Approach to Thyroid Disease/Subclinical Thyroid Disease: Fact or Fiction?

Thyroid dysfunction is present in up to 10% of the population, and thyroid nodules are present in up to 60% of the population. Thyroid dysfunction is typically not diagnosed as screening indications are unclear for the PCP. The PCP needs to understand how and when to screen for thyroid disease based on up to date recommendations. This gap will be addressed with current thoughts on approach to diagnosing and treating thyroid dysfunction and the thyroid nodule.
For additional information about SMA and quality continuing medical education, visit our website - sma.org.

[@abbykincaid4596]

This was the most informative video I’ve seen on this subject! Very very helpful information.

[@melissafarrugia9531]

I personally feel that because hyperthyroidism is far less common yet far more complicated than hypothyroidism it is not yet understood that the risks even associated with subclinical hyperthyroidism are not covered by studies as well as the hypothyroidism.

[@lisaeischens2352]

This was just perfect for me. I’m in the process of testing and had come in to my doctor because I’ve been feeling just awful with symptoms of extreme heat intolerance with any activity, feeling exhausted with shortness of breath with exertion or when feeling upset, increased anxiety and depression which I normally have struggled with but it’s really interfering with my life. My arms and legs feel weak, I feel out of balance walking sometimes with numbness in my feet and cold feet. I had initially gained weight but was eating huge portions of yogurt with berries and granola all winter because I didn’t crave anything else but the last 6 weeks, I have totally lost my appetite and have to force myself to eat. In the office I was feeling SOB and had a BP of 160/110 with resting heart rate of 112 and I have lost 6 pounds in 3 weeks. I have also been having stomach and digestive issues with a severe stomach pain after eating pancakes; was doubled over and sweating profusely with my heart bounding. When I finally was able to have a bowel movement it was very soft/loose and the gas and pain was relieved after going. I was supposed to see a GI doctor 2 hours drive but I didn’t feel well enough to go that far so I went back to see my GP. I am almost 51 and come July, I will be officially Menopausal if I don’t get my period as it will be one full year. A lot of my symptoms I thought were probably Menopausal but the heat intolerance has been just terrible with constantly profuse sweating just doing simple tasks and feeling really agitated. I’m not getting much sleep at all because I already have insomnia but now with the sweating, I’m up off and on all night turning my fan on and off. When I get emotional, my husband tells me that I talk so fast that he can’t understand a word that I say. I feel really irritated and have been withdrawing from everyone because I’m feeling so shitty. I already have OA, RA (serum negative) and Fibromyalgia and these other symptoms are just making me feel so rotten that I’m getting severely depressed from never feeling good anymore. I’m forgetting where I place things and having trouble getting the right words to come out and have mixed up appointment times and went to the wrong place, I even missed my sister’s wedding ceremony because I got the time mixed up so she was really upset with me. My doctor ordered labs for Celiac, B Vitamins, Peripheral Smear, TSH, and Free T4. This was on Friday and the Thyroid tests had results that were in my chart that evening. My TSH is 0.29 with a Free T4 of 0.9 The Folate and B12 are normal and I’m still waiting for the Thiamine and Celiac tests to come back. After listening to this lecture, I’m concerned now with all the cardiac symptoms snd shortness of breath. I seen the doctor on Friday and now it’s Tuesday and I haven’t heard anything back yet. Maybe he’s waiting to get all the labs back before he calls. I’m thinking that I probably need some further tests considering that I’m having some pretty severe symptoms. I was a RN for 20 years but have been disabled for 10 years now because of the chronic pain and fatigue. This Thyroid stuff can be a bit confusing, especially when I haven’t been working. This was really a great refresher for me and I feel like I have a pretty decent understanding of what’s going on now. Thank you for the lecture.

[@haqzahoorul]

Brilliant presentation. Thanks very much. 👌 👌 👌

[@jeffrey4577]

Low carb diets and long fadts before morning text will result in elevated tsh but no mention by conventional medicine

[@wwpetko-6760]

I have a HIGH TSH, normal T4, HIGH Thyroid Anti Thyroid Peroxidase and HIGH LDL cholesterol (my BMI is 20) I have all the symptoms and have since 2018. The fatigue is SEVERE every day from 2pm on. Waiting to see if my endocrinologist will put me on medication.

[@raina5449]

I wish my endocrinologist would take the time to look at things like this. My symptoms are heat intolerance, heart palpitations, tachycardia, anxiety, tremors, and I’m sure I’m forgetting a few. It’s been this way for years based off my levels she said I’m subclincal. Sometimes my tsh is normal but my free t3 isn’t and other time my tsh isn’t normal but my free t4 is and this has been going on for years. Last year I had the uptake and scan done where it indicated I have hyperthyroidism but not by a lot and no goiter or nodules. This year I went for a chest ct that found a goiter and 3 nodules I’m going to get a biopsy on one of the nodules because the size but she still doesn’t really seem to want to treat me because based on my levels she’s not sure why my symptoms are so bad. I have no quality of life anymore and haven’t for years it’s so bad I hate to admit I started thinking of suicide. I see a therapist now and psychiatrist and take Ativan daily but I just want to be normal again.

[@melissafarrugia9531]

I know it's difficult, I'm only 37 kgs look anorexic or bulimic and I eat well. Keep trying look-up Dr Brownstein please 😊

[@melissafarrugia9531]

Also potassium magnesium and calcium are needed to convert T4 to T3.

[@raina5449]

@@melissafarrugia9531 After they did an ultrasound and realized my thyroid was pushing against my esophagus they have decided it has to go just because the size but still they only say I only have subclinical hyperthyroidism. I had to put off surgery due to Covid but it’s rescheduled for later this month.

[@cashyf_88]

Don't even consider suicide those thoughts are temporary , my dad killed his self u will destroy alot of lives if u do

[@fhowland]

My resting pulse is 35-40 and I can’t lose weight no matter how much I bike.. I’m 15 lbs heavier than I used to be with same lifestyle… TSH around 5. Doctor doesn’t want to treat.