1. Should I take medication for life for hypothyroidism? Are there any side effects?
Is there any way to cure hypothyroidism? Are there any side effects of taking levothyroxine for a long time?
Answer.
Most hypothyroidism cannot be cured and requires long-term medication. The most commonly used medication is levothyroxine.
As long as the dosage of levothyroxine is appropriate and the thyroid function can be maintained within the normal range of not too high and not too low, there will be no side effects.
Because thyroxine is originally a hormone produced by the body itself, the amount produced by a hypothyroid patient is not enough to meet the body’s needs, so it is supplemented by medication. How can this cause side effects?
It is only when there is an excess of levothyroxine that side effects such as heart disease and osteoporosis may occur. Therefore, patients with hypothyroidism must have their nail function reviewed regularly to assess whether the amount of medication is appropriate.
2. Can I eat iodized salt with Hashimoto’s thyroiditis?
My doctor said that Hashimoto should eat non-iodized salt, but in the last issue of Thyroid Q&A, it said that I should eat iodized salt.
Answer
Studies have shown that excessive iodine intake can trigger or worsen Hashimoto’s thyroiditis.
What does excessive iodine intake mean?
The WHO recommends a daily intake of about 150 micrograms of iodine to maintain good health.
Iodized salt contains 20-30 micrograms of iodine per gram, and since you eat about 5-6 grams of salt per day, you can consume 100-180 micrograms of iodine per day by eating iodized salt (some of the iodine is lost during the cooking process).
If you eat iodized salt along with a lot of highly iodized foods (such as kelp, nori, shrimp and shellfish), there is a risk of excessive iodine intake.
Therefore, Hashimoto patients who want to avoid excessive iodine intake have two options.
Eat iodized salt and no kelp or nori;
Eat non-iodized salt and moderate amounts of highly iodized foods such as kelp and nori.
In the last issue of Thyroid Q&A, the thyroid doctor’s advice was – pregnant Hashimoto patients should eat iodized salt.
This is because pregnant and breastfeeding women have higher iodine needs than the general population and should consume about 250 micrograms of iodine per day to ensure the growth and development of their babies.
Therefore, Hashimoto patients who are pregnant and breastfeeding need to eat iodized salt, and they can eat seafood in moderation.
3. Can nodules with normal nail function be operated without surgery?
I am a patient with thyroid nodules, and all five of my thyroid tests are normal, but my doctor recommended surgery. What should I do?
Answer
The need for surgery for thyroid nodules depends not on whether there are abnormalities in the thyroid function, but on whether there are any of the following conditions.
The nodule is causing significant pressure symptoms, such as difficulty in breathing, pronunciation, or swallowing;
The nodule is combined with hyperthyroidism, and the medication is not effective;
Nodules located behind the sternum or in the mediastinum;
Nodules that are increasing in size and are considered to have a tendency to become malignant;
Fine needle aspiration to determine that the thyroid nodule is malignant.
4.What is the problem of high TSH in newborns?
What is the reason for the high TSH in newborns, while the other items are normal? Does it affect growth and development? Do I need treatment?
Answer
High TSH in newborns may indicate congenital hypothyroidism (referred to as “congenital hypothyroidism”). Note that it is only a possibility.
It is a national requirement that all newborns have their heel blood tested for TSH 72 hours after birth to detect congenital hypothyroidism. Because congenital hypothyroidism can seriously affect your baby’s growth and development, it needs to be treated early.
If the heel blood TSH is high, further blood tests are needed to check the nail function, mainly looking at the TSH and T4 indicators in the nail function.
If the TSH is high but the T4 is normal, it may not be congenital hypothyroidism, and most babies’ TSH will drop to normal on its own. Your doctor will ask you to take your baby for regular checkups.
If the TSH is still greater than 10 mU/L after 2 weeks of life, congenital hypothyroidism should be considered and treated.