Thyroid diseases: more than just treating, caring

It is estimated that 5% of the population has thyroid nodules that can be detected by palpation, a simple examination with the hands. However, if an ultrasound is performed, this rate can reach 65%. This high incidence calls for us to be alert to the signs, ensuring early detection and subsequent action.

The thyroid is a shield-shaped gland located at the front of the neck that is responsible for producing hormones. It was first described in the 16th and 17th centuries, but its function only began to be understood later, at the end of the 19th century, through the work of surgeons Billroth and Kocher – the first surgeon to receive the Nobel Prize for Medicine, in 1909 – who revolutionized the treatment of thyroid diseases.

While it is true that most nodules are benign and go unnoticed, changes in thyroid function can cause relevant signs and symptoms that should be noted. In cases where the thyroid is overactive, a condition known as hyperthyroidism, symptoms such as excessive sweating, unintentional weight loss, heat intolerance, increased thirst, menstrual changes, anxiety, diarrhea, palpitations, hair loss and sleep disorders may occur. When there is a deficit in thyroid function, in cases of hypothyroidism, weight gain, hair loss, cold intolerance, constipation, menstrual changes, depression and joint pain may occur.

It is essential to see a doctor whenever you notice swelling in your neck or have persistent symptoms of thyroid problems. Assessment of the situation may include tests, ultrasound, CT scan or other tests directed at Nuclear Medicine. In some cases, an ultrasound-guided biopsy may also be necessary.

It is also important to consider some relevant risk factors for the development of more serious diseases, such as thyroid cancer. These include having a family history of thyroid disease or cancer, voice changes, difficulty swallowing, presence of lymph nodes and nodules larger than 4 cm, rapid growth of a nodule, exposure to radiation, age under 20 and over 60, and being male.

To obtain the best possible results, treatment must be personalized, according to each patient's case, and carefully discussed by multidisciplinary teams, which include, among others, specialists in Endocrinology, General Surgery, Otorhinolaryngology, Imaging and Pathological Anatomy, ensuring safe and individualized decisions.

For cases that require surgical treatment, there are now modern approaches, with minimally invasive techniques, such as endoscopic and robotic surgery – which allow the patient to be treated through small incisions in the armpit, avoiding a visible scar on the neck – and the application of ethanol, microwaves or radiofrequency. When necessary, surgery can include cutting-edge technologies that reduce the risk of complications, such as so-called “neuromonitoring”, to preserve the voice. In addition, both pre- and post-operatively, support from Otorhinolaryngology and Speech Therapy are essential.

I remember the case of a patient who proves that being alert to symptoms and monitoring your health regularly are crucial for the early detection of diseases, successful treatment and a good recovery.

This patient came to the consultation when she began to notice weight gain and persistent fatigue. She underwent an ultrasound, which revealed a nodule in her thyroid, followed by a biopsy, which confirmed that it was benign.

After several years of monitoring, the nodule grew and a new biopsy was inconclusive, so it was decided to proceed with surgery. The patient was apprehensive, but the team managed to reassure her and make her feel calm and confident. Three months after the surgery, she now feels more energetic, has resumed her normal life, is back to training and her scar is barely noticeable.

Cases like this prove that taking care of your health is not just about treating diseases. It is also about prevention, listening to the patient and using technology to achieve the best possible results, with humanity, in cases of thyroid disease or other types of pathologies.