The thyroid gland is located in the middle of the lower neck, below the larynx (voice box) and wraps around the front half of the trachea (windpipe). It is shaped like a bow tie, just above the collarbones, having two halves (lobes) which are joined by a small tissue bar (isthmus.). You can't always feel a normal thyroid gland.
Diseases of the thyroid gland are very common, affecting millions of Americans. The most common thyroid problems are:
- an overactive gland, called hyperthyroidism (e.g., Graves' disease, toxic adenoma or toxic nodular goiter)
- an underactive gland, called hypothyroidism (e.g., Hashimoto's thyroiditis)
- Thyroid enlargement due to over activity (as in Graves' disease) or from under-activity (as in hypothyroidism). An enlarged thyroid gland is often called a "goiter".
What treatment may be recommended?
- Thyroid hormone replacement pills
- Medication to block the effects of excessive production of thyroid hormone
- Radioactive iodine to destroy the thyroid gland
- Surgical removal of the thyroid gland
A fine needle aspiration biopsy - a safe, relatively painless procedure. With this procedure, a hypodermic needle is passed into the lump, often after administration of local anesthesia into the skin, and tissue fluid samples containing cells are taken. Often several passes with the needle are required. Sometimes ultrasound may be used to guide the needle into the nodule. There is little pain afterward and very few complications from the procedure occur. This test gives the doctor more information on the nature of the lump in your thyroid gland and specifically may help to differentiate a benign from a malignant thyroid mass.
Thyroid surgery - may be required when:
- The fine needle aspiration is reported as suspicious for or suggestive of cancer
- The trachea (windpipe) or esophagus are compressed because both lobes are very large
- Historically, some malignant thyroid nodules have shown a reduction in size with the administration of thyroid hormone. However, this treatment, known as medical "suppression" therapy, has proven to be an unreliable treatment method.