Health Chats
Thyroid Disorders: When Your Thyroid Malfunctions
Wednesday Jun 03, 2009, 07:00PM - 08:00PM (EST)
Thyroid & Endocrine Center of Florida
, Sarasota, FL
Thyroid disorders affect an estimated 200 million people worldwide, and an estimated 27 million Americans. More than half remain undiagnosed. In fact, thyroid disease is more common than diabetes or heart disease. Untreated thyroid disease may lead to elevated cholesterol levels and subsequent heart disease, as well as infertility and osteoporosis. Research also indicates a strong genetic link between thyroid disease and other autoimmune diseases, including certain types of diabetes, arthritis, and anemia. Come join Dr. Lupo in an hour long chat discussing thyroid cancer, Grave's Disease, Hashimoto's, hypothyroidism, hyperthyroidism, and other thyroid diseases, symptoms, medications and treatments, including thyroid surgery, Radioactive Iodine treatment (RAI), fine needle aspiration (FNA) and thyroid stimulating hormones (TSH).<br><br> Mark A. Lupo, M.D. is board-certified in Endocrinology and Internal Medicine and has a subspecialty focus in thyroid and parathyroid disorders. Dr. Lupo is President of the Academy of Clinical Thyroidologists (2008-2009), member of the American Thyroid Association (ATA), American Association of Clinical Endocrinologist (AACE), AACE Nuclear Medicine Task Force, ATA Programming Committee, Endocrine Society, Florida Medical Association, and American Mensa Society. Dr. Lupo serves as the moderator for the patient-oriented Medhelp International Thyroid Disorders forum.
Mark Lupo, M.D.:
Would consider an ENT evaluation to look at the throat area.  If negative, then consider GI evaluation to look at esophagus as well.  This is a high dose for Graves but a moderate dose for cancer, etc -- the risk of it causing a cancer is very low.
I am 30 Yr old female and currently going through fertility treatment(IUI). All my hormones except Progesterone are in good normal range. Is this related to Hypothyroidism.?
Mark Lupo, M.D.:
The progesterone abnormality is not likely related to thyroid.  if you have hypothyroidism and are going through infertility - it is important to monitor thyroid levels very closely.
Mark Lupo, M.D.:
Earlier you mentioned TSH of 0.475 - was this on armour?  It is possible to take 30mg in am and 30mg in pm.  that often works much better.
I just found out I have hypothyroid. I have been put on 60mg. I take it in the morning and it makes me tired. Can I split this up? Is it possible that this is causing fatigue?
Mark Lupo, M.D.:
see note above -- to frustrated953
Mark Lupo, M.D.:
I can do a few more questions.....
Hello, I had an US which showed a nodule on the right side of the thyroid with increased blood flow. Surgeon felt neck and did not feel a lump. Sent me for a US guided FNA and tech saw no nodule. The lft thyroid was very very small hard to see and right side in their words was, "Lobulated and Very Ugly." I am taking 200 mcg Synthroid & .25 Levothyroxine and my TSH #'s are running from 30 to 42.82. What has happened to the left thyroid and why is the right side lumpy and lobulated and ugly as tech said? Meds are not helping, I am feeling tired, legs hurt, skin dry, lump in throat when I eat something, and have gained lots of weight. What is going on with my thyroid? Am waiting on call from Endo for an appt.  Thank You!
Mark Lupo, M.D.:
You likely have hashimoto's as the cause of the hypothyroidism (which makes the ultrasound irregular appearing) and the high TSH makes the goiter larger as well as increases blood flow to the gland.  May be worth seeing an endocrinologist to regulate the TSH and do the ultrasound to see if this is all hashimoto's or needs biopsy or possibly surgery.
I have hashimoto's and have been losing my hair over the periods of several years.  I also have vitiligo both I am told is a result of my underactive thyroid.  Is there anything I can do?
Mark Lupo, M.D.:
Vitiligo is not directly from the hypothyroidism but is an auotimmune problem (like hashi) that is more common in patients with hashi.Biotin can be helpful for hair loss, but otherwise no specific recs other than considering dermatology evaluation.
Many of those having various thyroid disorders have difficulty losing weight.  In addition, it is my understanding there may be some glycemic issues as well.  What would you suggest a person do, in accordance with making lifestyle changes of better nutrition and exercise, that would help them with weight loss?  Are there any food groups to focus on or just generally a balanced diet?
Mark Lupo, M.D.:
Most of the 66% of Americans who are overweight do not have a thyroid problem.  Patients with hypothyroidism may gain some weight (5-15 pounds), but the real issue is usually that they are still eating more calories than they burn -- ie, not something that "fine-tuning" thyroid medications can address.  There is no specific thyroid diet -- only the usual recs of balanced diet , exercise etc to lose the weight (ie create a negative calorie balance).
Are the thyroid antibodies tests enough info to tell if someone has thyroid disease?
Mark Lupo, M.D.:
Thyroid antibodies can detect autoimmune thyroid disease - but in many cases the thyroid can still function properly - so TSH, T4 and T3 are important to determine if the thyroid is normal, low or high === and if treatment is needed..
Thank you, Dr. Lupo, for taking the time to answer our members' questions today. This has been an extremely popular chat and we apologize if your question didn't get an answer. We hope to be able to bring Dr. Lupo back in the future for another chat. In the meantime, please don't forget about the upcoming LASIK chat with Dr. Awad.
Mark Lupo, M.D.:
Thanks -- hopefully that was helpful to all the participants.  See you next time!  ML
Thanks again, Dr. Lupo!