The Thyroid Gland: Form and Function
1. I have found it helpful to separate how the thyroid works from how the thyroid looks and feels.
The form of a thyroid gland is the anatomy: how it looks and feels. Expert [small hands] can palpate nodules, but the ultrasound is the gold-standard. The master of the anatomy is a head-and-neck surgeon.
Other terms for such specialists include otolaryngologist, ENT, ear-nose-throat doctor, endocrine surgeon and sometimes, general surgeon.
The function of a thyroid gland is “how it works”: the hormones it produces, at what level, and does it do it’s job consistently. TFT’S, or “thyroid function tests”, are the gold standard.
Controversy lies in which are sufficient, when they are drawn, and such…see part 2 below!
Why is this mental construct useful? Let me go through a few vignettes:
Patient with nodules and normal thyroid function tests (TFT)
Patient with normal thyroid [ultrasound] and abnormal TFT
Many experts may scoff at this idea, since there is overlap in form and function in many.
However, let us be clear on these facts:
the majority of people we see with “nodules” have normal function
many people with abnormal function do not have form abnormalities (i.e. nodules)
So, many patients find this surprising. Or, maybe it should be written: So many patients find this surprising!
Now, there are many who have multinodular goiter with Hashimoto’s thyroiditis and hypo (and sometimes hyper) -thyroidism. In other words, the “useful mental construct” has exceptions, like so much in life!
Also, if one has their thyroid gland removed with “thyroidectomy” then there is no form or function and patients must take supplemental thyroid hormones.
2. Doctor, my ______ (primary doctor, endocrinologist) told me my TFT’s were fine, but I have so many symptoms!
This is a very common issue, unfortunately. Of course, you may actually have normal thyroid function with symptoms from other diseases and the proper diagnosis is proving elusive. Medical practice can be challenging!
However, if you are convinced there is an error then you have options:
re-do the testing,
seek an endocrinologist or second opinion if not done already
seek a complementary / alternative medicine (CAM) provider
Here, again, many “experts” will scoff! But there is great talent in many who do such work. I mean naturopathic doctors, chiropractors and “other providers” are involved here.
For example, locally I do not know any allopathic (MD) providers who use a saliva test, but there is a local chiropractor that does!
Here is someone else’s blog on this topic:
So, in summary, if you see or feel a lump in your throat or neck, give Doctor Kortbus and our staff at hudsonENT a call now: 845-758-1456 for expert care!
Here is one happy patient who had thyroidectomy years ago for carcinoma.