What is thyroid gland?
Thyroid is an endocrine gland located in the front of the neck. All glands in the body produce something. Those glands produce proteins and release them in the blood stream are called endocrine glands. The proteins thus produced are called hormones..

What hormones are produced by the thyroid gland?
There are two types of hormones produced by thyroid gland. T3 & T4 are commonly known thyroid hormones and Calcitonin. Both have distinctly different functions. T3 and T4 are very essential in the day to day energy production by all the cells of the body. Iodine is essential in the final stages of production of the T3 & T4 hormones.

How does the thyroid gland know how much to produce?
Normally the thyroid gland remains under control of another endocrine gland called Pituitary gland. The pituitary gland is located at the bottom of the brain. Pituitary produces a hormone called TSH (Thyroid Stimulating Hormone). TSH is sent to the thyroid gland via the blood circulation and its job is to make the thyroid hormone producing cells to grow so that they produce more T3 & T4. Normally when T3 & T4 levels are low more TSH is produced and when T3 & T4 levels become normal then TSH production is reduced by the pituitary gland.

When my doctor says I am hypothyroid what does it mean?
In this case thyroid gland is not producing enough T3 and T4. These people have low energy level and they tend to tire easily and tend to gain weight. The levels of T3 & T4 can be checked by a simple blood test. When the thyroid hormones are checked the TSH level should also be checked.

There are various reasons why the thyroid gland may not be producing enough T3 & T4.

1.Thyroid gland is diseased and is not responding to the stimulation of TSH.
2.There is iodine deficiency in the diet of the person.
3.The pituitary gland is diseased or destroyed and is not producing enough TSH.
4.The thyroid gland is surgically removed due to cancer.
5.Other reasons.

If your doctor determines that you need medical treatment only then you need to take the thyroid medication daily for the rest of your life. The dose of the thyroid medication needs to be adjusted at least at 3-month interval until appropriate blood levels of T3 & T4 and TSH are obtained. Then it needs to be checked at least yearly.

What are the other thyroid tests?
When appropriate your doctor may also order tests to check the autoantibodies against the thyroid cells. These blood tests may reveal Hashimoto's disease among other conditions.

Evaluation of thyroid gland includes the Ultrasound examination of the thyroid gland. This is a painless and simple test and gives information regarding the size and structure of the thyroid gland. If there are nodules in the thyroid they may be revealed by this test. If there are nodules then under the ultrasound guidance a small tissue sample may be obtained to check whether or not there is any malignant tumor.  This is called Ultrasound guided thyroid biopsy.

Thyroid gland is also examined by a nuclear medicine test. This is usually done as a specialized test in the hospital. The person would take an oral dose of radioactive iodine isotope. The functioning portions of the thyroid gland removes the radioactive iodine. Then the gland is examined with a radioactivity counter from the outside of the neck. This test reveals if portions of the gland are functioning or not. The nonfunctioning areas are called cold nodules. Cold nodules may be due to a benign or malignant process. The cold nodules need to be examined for presence of cancer. One minimally invasive way to approach the cold nodule is to do an Ultrasound guided thyroid biopsy. When it is necessary cold nodules require Thyroidectomy.

What is Thyroidectomy and how is it done?
Thyroidectomy is a surgical procedure done under general anesthesia in a hospital. The procedure includes a 4 to 6 inch incision in the front of the neck. I would then remove a part or all of the thyroid gland depending upon the underlying condition. This involves 2 to 3 day hospitalization. The recovery time is 4 to 6 weeks.

When my doctor says I am hyperthyroid what does it mean?
In this case thyroid gland is over producing T3 & T4 with out simulation from the pituitary gland. This is the opposite problem then hypothyroidism. The person with hyperthyroidism is usually thin with high heart rate and at times very prominent eyes called exophthalmos. The thyroid gland needs evaluation with blood tests, Ultrasound of the thyroid gland and a thyroid radioisotope scan. The management includes radiation treatment and or surgical removal of the diseased thyroid gland.