroid gland doesn't make enough hormones. Many people with hypothyroidism may say, "I just can't lose weight even though I'm hardly eating anything," "I feel cold all the time," or "my hair is falling out, and my skin feels dry all the time." Unfortunately, diagnosing hypothyroidism is not as easy as just performing blood work because the body does everything possible to keep the hormones at a specific normal range in the bloodstream so that other organs can function properly. Therefore, thyroid function blood tests don't tell the whole story.
Additionally, many changes in thyroid function occur in our lives when other hormones are also changing, such as during pregnancy or menopause. Both women and men experience hormonal changes at about age 50. In women, we refer to this time as perimenopause, and in men, we refer to this time as "mano-pause." Many other hormonal changes also occur at this time so these changes may mask the complaints of fatigue or low libido from thyroid dysfunction.
Some people suffer from an overly active thyroid which produces too much hormone and affects the downstream organs. This condition is called hyperthyroidism. People affected by excess thyroid hormone production may present with cardiac palpitations, flushing, memory loss or mood disturbances, unexplained weight loss, difficulty regulating body temperature, and changes in vision or muscles of the eyes.