Patient Question:Disease:Hypothyroidism
Description:In 2013, I had no symptoms and my family noticed that I had a thick neck.
Dr. Cheng, hello, I saw your homepage on the internet and was deeply moved to see that you are so attentive to patients’ problems, so I dare to ask you some questions. I was diagnosed with hypothyroidism in 13 years, my family found that my neck was a bit thick, the test results were not very serious, I have been taking Eugenol, 25ug per day, and the results of the review are stable, within the normal range, only one antibody is high, more than 100. I would like to ask you whether my condition is transient or permanent, and whether I need to take medication for life? And can the thickened thyroid gland go down? Since I am planning to get married, I would like to ask you if my condition is not suitable for having children. Please take your time to answer my questions.
Reply from Cheng Muhua, Department of Nuclear Medicine, The Third Affiliated Hospital of Sun Yat-sen University.
From the analysis of medical history and medication, it is estimated that it is not permanent hypothyroidism. It is estimated that the hypothyroidism is in the late stage of thyroiditis (you can tell by the thyroid scan in nuclear medicine), and secondly, it may be caused by iodine deficiency (you can tell whether the iodine intake is sufficient by checking the urine iodine). If it is iodine deficiency, after gradually supplementing with iodine-containing foods, the medication can be stopped for 1 month and the thyroid function can be rechecked if it is normal.
Secondly, your case does not affect pregnancy, but you need to monitor your nail function regularly after pregnancy. If TSH increases, you need to adjust the amount of Eugenol in time (because the amount needed will increase as the fetus grows).
Patient Question.
Thank you, Dr. Cheng. I would also like to ask you how long does the late phase of thyroiditis usually last? Now I think I have been suffering from this disease for a few years, so I probably didn’t pay attention to it because I didn’t have any symptoms, but I only found out by chance that my neck was thick before I went for a checkup. If my nail function is normal after one month of iodine supplementation, I don’t need to take any medication afterwards? Will there be a relapse? How can I supplement iodine? Is there any way to reduce the swelling of my thick neck? I have a lot of questions, so I would like to ask Dr. Cheng. Thank you again.
Patient Question.
Dr. Cheng, here are my test results, please take a look at them.
Reply by Cheng Muhua, Department of Nuclear Medicine, The Third Affiliated Hospital of Sun Yat-sen University.
A: 1 How long does the late phase of thyroiditis usually last? The time varies from person to person, from a few months to a long term hypothyroidism. 2 After iodine supplementation and one month off the medication, if the thyroid function is normal, there is no need to take medication in the future? Will there be a relapse? How can I supplement iodine? Is there any way to reduce the swelling of the thick neck? If the iodine supplementation is not enough, hypothyroidism will occur again. Therefore, it is necessary to review the nail function regularly, i.e. when the TSH is elevated, you should supplement with Eugenol. Iodine supplementation can be done through iodine-containing foods (e.g. seaweed, nori, kelp, etc.). Treatments for the cause, such as iodine supplementation for iodine deficiency and Eugenol supplementation for low thyroid.
Patient Question.
Dr. Cheng, please take a look at my test results, am I very serious and is it possible to cure it? How thick is a normal thyroid gland? I have a thick neck, is there any way to reduce the swelling? I’m getting married soon and will be taking wedding photos.
Cheng Muhua, Department of Nuclear Medicine, The Third Affiliated Hospital of Sun Yat-sen University, replied.
A: 1 check the laboratory test, not very serious, 2. hypothyroidism is possible to cure. 3. your thyroid gland is mildly enlarged, normal adult reference value (cm): left and right lobes thickness of 1.5 ~ 2.0cm each, width 2.0 ~ 2.5cm. 4. neck thick swelling: for the cause, iodine or levothyroxine supplementation.
Patient Question.
Dr. Cheng, look at my test results, I have been taking Eugenol 25ug per day, do I need to increase the dosage in my case? Will my neck get thicker if I take medication to control it? Do I have to keep my tsh below 2.5 if I want to get pregnant? Why can’t my antibodies come down? Is it true that eating kelp will make my neck harder? Please help me.
Cheng Muhua, Department of Nuclear Medicine, The Third Hospital of Sun Yat-sen University, replied.
A: 1. No need to increase the dosage for the time being. 2. Can’t predict, usually not. 3. TSH needs to be controlled to 0.25-2.5 after pregnancy.
4. It is related to autoimmunity and needs time. 5. Eating kelp in your body iodine excess case, the neck may become hard. But you may belong to relative iodine deficiency.
Patient Question.
Dr. Cheng, I have been taking medication for more than two years, does that mean I need to take medication for life? How can I control it to 0.25-2.5, by increasing the amount of medication? I feel like I’m under a lot of psychological pressure, and there are people who say that iodine supplementation is bad. If I get better and don’t need to take medicine, is there still a possibility of recurrence? My neck has become thicker, can it still go down? Is there anything I should avoid eating? I don’t want to eat anything, and I don’t want to drink alcohol either. I would like to thank you for your advice.
Reply from Cheng Muhua, Department of Nuclear Medicine, The Third Affiliated Hospital of Sun Yat-sen University.
Don’t be nervous, eugenol is a physiological drug, treat it as if it is a nutritional supplement.
Not enough to increase the amount can be, 1-2 weeks will be controlled in the normal range, and then adjusted to fit their own drug amount can be, the amount of reduction will soon return to normal. As long as the Ft3 and Ft4 are in the normal range, you can control them. Hypothyroidism does not need to be avoided, and it is enough to pay proper attention to more iodine-containing foods.
Patient Question.
Dr. Cheng, first of all, thank you for answering my question so carefully, I would also like to ask you some questions, will there be any side effects if you take more years of Eugenol? I’d like to ask you a question, will there be any side effects from taking Eugenol for more years? Will it affect other organs in the body? In a normal person, the left and right lobes of the thyroid gland should be the same thickness, right? My right side looks especially thicker than my left. And how can I tell if I have permanent hypothyroidism? Can the hospital do the two tests you mentioned, a nuclear medicine thyroid scan and a urine iodine test? My doctor didn’t let me do either. If it’s a transient hypothyroidism, is it possible for it to become permanent? I’ve been taking medication for over two years. I am afraid that my neck will become thicker and thicker. If I take more medication, will it become hyperthyroidism? I’ll go for a review in a few days, and I’ll send you my labs so you can take a look at them for me. Thank you.
Reply from Cheng Muhua, Department of Nuclear Medicine, The Third Affiliated Hospital of Sun Yat-sen University.
You have a lot of questions.
1, eugenol eat more years will not have any side effects ah? Will it have an effect on other organs of the body? A: Eugenol is a physiological drug, is a supplement, as long as you do not overdose, there are no side effects.
If you take too much, you may experience hyperthyroidism, but the symptoms will disappear once the dosage is reduced.
For those who take Eugenol for a long time, pay attention to proper calcium supplementation to prevent osteoporosis. If necessary, do a bone density test.
2. The left and right lobes of the thyroid gland in normal people should be the same thickness, right? My right side looks especially thicker than my left. A: Generally, there is a slight difference between the size and thickness of the left and right lobes, but not much. 3. A: A thyroid scan can be done, if the thyroid size and uptake function are close to normal, the thyroid function may return to normal after a period of time. 4. A: Of course, they are tests that can be done in hospitals, but not all hospitals carry out these tests. 5. If hypothyroidism is transient, is it possible for it to become permanent? A: The concept of transient and permanent is relative. Transient is defined as those who return to normal within one year. Permanent is hypothyroidism for more than 1 year, but in fact, we have met many people who have been hypothyroid for more than 1 year and their nail function has returned to normal. 6. I am afraid that my neck will become thicker and thicker. If you take a large amount of medication, will it become hyperthyroidism A: The neck of a person with hypothyroidism usually does not gradually increase in size, unless the hyperthyroidism recurs. If you take too much medication, you can develop hyperthyroidism, but you can return to normal if you reduce the dosage or stop taking the medication.
Patient Question.
Hello, Dr. Cheng. I’m getting married, can I get pregnant at this level? The doctor here said yes, so I would like to confirm with you. What do you think of my condition? Do I need to increase the dosage now? I had mumps 8 years ago and I wonder if it is the cause of hypothyroidism? Will hypothyroidism turn into hyperthyroidism and will it cause protrusion? I’m very worried and I feel very nervous every day. Is it possible to be cured with my labs and do I need to take medication for the rest of my life? And most importantly, is this hereditary? Will it be passed on to the next generation and what are the chances that the child’s IQ will be affected? I feel like my life is over. I also want to ask if thyroid nodules will affect the next generation, I am surrounded by people who have nodules, but they do not take it seriously and do not go to the hospital for treatment. I’d like to ask if the thyroid nodules will affect the next generation.
Reply from Cheng Muhua, Department of Nuclear Medicine, The Third Affiliated Hospital of Sun Yat-sen University.
1.How do you see my situation, do I need to increase the amount of medicine now?
A: It is basically normal now, please ask if you are still taking half tablet of Eugenol? If yes, continue to maintain. Is there any increase in iodine-containing food?
2. I had mumps 8 years ago, I wonder if it is the cause of hypothyroidism? A: It can only be inferred that it may be related to immunity. 3. Will hypothyroidism become hyperthyroidism? A: This depends on the cause, if the previous is Grave hyperthyroidism, drug hypothyroidism will be a lot of recurrence of hyperthyroidism after stopping the drug. 4, I am particularly worried, mood every day is very nervous. Do you see any possibility of healing with my labs and do I need to take medication for the rest of my life? A: You have a mild hypothyroidism, don’t worry, it is very common, from the analysis of the laboratory test is clinically cured, but temporarily need to maintain the drug supplement, but also through food supplementation containing iodine, no drug supplementation. (Of course, if there is thyroiditis activity, then you can not increase the iodine food) 5. Will it be passed on to the next generation and what are the chances of the child’s IQ being affected? A: It also depends on the cause of the disease. If the hypothyroidism is caused by Hashimoto’s disease or Grave’s disease, the gene may be inherited, but the next generation will not necessarily develop the disease. Only the probability of occurrence is slightly increased. If there is an abnormality, timely supplementation to normal will have no effect on the IQ of the offspring. 6, I also want to ask whether thyroid nodules will affect the next generation, I am surrounded by people with nodules, but they do not take it seriously and do not go to the hospital for treatment, what is the harm? A specific analysis of the problem, if it is a benign nodules, do not pay attention to, regular review can be. If the nodule is malignant or malignant, it needs to be treated.
Patient Question.
First of all, thank you Dr. Cheng for your careful answer. I am still taking Eugenol, and I have been taking quarter tablets of 25ug since I was diagnosed with hypothyroidism for more than two years now, and I have not increased my iodine-containing food because I heard that excessive iodine supplementation is not good. Dr. Cheng, do you think I might become hyperthyroid in my case? I am very worried and scared. What do you mean when you say that I have mild hypothyroidism and I am clinically cured? And how can I be sure if it is Hashimoto’s disease or Grave’s disease, and if so, what are the chances of the next generation developing it? I’m too scared to have a baby. If the nodules get bigger and bigger, does that mean they are bad? I’m not sure if I’m going to be able to get a good deal on this. I am now taking a kind of Xia Gu Cao Cao cream, is that medicine effective in eliminating goiter? Do you think I should take this medicine in my case? Is hypothyroidism a very troublesome disease to treat? I feel very inferior after getting this disease, like I have a terminal disease.
The Third Hospital of Sun Yat-sen University, Department of Nuclear Medicine, Cheng Muhua replied.
1. I have been taking quarter tablets of 25ug, and I have not increased my iodine-containing food, because I heard that too much iodine is not good. Dr. Cheng, do you think I might become hyperthyroid in my case? A. I can’t predict it, there are all kinds of possibilities. 2. I am especially worried and afraid. What do you mean when you say that I am mildly hypothyroid and clinically cured? A: Don’t worry, hypothyroidism is not a thing, is a daily supplement, because eugenol is a physiological substance, equivalent to supplemental vitamins. The first thing you need to do is to make sure that you are not suffering from Hashimoto’s disease or Grave’s disease, and if so, what are the chances of the next generation developing it? I am too scared to have children. A: The probability is very low, do not worry, worry is also useless. 4, nodules if it becomes larger and larger is not a bad ah, malignant nodules will be painful? A, yes 5, hypothyroidism caused by thick neck, thyroid enlargement by taking eugenol can reduce the swelling? A: No. Hypothyroidism does not lead to a thick neck, but iodine deficiency or hyperthyroidism or disease may lead to an enlarged thyroid gland. 6: Dr. Cheng, I am now taking a kind of Xia Gu Cao Cao cream, is that medicine effective in eliminating goiter? A: The effect is general and long-term use of the drug is not recommended. It is best to supplement iodine through food. 7. Is hypothyroidism a very troublesome disease to treat? I feel very inferior when I have this disease, as if I have a terminal illness. A: Hypothyroidism is the easiest to treat. After you start to figure out the right amount of supplementation for you, and after your condition stabilizes, just check your thyroid hormones every 3-6 months and fine-tune the dosage according to the results.