Thyroid For Dummies®
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Copyright © 2007 John Wiley & Sons, Ltd, Chichester, West Sussex, England
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British Library Cataloguing in Publication Data: A catalogue record for this book is available from the British Library
ISBN-13: 978-0-470-03172-8
ISBN-10: 0-470-03172-7
Printed and bound in Great Britain by Bell & Bain Ltd, Glasgow
10 9 8 7 6 5 4 3 2 1
Dr Sarah Brewer qualified as a doctor in 1983 from Cambridge University. She was a full-time GP for five years and now works in nutritional medicine and sexual health. Sarah is currently completing an MSc in Nutritional Medicine at the University of Surrey, Guildford.
Although her first love is medicine, her major passion is writing. Sarah writes widely on all aspects of health and has written over 40 popular self-help books. She is a regular contributor to a number of newspapers and women’s magazines, and appears regularly on TV and radio. She was voted Health Journalist of the Year 2002.
Alan L. Rubin, MD, is one of the US’s foremost experts on the thyroid gland in health and disease. He is a member of the Endocrine Society and has been in private practice specialising in thyroid disease and diabetes for over 30 years. Dr. Rubin was Assistant Clinical Professor of Medicine at UC Medical Center in San Francisco for 20 years. He has spoken about the thyroid to professional medical audiences and non-medical audiences around the world. He is a consultant to many pharmaceutical companies and companies that make thyroid products.
Dr. Rubin has written extensively on the thyroid gland as well as diabetes mellitus. As a result, he has been on numerous radio and television programs, talking about the cause, the prevention, and the treatment of conditions of the thyroid. He is also the best-selling author of Diabetes For Dummies and Diabetes Cookbook For Dummies.
From Alan: This book is dedicated to my wife, Enid, who was there for every page. She smilingly let me do my work, sometimes into the wee hours of the morning, and missed many an opportunity to go out to dinner or a movie so that I could produce this book for you. If you have a fraction of the support in your life that she has given me, you are a lucky person, indeed.
From Alan: The great publisher and midwife, Kathy Nebenhaus, deserves enormous appreciation for helping me to deliver yet another bright-eyed baby. Her optimism and her enthusiasm actually made this book possible. Her assistant, Natasha Graf, played a huge role in ironing out the inevitable problems that arise when book-publishing and medicine meet.
My editor, Joan Friedman, did a magnificent job turning my sometimes- incomprehensible prose into words that you can understand. She also conducted a whole orchestra of other editors who contributed to the book, including Robert Annis, Christy Beck, Mary Fales, Alison Jefferson, and Greg Pearson.
My thanks to Dr. Catherine Bain for the technical editing of the book.
Librarians Mary Ann Zaremska and Nancy Phelps at St. Francis Memorial Hospital were tremendously helpful in providing the articles and books upon which the information in this book is based.
My teachers are too numerous to mention, but one person deserves special attention. Dr. Francis Greenspan at the University of California Medical Center gave me the sound foundation in thyroid function and disease upon which this book is based.
Finally, there are my patients over the last 28 years, the people whose trials and tribulations caused me to seek the knowledge that you will find in this book.
This book is written on the shoulders of thousands of men and women who made the discoveries, tried the medications, and held the committee meetings. Their accomplishments cannot possibly be given adequate acclaim. We owe them big time.
From Sarah: Thanks to Alan L. Rubin, MD, author of the original US version of Thyroid For Dummies. The quality of his original script made my job easy, as I had so very little to do when adapting his excellent book for the UK market.
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As part of my medical training, I (Sarah) was taught by an enlightened physician, Dr David Rubenstein of Addenbrooke’s Hospital, Cambridge. He encouraged me to do three things when evaluating a patient with puzzling symptoms: Think Drugs (so as not to miss unsuspected side effects), Think Dirty (to exclude syphilis, a disease that mimics so many other conditions) and Think Thyroid – because under and overactive thyroid problems are so often missed, especially in older people.
I went on to make a career out of thinking drugs and thinking thyroid (thinking dirty is no longer as necessary as it was just a generation ago).
For hundreds of years, people understood that a connection exists between a strange looking growth in the neck and certain diseases. Until about 60 years ago, confusion reigned as people with similar growths in their necks often have opposite symptoms. One group shows excessive excitement, nervousness, and shakiness, while the other has depression, sleepiness, and general loss of interest. What the two groups have in common is that they are mostly all women.
As recently as 60 years ago, scientists started to measure the chemicals coming from these growths (enlarged thyroid glands), and suddenly the whole picture began making sense. Now, many of the secrets of the thyroid gland and the hormones it makes are known, although it undoubtedly still has a few surprises up its sleeve.
This book explains that, with very rare exceptions, thyroid diseases, including thyroid cancer, are some of the most easily treated of all disorders. This fact is why many thyroid specialists say, ‘If I have to have cancer, let’s hope it’s a thyroid cancer.’
This book reveals the thyroid in all its glory. As it regulates body temperature, one of the main symptoms of thyroid problems is feeling hot or feeling cold. Unfortunately, this symptom leads to a lot of confusion within the thyroid itself. So much so that the left lobe of the thyroid was once heard to say to the right lobe: ‘Now I know it’s summer – here comes another swallow.’
The good news is that you don’t need to read this book from cover to cover. Since the first few chapters are a general introduction to the thyroid, you may find it helpful to start in Part I, but if you prefer to go right to information about the thyroid condition that affects you, off you go to find it. If you run across any terms you don’t understand, look for them in the glossary of terms in Appendix A.
This book is written as a sort of medical biography of a family – Toni, Stacy, Linda, Ken, and other members of the clan whom you meet during your reading. These folks illustrate the fact that thyroid disease often runs in families. You meet members of the family, as well as some other fine fictional characters, at the beginning of each chapter that describes a thyroid disease, so you have a good picture of the condition covered in that chapter.
Although books such as this are easiest to read if they only use non-scientific terms, you and your doctor would soon find that you’re speaking two different languages. Therefore, Thyroid For Dummies does use scientific terms, but these terms are explained in everyday English the first time you run across them. Plus, definitions of those difficult terms are available in the Glossary at the back of the book.
Three scientific terms come up over and over again in this book: thyroxine, triiodothyronine, and thyroid-stimulating hormone (also known as thyrotropin). These terms are explained in detail in Chapter 3. For these three words, abbreviations are used for easier reading: Thyroxine is T4, triiodothyronine is T3, and thyroid-stimulating hormone is TSH.
Throughout the book, you find shaded boxes of text called sidebars. These contain interesting material but not essential to your understanding. If you don’t care to go so deeply into a subject, skip the sidebars; you can still understand everything else.
This book assumes that you or someone you care about has a thyroid condition that is not yet treated or perhaps is not treated to your satisfaction. If this assumption doesn’t apply to you, perhaps you suspect that you have a thyroid condition and want to determine whether you should see a doctor. Or perhaps you can’t get your doctor to run the necessary tests to determine whether a thyroid problem exists. Regardless of your individual situation, this book has valuable information for you.
The material in the chapters does not make any assumptions about what you know regarding the thyroid and doesn’t introduce any new terms without explaining what they are. If you already know a lot about the thyroid and its functions, you can still find new information that adds to your knowledge.
The book is divided into six parts to help you find out all you want to know about the thyroid gland.
So much (right and wrong) is written about the way the thyroid affects your mood that this issue is cleared up at the very beginning of the book. After you understand how the thyroid affects your emotions, you find out just what the thyroid is and what it does. Finally, in this part you learn about the medical tests that help to determine if something is wrong with your thyroid.
This part explains each of the conditions that affect the thyroid and how they affect you. After finishing this part of the book, you will know just about everything we know about thyroid disease, how to identify it, and how to treat it.
Here you discover how medications can influence your thyroid function. We also explain thyroid infections, along with the worldwide problem of iodine deficiency. I also show you why thyroid surgery is rarely done, and look at new treatments coming along. The final two chapters look at ways to improve your thyroid health – and your health in general – using diet, exercise, lifestyle choices, and complementary therapies.
Thyroid problems often run in families and this part looks at the genetic basis of some thyroid diseases. Three groups of people also deserve special consideration in this book: pregnant women, children, and those over the age of 65 years. Thyroid conditions take unusual directions in these groups, so the chapters in this part address their unique difficulties.
Misinformation about the thyroid is rampant. This part aims to clear up some of that misinformation – though not all, as it accumulates faster than dust. The information also shows you how you can maximise your thyroid health.
In Appendix A, you find a glossary of medical terms that relate to the thyroid; you may want to bookmark it so you can go back and forth with ease as you read other chapters. Appendix B directs you to the best-of-the-best Web sites where you can get dependable facts to fill in any blank spots that remain after you’ve read this book.
Books in the For Dummies series feature icons in the margins, which direct you towards information that may be of particular interest or importance. Here’s an explanation of what each icon in this book signifies:
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Where you go from here depends upon your needs. If you want to understand how the thyroid works, head to Part I. If you or someone you know has a thyroid condition, you may want to pay particular attention to Part II. For help in maintaining good thyroid health, turn to Part III. If thyroid disease runs in your family, or if you’re pregnant or have a child or parent with a thyroid disorder, Part IV is your next stop. In any case, as my mother used to say when she gave me a present, use this book in good health.
In this part . . .
What, exactly, is the thyroid gland, and what does it do? In this part, you discover how important this little gland in your neck really is, what function it plays in your body, and how to determine if it is functioning properly. We show you that your thyroid affects your mind as well as your body in critical ways.