Dengue Fever.

Question

Doc, My Cousin is admitted in ….Hospital in Mombasa with severe Malaria-like fever. We were sure it was Malaria or Typhoid. These are very common at the Coast. But he is not improving. The Doctors now say it is something called Dengue Fever. He is in kidney failure. As a family we are very worried. What is this “animal” called Dengue? It’s a new one for us. Please shed light on this condition. What causes it? Any treatment available? Is it infectious? Does one develop immunity? We visited him and stayed for quite some time. Will I get it now? Please help. We are very worried…

Sincerely,

XYZ

Answer

XYZ, Thank you for asking this question. Yes, lately we have had scores of cases of Dengue at the Coast. It has not always been a very common condition and neither has it always been very easy to detect as it easily mimics Malaria and Typhoid. Both conditions being common at the Coast. We shall, respond hereby.

What is Dengue?

This is an illness caused by a virus which is transmitted by a variety of Mosquito we call Aedes whose principal cause is often Aedes aegypti. This is a slightly smaller Mosquito than the one that transmits Malaria (we call Anopheles). The virus has five different types. Infection with one type usually gives lifelong immunity to that type, but only short-term immunity to the others. Subsequent infection with a different type increases the risk of severe complications. Infection occurs from a single female mosquito bite and can also be transmitted via infected blood products, through organ donation and pregnant mother to her unborn child via the placenta. Infection by one virus grants lifelong immunity from that virus.

An Aedes female mosquito looks like this

Mosq

What are the signs and symptoms of Dengue

The characteristic symptoms of dengue are sudden-onset fever, headache (typically located behind the eyes), muscle and joint pains, and a body rash. The alternative name for Dengue, “Break-bone fever“, comes from the associated muscle and joint pain. They typically bite during the day, particularly in the early morning and in the evening, but they are able to bite and thus spread infection at any time of day all during the year. The Aedes mosquitos love laying eggs near a homestead. They prefer human hosts rather than animals. So they tend to stay close to human habitation preferring to lay its eggs in artificial water containers, to live in close proximity to humans, and to feed on people rather than other vertebrates

Dengue fever begins with a sudden high fever, then a flat rash may appear over most of the body. Infected people may have increased skin sensitivity and are very uncomfortable from this rash

The rash looks like this

rash

symp

Other symptoms include: fatigue, nausea, swollen lymph nodes, vomiting, cough, sore throat and nasal stuffiness. In a small proportion of cases the disease develops into the life-threatening dengue hemorrhagic fever, resulting in bleeding, or into dengue shock syndrome, where dangerously low blood pressure occurs

Dengue progression

There are 3 phases of the disease

  • Febrile phase – here the patient has fever with high temperatures that will not respond to regular medication. The condition can easily mimic malaria or typhoid. Fever is often associated with headaches, generalized body aches and even nausea and vomiting. At this stage a typical rash forms all over the bod
  • Critical phase – At this time the patient is very ill. Typically starts bleeding from the gut (mouth and rectum), becomes very dehydrated and may eventually go into multiple organ complications (such as kidney failure), shock and even death. This is 5% of all case.
  • Resolution phase – In the majority (80%) of patients, the condition resolves well and the person is cured. The rash disappears and may result in itchy skin and peeling off. The fluid overload may cause altered level of consciousness with even convulsions. But the patient improves completely, leaving fatigue and extreme tiredness which may last for weeks. Our worry is those who end up developing complications in the critical phase above.

Treatment of Dengue

There is no specific treatment to eradicate the virus from the body. Most viral conditions don’t have specific medications as you would for Malaria or Typhoid. The treatment usually consists of symptomatic such as bringing down the fever, rehydrate with intravenous fluids, treating the abdominal upsets/pains, transfusions for the anemia and avoiding convulsions.

Does one become get immunity after infection

The virus has five different types; infection with one type usually gives lifelong immunity to that type, but only short-term immunity to the others. Subsequent infection with a different type increases the risk of severe complications. As there is no commercially available vaccine, prevention is sought by reducing the habitat and the number of mosquitoes and limiting exposure to bites

Prevention of Dengue

To prevent Dengue, a few things you can do include the following

Clear all containers with stagnant water close to homestead. This will eradicate the breeding area for the Aedes mosquitos. We don’t why. But the most predisposed to getting mosquito bites that bring Dengue are youth, women, babies and those women who are big bodied. Probably due to the larger surface area for the mosquito to feed on in these women

Mosquito nets. We cannot overemphasize the need to sleep under a mosquito net. Many people complain that it gets too hot in the Coast. Yet, this remains the one single most effective way of avoiding both Dengue and even Malaria: Sleeping under a mosquito net! Whether a treated net or not, the most important thing is to sleep under a net.

Prevention. Ensure safe pregnancies and blood products screening

In this picture, a community is dispersing stagnant water and thus decreasing mosquito breeding grounds

drain

How about Vaccines

There are no approved vaccines for the dengue virus. Prevention thus depends on control of and protection from the bites of the mosquito that transmits it. The World Health Organization recommends an Integrated Vector Control program. As there is no commercially available vaccine, prevention is sought by reducing the habitat and the number of mosquitoes and limiting exposure to bites

The primary method of controlling Aedes is by eliminating its habitats. This is done by getting rid of open sources of water, or if this is not possible, by adding insecticides or biological control agents to these areas.  Reducing open collections of water through environmental modification is the preferred method of control, given the concerns of negative health effects from insecticides and greater logistical difficulties with control agents. People can prevent mosquito bites by wearing clothing that fully covers the skin, using mosquito netting while resting, and/or the application of insect repellent (DEET being the most effective). However, these methods appear not to be sufficiently effective, as the frequency of outbreaks appears to be increasing in some areas, probably due to urbanization increasing the habitat of Aedes. The range of the disease appears to be expanding possibly due to climate change witnessed in 2014

In short, avoid mosquito bites and you need not worry about getting Dengue

Have a cold Dengue free month

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Acne

Acne is a disorder that causes outbreaks of skin lesions commonly called pimples. It is caused by the skin’s oil glands making too much sebum, an oily substance, which leads to plugged pores. It also can be caused by the rapid production of a bacteria P. acnes.

Acne lesions occur mostly on the face, neck, back, chest, and shoulders. It is the most common skin disease. Although acne is not a serious health threat, severe acne can lead to disfiguring and permanent scarring.

Most young women and men will have at least a few pimples over the course of their lives. But acne seems to affect men and women in different ways. Young men are more likely to have a more serious form of acne. Acne in young women tends to be more random and linked to hormone changes, such as the menstrual cycle.

As women get older, acne often gets better. But some women have acne for many years. Some women even get acne for the first time at age 30 or 40.

For many women, acne can be an upsetting illness. Women may have feelings of depression, poor body image, or low self-esteem. But you don’t have to wait to outgrow acne or to let it run its course. Today, almost every case of acne can be resolved. Acne also can, sometimes, be prevented. Talk with us, your doctor or dermatologist (a doctor who specializes in treating skin problems) about how you can help prevent acne and if treatment would help you.

Different types of acne lesions

  • Comedo (whiteheads or blackheads) or papules.

The comedo is the basic acne lesion, which is a plugged pore. If the plugged pore stays under the skin, it’s called a closed comedo and forms a white bump or whitehead. Blackheads are comedos that open up and appear blackish on the surface of the skin. This black color is not due to dirt, but because the air reacts with the excess oil.

  • Pustules or pimples

Pustules or pimples are acne lesions that contain pus and are red at the base.

  • Nodules

These are more serious acne lesions. They lodge deeper in the skin, are painful, and can cause scarring.

  • Cysts

Like nodules, these lesions are deep within in the skin, are painful, and are filled with pus, and can cause scarring.

Triggers for Acne

  • Hormone changes during puberty an increase in male sex hormones called androgens. This increase causes the glands to get larger and make more sebum.
  • Hormone changes as an adult. The menstrual cycle is one of the most common acne triggers. Acne lesions tend to form a few days before the cycle begins and go away after the cycle is completed. Other hormone changes, such as pregnancy and menopause, improve acne in some women. But some women have worse acne during these times. Stopping use of birth control pills can play a role as well.
  • Medicines. Certain medicines, such as those used to treat epilepsy and types of depression.
  • Make-up.
  • Pressure or friction on the skin. Friction caused by bike helmets or backpacks can make acne worse.
  • Family history. If other people in your family have acne, there is a greater chance you will have it.

Myths about Acne

  • It is a myth that people get acne because they don’t wash enough. Too much washing or scrubbing the skin harshly can make acne worse. Washing away surface oils doesn’t do much to prevent or cure acne, because it forms under the skin. The best way to clean the face is to gently wash it twice a day with a mild soap or cleanser.

Women must be careful to remove make-up without harsh scrubbing.

  • Stress does not cause acne. But, acne may be a side effect of some medicines used to treat stress or depression. And in some cases, the social and emotional impact of acne lesions causes stress.
  • While many women feel that eating chocolate or greasy foods causes acne, experts have not found a link between the diet and acne. Foods seem to have little effect on acne in most people. But, it’s important to eat a healthy diet for good health.

Treatment for Acne

Mild Acne

There are many treatments for mild acne. Mild acne can consist of whiteheads, blackheads and small pustules. At home, you can wash your face twice per day with warm water and a gentle cleanser or soap. Your doctor may suggest you also try an over-the-counter lotion or cream. These medicines may make your skin dry if you use them too much. Be sure to follow the directions.

If these medicines don’t work, your doctor may prescribe a cream or lotion with benzoyl peroxide, resorcinol, salicylic acid, or sulfur. Benzoyl peroxide works to reduce oil made by the glands. Resorcinol, salicylic acid, and sulfur help breakdown whiteheads and blackheads. If your acne does not get better after six to eight weeks, talk with your doctor about changing your treatment.

Moderate to Moderately Severe Acne

This type of acne consists of several whiteheads, blackheads, papules and pustules that cover from ¼ to ¾ of the face and/or other parts of the body. It can be treated with antibiotic lotions or gels, as well as retinoic acid. Retinoic acid is an altered form of vitamin A. It helps prevent whiteheads and blackheads. Your doctor may also prescribe an antibiotic pill, such as erythromycin. If you take birth control pills to prevent pregnancy, antibiotics can affect how well they work. Be sure to use a second method of birth control with the pill, such as a condom. Retinoic acid and antibiotic pills can make the skin sensitive to the sun. So, wear sunscreen and stay in the shade while using them.

Severe Acne

Severe acne consists of deep cysts, redness, swelling, extreme damage to the skin and scarring. You should see a dermatologist to care for this type of acne. Scarring can be prevented with appropriate treatments. Your dermatologist can prescribe oral antibiotics and oral contraceptives. Large inflamed cysts can be treated with an injection of a drug that lessens the redness, swelling, and irritation, and promotes healing.

Some large cysts do not respond to medication and may need to be drained or removed. Your dermatologist is the only person who should drain or remove these. You should never try to drain or remove your acne by squeezing or picking. This can lead to infection, worsen your acne, and cause scarring.

Overall, if you don’t see a change in your skin in six to eight weeks, talk with your doctor about your treatment plan.

Prevention of acne and acne scars

  • Clean your skin gently with a mild soap or cleanser twice a day — once in the morning and once at night. You should also gently clean the skin after heavy exercise. Avoid strong soaps and rough scrub pads. Harsh scrubbing of the skin may make acne worse. Wash your entire face from under the jaw to the hairline and rinse thoroughly. Remove make-up gently with a mild soap and water. Ask your doctor before using an astringent.
  • Wash your hair on a regular basis. If your hair is oily, you may want to wash it more often.
  • Do not squeeze or pick at acne lesions. This can cause acne scars.
  • Avoid getting sunburned. Many medicines used to treat acne can make you more prone to sunburn. Many people think that the sun helps acne, because the redness from sunburn may make acne lesions less visible. But, too much sun can also increase your risk of skin cancer and early aging of the skin. Use sunscreen of at least SPF 15. Also, try to stay in the shade as much as you can.
  • Choose make-up and hair care products that are “non-comedogenic” or “non-acnegenic.” These products have been made in a way that they don’t cause acne. You may also want to use products that are oil-free.
  • Avoid things that rub the skin as much as you can, such as backpacks and sports equipment.
  • Talk with your doctor about what treatment methods can help your acne. Take your medicines as prescribed. Be sure to tell your doctor if you think medicines you take for other health problems make your acne worse.

Rosacea is a common skin problem often called “adult acne.” Fair skinned and menopausal women are more likely to have rosacea. Rosacea also seems to run in families. It causes redness in the center parts of the face and pimples. Blood vessels under the skin of the face may enlarge and show through the skin as small red lines. The skin may be swollen and feel warm.

People with rosacea don’t have the same lesions as seen with common acne. They may have flushing of the face, when they are hot, drink alcohol or hot drinks, or eat spicy foods. This flushing causes the face to appear red. In the most severe form, this redness does not go away. The eyes may become swollen and nodules in the skin may be painful.

You can help keep rosacea under control by keeping a record of things that cause it to flare up. Try to avoid or limit these triggers as much as you can. Antibiotic lotions or gels can also help. Sometimes, you may need to take antibiotic pills. Your dermatologist may treat you with laser surgery. If you think you have rosacea, talk with your doctor about these treatments.

 

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At UAP we authorize at-least 20 Hysterectomies every month. It is important to know what a Hysterectomy is and indications for having this procedure done.

A hysterectomy is a surgery to remove a woman’s uterus or womb. The uterus is where a baby grows when a woman is pregnant. The whole uterus or just part of it may be removed. After a hysterectomy, you no longer have menstrual periods and cannot become pregnant.

During the hysterectomy, the doctor also may remove your fallopian tubes and ovaries. The ovaries produce eggs and hormones. The fallopian tubes carry eggs from the ovaries to the uterus. The cervix is the lower end of the uterus that joins the vagina. These organs are located in a woman’s lower abdomen, as shown in the image below.

Hysterectomy

If you have not yet reached menopause and:

  • You keep your ovaries during the hysterectomy, you may enter menopause at an earlier age than most women.
  • Your ovaries are removed during the hysterectomy, you will enter menopause. You can talk with your doctor about ways to manage menopausal symptoms, such as hot flashes and vaginal dryness.

Types of hysterectomy:

  • Partial, subtotal, or supra-cervical removes just the upper part of the uterus. The cervix is left in place.
  • Total removes the whole uterus and the cervix.
  • Radical removes the whole uterus, the tissue on both sides of the cervix, and the upper part of the vagina. This is done mostly when there is cancer present.

There are different ways that your doctor can perform a hysterectomy. It will depend on your health history and the reason for your surgery.

  • Abdominal hysterectomy. This is done through a 5- to 7-inch incision, or cut, in the lower part of your belly. The cut may go either up and down, or across your belly, just above your pubic hair.
  • Vaginal hysterectomy. This is done through a cut in the vagina. The doctor will take your uterus out through this incision and close it with stitches.
  • Laparoscopic hysterectomy. A laparoscope is an instrument with a thin, lighted tube and small camera that allows your doctor to see your pelvic organs. Your doctor will make three to four small cuts in your belly and insert the laparoscope and other instruments. He or she will cut your uterus into smaller pieces and remove them through the incisions.
  • Laparoscopically assisted vaginal hysterectomy. Your doctor will remove your uterus through the vagina. The laparoscope is used to guide the procedure.
  • Robotic-assisted surgery. Your doctor uses a special machine (robot) to do the surgery through small cuts in your belly, much like a laparoscopic hysterectomy (see above). It is most often done when a patient has cancer or is very overweight and vaginal surgery is not safe.

Indication for Hysterectomies:

Hysterectomy may be needed if you have:

  • Cancer of the uterus, ovary, cervix, or endometrium Hysterectomy may be the best option if you have cancer in these organs. The endometrium is the tissue that lines the uterus.
  • Fibroids. Fibroids are non-cancerous, muscular tumors that grow in the wall of the uterus. Many women with fibroids have only minor symptoms and do not need treatment. Fibroids also often shrink after menopause. In some women, fibroids can cause prolonged heavy bleeding or pain. Fibroids can be treated with medications. There are also procedures to remove the fibroids, which block the blood supply to the tumors. Without blood, the fibroids shrink over time, which can reduce pain and heavy bleeding. Another procedure called myomectomyremoves the tumors while leaving your uterus intact, but there is a risk that the tumors could come back. If medications or procedures to remove the fibroids have not helped, and a woman is either near or past menopause and does not want children, hysterectomy can cure problems from fibroids.
  • Endometriosis. This health problem occurs when the tissue that lines the uterus grows outside the uterus on your ovaries, fallopian tubes, or other pelvic or abdominal organs. This can cause severe pain during menstrual periods, chronic pain in the lower back and pelvis, pain during or after sex, bleeding between periods, and other symptoms. You might need a hysterectomy when medications or less invasive surgery to remove the spots of endometriosis have not helped.
  • Prolapse of the uterus. This is when the uterus slips from its usual place down into the vagina. This can lead to urinary and bowel problems and pelvic pressure. These problems might be helped for a time with an object called a vaginal pessary, which is inserted into the vagina to hold the womb in place.
  • Adenomyosis. In this condition, the tissue that lines the uterus grows inside the walls of the uterus, which can cause severe pain. If other treatments have not helped, a hysterectomy is the only certain cure.
  • Chronic pelvic pain. Surgery is a last resort for women who have chronic pelvic pain that clearly comes from the uterus. Many forms of pelvic pain are not cured by a hysterectomy, so it could be unnecessary and create new problems.
  • Abnormal vaginal bleeding. Treatment depends on the cause. Changes in hormone levels, infection, cancer, or fibroids are some things that can cause abnormal bleeding. There are medications that can lighten heavy bleeding, correct irregular bleeding, and relieve pain. These include hormone medications, birth control pills, and nonsteroidal anti-inflammatory medications (NSAIDs). One procedure for abnormal bleeding is dilatation and curettage (D&C), in which the lining and contents of the uterus are removed. Another procedure, endometrial ablation also removes the lining of your uterus and can help stop heavy, prolonged bleeding. But, it should not be used if you want to become pregnant or if you have gone through menopause.
  • Control Postpartum Bleeding: Sometimes hysterectomy is needed to control bleeding during a cesarean delivery following pregnancy complications. There are other methods doctors use to control bleeding in most of these cases, but hysterectomy is still needed for some women.

When your doctor recommends Hysterectomy:

  • Ask about the possible risks of the surgery.
  • Talk to your doctor about other treatment options. Ask about the risks of those treatments.
  • Consider getting a second opinion from another doctor.

Recovery Post Hysterectomy

Recovering from a hysterectomy takes time. Most women stay in the hospital from 1 to 2 days for post-surgery care. Some women may stay longer, often when the hysterectomy is done because of cancer. The time it takes for you to resume normal activities depends on the type of surgery. If you had:

  • Abdominal surgery. Recovery takes from 4 to 6 weeks. You will gradually be able to increase your activities.
  • Vaginal or laparoscopic surgery. Recovery takes 3 to 4 weeks.

You should get plenty of rest and not lift heavy objects for a full 6 weeks after surgery. About 6 weeks after either surgery, you should be able to take tub baths and resume sexual intercourse. Research has found that women with a good sex life before hysterectomy can maintain it after the surgery.

Risks of having a Hysterectomy

Most women do not have health problems during or after the surgery, but some of the risks of a hysterectomy include:

  • Injury to nearby organs, such as the bowel, urinary tract, bladder, rectum, or blood vessels
  • Pain during sexual intercourse
  • Early menopause, if the ovaries are removed
  • Anesthesia problems, such as breathing or heart problems
  • Allergic reactions to medicines
  • Blood clots in the legs or lungs. These can be fatal.
  • Infection
  • Heavy bleeding

Pap smear after Hysterectomy

You will still need regular Pap tests to screen for cervical cancer if you had a partial hysterectomy and did not have your cervix removed, or if your hysterectomy was for cancer. Ask your doctor what is best for you and how often you should have Pap tests.

Even if you do not need Pap tests, all women who have had a hysterectomy should have regular pelvic exams and mammograms.

 

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The thyroid is a small gland found at the base of your neck, just below your Adam’s apple. The thyroid produces two main hormones called T3 and T4. These hormones travel in your blood to all parts of your body. These thyroid hormones control the rate of many activities in your body. These include how fast you burn calories and how fast your heart beats. All of these activities together are known as your body’s metabolism. A thyroid that is working normally will produce the right amounts of hormones needed to keep your body’s metabolism working at a normal rate.

Women are more likely than men to develop thyroid disorders. Thyroid disorders include:

  • Hyperthyroidism
  • Hypothyroidism
  • Thyroid nodules
  • Thyroiditis
  • Thyroid cancer
  • Goiter

Hyperthyroidism

Some disorders cause the thyroid to produce more thyroid hormones than the body needs. This is called hyperthyroidism or overactive thyroid. The most common cause of hyperthyroidism is Graves’ disease. Graves’ disease is an autoimmune disorder, in which the body’s own defense system, called the immune system, stimulates the thyroid. This causes it to make too much of the thyroid hormones. Hyperthyroidism can also be caused by thyroid nodules that prompt excess thyroid hormones production.

Symptoms of hyperthyroidism

  • Weight loss, even if you eat the same or more food
  • Eating more than usual
  • Rapid or irregular heartbeat or pounding of your heart
  • Anxiety
  • Irritability
  • Trouble sleeping
  • Trembling in your hands and fingers
  • Increased sweating
  • Increased sensitivity to heat
  • Muscle weakness
  • More frequent bowel movements
  • Less frequent menstrual periods with lighter than normal menstrual flow
  • Osteoporosis, or weak, brittle bones.

Hypothyroidism

Hypothyroidism is when your thyroid does not produce enough thyroid hormones. It is also called underactive thyroid. The most common cause of hypothyroidism is Hashimoto’s disease. Hashimoto’s disease is an autoimmune disease, in which the immune system mistakenly attacks the thyroid. This attack damages the thyroid resulting in reduced hormone production. Hypothyroidism also can be caused by:

  • Treatment of hyperthyroidism
  • Radiation treatment of certain cancers
  • Thyroid removal
  • In rare cases, problems with the pituitary gland can cause the thyroid to be less active.

Symptoms of hypothyroidism

  • Weight gain, even though you are not eating more food
  • Increased sensitivity to cold
  • Constipation
  • Muscle weakness
  • Joint or muscle pain
  • Depression
  • Fatigue (feeling very tired)
  • Pale dry skin
  • A puffy face
  • A hoarse voice
  • Excessive menstrual bleeding
  • High blood levels of LDL (bad) cholesterol.

Thyroid nodules

A thyroid nodule is a swelling in one section of the thyroid gland. The nodule can be solid or filled with fluid or blood; one thyroid nodule or many. Most thyroid nodules do not cause symptoms however some thyroid nodules make too much of the thyroid hormones, causing hyperthyroidism. Sometimes, nodules enlarge and cause problems with swallowing or breathing. In fewer than 10 percent of cases, thyroid nodules are cancerous.

Thyroid nodules are quite common. There is a 50 percent chance of having a thyroid nodule larger than a half inch wide.

Thyroiditis

Thyroiditis is inflammation, or swelling, of the thyroid. There are several types of thyroiditis, one of which is Hashimoto’s thyroiditis. Other types of thyroiditis include:

Postpartum Thyroidits

Like Hashimoto’s disease, postpartum thyroiditis seems to be caused by a problem with the immune system. Post-partum thyroiditis occurs in about 5 -10 percent of women. The first phase starts 1 to 4 months after giving birth. In this phase, one may get symptoms of hyperthyroidism because the damaged thyroid releases thyroid hormones out into the bloodstream. The second phase starts about 4 to 8 months after delivery. In this phase, one may get symptoms of hypothyroidism because, by this time, the thyroid has lost most of its hormones. Not everyone with postpartum thyroiditis goes through both phases. In most women who have postpartum thyroiditis, thyroid function returns to normal within 12 to 18 months after symptoms start.

Risk factors for postpartum thyroiditis include having:

  • An autoimmune disease, like type 1 diabetes
  • A personal history or family history of thyroid disorders
  • Having had postpartum thyroiditis after a previous pregnancy

Silent or painless thyroiditis

Symptoms are the same as in postpartum thyroiditis, but they are not related to having given birth.

Subacute thyroiditis

Symptoms are the same as in postpartum and silent thyroiditis, but the inflammation in the thyroid leads to pain in the neck, jaw, or ear. Unlike the other types of thyroiditis, subacute thyroiditis may be caused by an infection.

Thyroid cancer

Most people with thyroid cancer have a thyroid nodule that is not causing any symptoms. If you have a thyroid nodule, there is a small chance it may be thyroid cancer. To tell if the nodule is cancerous, your doctor will have to do certain tests. A few people with thyroid cancer may have symptoms. If the cancer is big enough, it may cause swelling you can see in the neck. It may also cause pain or problems swallowing. Some people get a hoarse voice.

Thyroid cancer is rare compared with other types of cancer. It is more common in people who:

  • Have a history of exposure of the thyroid to radiation (but not routine X-ray exposure, as in dental X-rays or mammograms)
  • Have a family history of thyroid cancer
  • Are older than 40 years of age

Goiter

A goiter is an abnormally enlarged thyroid gland. Causes of goiter include:

  • Iodine deficiency. Iodine is a mineral that your thyroid uses for making thyroid hormones. Not getting enough iodine in your food and water can cause your thyroid to get bigger. This cause of goiter is uncommon in the United States because iodine is added to table salt.
  • Hashimoto’s disease
  • Graves’ disease
  • Thyroid nodules
  • Thyroiditis
  • Thyroid cancer

Usually, the only symptom of a goiter is a swelling in your neck. But a very large or advanced goiter can cause a tight feeling in your throat, coughing, or problems swallowing or breathing.

Having a goiter does not always mean that your thyroid is not making the right amount of hormones. Depending on the cause of your goiter, your thyroid could be making too much, not enough, or the right amount of hormones.

Thyroid disorders diagnosis

Thyroid disorders can be hard to diagnose because their symptoms can be linked to many other health problems. The doctor will start by taking a medical history and asking if any of your family members has a history of thyroid disease.

The doctor will also give you a physical exam and check your neck for thyroid nodules. Depending on your symptoms, your doctor may also do other tests, such as:

  • Level of thyroid stimulating hormone (TSH)
  • Radioactive iodine uptake test
  • Thyroid scan
  • Thyroid fine needle biopsy
  • Thyroid ultrasound