THYROID explain
INTRODUCTION
Good afternoon my name is Ranga Fernando, I am a third year medical student
with the university of Manchester.
Can I ask your name and date of birth please? Please could I have a look at that
wristband?
Can I call you *NAME* today?
Just to let you know, anything we do discuss is confidential between your medical
team and ourselves.
I understand you are here for. Is that correct?
Ok great, so what we are going to do today is discuss. go through an overview of
what it is, how it works, treatment options and any questions you may have, does
that sound ok?
Ok great, and is there anything in particular you want from today that I havent
mentioned?
So what do you already know about?
Normal anatomy / phys
The thyroid is located in the neck
The thyroid determines the pace of what happens in your body.
It makes things go faster, or slower by releasing a chemical
What is the disease?
The thyroid can be overactive, or underactive and this is diagnosed by measuring
the levels of chemicals related to the thyroid in your blood
THYROID explain
Most common in the elderly
Cause?
OVERACTIVE:
It can be due to a disorder to do with your immune system most commonly
Too much iodine in the diet
Inflammation of the gland itself from a virus
It can also be due to some medications containing iodine.
UNDERACTIVE:
Most commonly occurs when your immune system attacks the thyroid
Also can happen with treatment for hyperthyroidism
Not enough iodine
Pregnancy
A problem with the 'boss', a part of your brain called the pituitary
Problems it causes and complications
HYPERACTIVE:
Jittery, Hot, Sweaty, Tremor
Anxiety
Palpitations
Diarrhoea
Weight loss
Double vision eye problems
THYROID explain
Weakness
LADY - period less
UNDERACTIVE:
Tired, Cold, Hair loss, Dry skin
Low mood and memory
Constipation
Weight gain
Hoarse voice
LADY- increased periods
Management
HYPERACTIVE:
So to deal with an overactive thyroid, we try to reduce the activity. We can do this
in 3 main ways. Medication, targeted radiation or surgery. There are benefits and
risks to all of these.
Carbimazole - is an antithyroid drug and acts quickly. You take a 10mg tablet
three times a day. You will see results within 2-3 weeks. Your thyroid chemical
levels will be monitored and the dose adjusted to make sure we're doing just the
right amount and to avoid any adverse effects.
There some very rare side effects to with the bone marrow. If you get a sore
throat or fever please stop taking the drug and come in to get a blood test done
and let your doctor know.
THYROID explain
Radio-iodine - reduces activity by delivering radioactive iodine direct to the
thyroid gland when taken as a drink. It can take 3-4 months to have an effect. In
that time it is important to remember it can be passed on so cannot be used in
those trying to get pregnant or pregnant. It is cleared via the urine so can be
passed on, avoid contact with children or pregnant women. Should sleep alone
for a week.
An adverse effect is that you can get the symptoms of hypothyroidism, so TFTs
need to be monitored.
Surgical- removal of the thyroid is used when the medication or other treatments
do not work. Complications include bleeding, vocal cord paralysis and
hypothyroidism. Long term follow up is needed.
UNDERACTIVE:
To deal with an underactive thyroid, we try to replace the chemical that is not
being produced. We do this by using a medication called levothyroxine. We then
adjust the dose to make sure just the right amount is being given, to avoid
adverse effects like heart beat irregularities and bone troubles.
Summarise
Is there anything in particular you are worried about?
Anything Ive missed?
