Clinical Exam Important In Thyroid Diagnosis

A lot of doctors, when getting initially tested for thyroid disease and even after diagnosis, rely only on blood tests. These are only part of the equation. The hardest part of getting an accurate thyroid diagnosis comes from the clinical thyroid exam.

During a thorough thyroid exam, the doctor include: (taken from http://www.prweb.com/releases/thyroid/awareness/prweb1840874.htm

• Feel (known as “palpate”) your neck for thyroid abnormalities
• Listen to your thyroid using a stethoscope.
• Test your reflexes
• Check your heart rate, rhythm and blood pressure
• Measure your weight, and discuss changes
• Measure body temperature
• Examine your face for puffiness and eyebrow loss
• Examine your eyes for protrusion, eyelid retraction and other potentially thyroid-related signs
• Discuss changes in the quality/quantity of your hair
• Examine your skin, for hives, lesions or roughness on the shins, and blister-like bumps on the face
• Note any tremor, shakiness, slowness in movement or speech, hoarseness of voice, and swelling of hands/feet
• Discuss your personal and family history of thyroid and autoimmune disease
• Listen carefully to your medical history, and your symptoms

“A doctor who doesn’t do a complete clinical thyroid exam,” says Shomon, “is shortchanging patients, and will miss many cases of thyroid disease. Unfortunately, in this day of managed care and 5 minute doctor visits, patients may have to push for the doctor to actually perform a full thyroid exam.”

The key will be finding the right thyroid doctor. I’ve yet to find one myself, and I think it’s because I’m dealing with an HMO with standard way of treating thyroid disease. Here’s a good place to start in finding a good thyroid doctor http://www.thyroid-info.com/topdrs/.

Basic Thyroid Tests You Should Receive or Ask For

A lot of doctors tend to base whether or not you have thyroid disease SOLELY on TSH (thyroid stimulating hormone) tests. This was probably the reason mine was not discovered for a long time, because it was always in the normal range. If it had not been for the doctor that discovered my kidney stone, after years of being told I had only UTIs (urinary tract infection), I probably would not have had my thyroid checked out completely by and endocrinologist.

With that said, I wanted to share with you the most basic profile you should get or ask for when testing for thyroid disease.

* Thyroid (TSH)
* Free T4 (FT4)-measures that total amount of circulating thyroxine in the blood.
* Free T3 (FT3)-measures free unbound triiodothyronine in your bloodstream.
* Thyroid Peroxidase Antibody (TPO)-this is the test that is used to check for Hashimoto’s Thyroiditis, post partum thyroid disease, and other types of thyroiditis.
* Thyroid Antibody (Anti-thyroid AB)-this is to test for hyperthyroidism

For more information regarding these tests, you can visit here, here, and here.

Could It Be Thyroid Disease? Signs and Symptoms

There are signs and symptoms that can signal thyroid disease. Some people get only one or two of these symptoms, some get several of these. For myself I had, and still have on occasion, every symptom listed here with the exception of five of them. Here is a list that is taken from http://thyroidawarenessmonth.com, but can be find almost anywhere during research into thyroid disease. If you find yourself with some of these symptoms, have your thyroid check. My next post will be the suggest ‘first time’ labs that should be done and what your exam should be like when getting checked for thyroid disease.

___ Low body temperature
___ Particularly low or high pulse re
___ Unusually low or high blood pressure
___ Enlarged, tender, or sensitive neck or lump in neck
___ Hoarse, husky, or gravelly voice
___ Extreme thirst or hunger
___ Noticeable change in weight (gain or loss) despite no change in diet and exercise
___ Feeling warm or hot when others are cold, or cold when others are warm
___ Heart palpitations, flutters, skipped beats, strange patterns or rhythms
___ Constipation and or diarrhea/loose stools
___ Fatigued, weakeness
___ Pains, aches, and stiffness in various joints, hands, and feet.
___ Carpal tunnel, tarsal tunnel, plantar’s fascitis
___ Puffiness around my eyes
___ Loss of outer eyebrow hair
___ Lesions on lower legs, feet, toes, arms, face, shoulders and/or trunk.
___ Hair loss
___ Dry eyes
___ Swollen hands or feet
___ Dry, sensitive, gritty or achy eyes
___ Changeable moods
___ Brain fog, difficulty concentrating or remembering
___ Depression
___ Anxiety, panic attacks, jumpy
___ Tremors
___ Insomnia
___ Irregular periods
___ Low sex drive
___ Infertility
___ Miscarriage or multiple miscarriages
___ Difficulty breastfeeding
___ Leaking milk when not lactating or breastfeeding
___ Difficult perimenopause/menopause symptoms

Thyroid Awareness Month

This was first written at my new blog One Weigh at a Time. I'll be writing about thyroid disease there for the rest of this month as well as including stuff here.

Some of you may not know that part of my weight problem stems from having Hashimoto's Thyroiditis. Hashimoto's Thyroiditis is when your immune system attacks your thyroid as it thinks it's a foreign body. I have been dealing with this disease about 10+ years now. It's said that about 60 million people are afflicted with thyroid disease. It often goes undiagnosed or misdiagnosed because a lot of the symptoms of the disease are also symptoms of other diseases such as diabetes, fibromyalgia, chronic fatigue syndrome, and various other diseases.

Have you heard that Oprah Winfrey had to see FOUR doctors and gained forty pounds before she was diagnosed? I know what that is like considering it took me four YEARS to get diagnosed. Lot of doctors only know of the thyroid what they learned in medical school. There's vast information out there with plenty of doctors who can deal with thyroid disease properly. Unfortunately, I have not found one yet, but then I have been dealing with an HMO. I've already switched primary physicians about five times. But I digress.

January is Thyroid Awareness Month. So this month my posts will be dedicated to thyroid disease. This is the first. One site that I visit often is http://thyroid.about.com It's a blog ran by patient advocate Mary Shomon, who herself has Hashimoto's. It also have lots of information in regards to thyroid disease and information in regards to other sites on thyroid disease.

This year's logo for Thyroid Awareness Month is Check Your Neck, Change Your Life. Mary Shomon has created a campaign along with a free ebook that you can download. Simply click on the banner.
This informative site will tell you some of the symptoms of thyroid disease, how to check your neck, what you should look for in a clinical exam, and how to find a doctor.

Here are the steps for doing a thyroid self-check: **important note: This will not rule out thyroid disease or thyroid cancer. For accurate diagnosis, please see your physician**

1. Stand in front of a mirror

2. Stretch neck back

3. Swallow water

4. Look for enlargement in neck (below the Adam's Apple, above the collar bone)

5. Feel area to confirm enlargement or bump

6. If any problem is detected, see a doctor

I've posted this particular item on my thyroid blog Life with Hashi, and you can find it on the site mentioned above. Stay tuned for more thyroid information.

Brrrr....It's Cold in Here

I started off with a stomach bug, and got runny nose, congestion, etc., to boot! I think I'm on day five of this whole ordeal. The last two or three nights I had my freezing moments...teeth-chattering kind. The first time was due to a slight fever, the last two was due to a drop in body temperature. One was 97.4, and last night was 97.1 which is the lowest I've been in awhile. It felt like I was out in some freezing cold snowy place. I don't like freezing cold snowy places. lol

Guess it's good to laugh about it. I don't want to be serious all the time in regards to my thyroid disease, because it's something that I live with everyday. I am SERIOUS about it when I need to get my TSH regulated, finding a doctor who knows more than the basic medical school crap and actually LISTENS. It's proven difficult so far as I have changed primary physicians about five times in the last four years. But, I digress.

These low temps are why many people with hypothyroidism are cold when no one else is. You can read about my little basal temperature experiment here. If you have Hashimoto's/hypothyroidism, and you take the basal temperature experiment, let me know your results. It will be interesting to see how many are or aren't like me in regards to the temps and overall wellness.