Features of the diagnosis of thyroid disease

Since the thyroid gland is facing today a large number of human cases. Knowing the necessary information, the disease can be prevented or consult a doctor when it is at an early stage. The expert on MED-info Olga Yuryevna Demicheva, an endocrinologist at Moscow City Clinical Hospital No. 11 , a doctor of the highest category, a member of EASD, talks about the diagnosis of thyroid pathology . In the daily work of any practitioner, patients with thyroid diseases are found regularly. These are, first of all, patients with reliably existing or pre-existing thyroid diseases, confirmed by extracts from the medical history.       

      

Complaints about a rapid change in body weight, heart rhythm disturbances, swelling, shortness of breath, eye pain , changes in skin moisture, reproductive function disorders, irregular stools, hair loss, and mood changes make it possible for the patient to suggest thyroid pathology . All this gives reason to conduct a study of thyroid function (namely function, not structure). Gland function is determined by the level of TSH (thyroid stimulating hormone). Normal TSH values are 0.4–4.0 μMU / ml. If TSH is less than the specified parameters, hyperthyroidism (thyrotoxicosis) is assumed, if more – hypothyroidism. But the structure of the gland is determined during examination, palpation and, if necessary, ultrasound. Any examination that a doctor prescribes to his patients should be conducted on the basis of the “necessary and sufficient” principle . In order to identify the structural pathology of the thyroid gland to a practical doctor, as a rule, it is enough to examine the area of ​​the front surface of the neck and palpate the gland. When palpation is difficult, additional examinations can be prescribed, most often ultrasound. On palpation of the thyroid gland, its location, symmetry are evaluated , skin over the gland, soreness, density, uniformity, palpable formations, lymph nodes are described. Sometimes patients complain of a sensation of a coma in the throat, a symptom of a turtleneck, a violation of swallowing, a feeling of lack of air. The cause of all these ailments, they consider a thyroid disease, which they are trying to convince the doctor. And here we can already talk about people suffering from tyrophobia (fear of thyroid pathology). Tyrophobia occurs mainly in women: up to 50% in females and less than 1% in males. They consider the purpose and meaning of life to be regular thyroid ultrasound. A doctor who makes a conclusion about the absence of thyroid pathology is not trusted. In the presence of a minimal, clinically insignificant pathology, they are absolutely sure that the thyroid gland is to blame for all problems with their health (as they persistently call the thyroid gland). Any “phobia” is a disease that requires psychotherapeutic help. Fear, fear of something is a neurotic disorder. This also applies to phobias associated with certain organs or diseases: cardiophobia (fear of heart disease), oncophobia (fear of getting cancer) and so on. Tyrophobia is only one of the phobias that relates to anxiety disorders. It arises, as a rule, without foundation and prevents the patient from enjoying life. Complaints such as a lump in the throat, suffocation, swallowing disorders are usually not associated with thyroid pathology and require a differential diagnosis between respiratory diseases , esophageal pathology, impaired muscle tone of the neck, and changes in the cervical spine. If after a visit to the endocrinologist, who explained to the patient the reason for his fears, the patient still suspects a thyroid disease, the help of a psychotherapist is needed .        

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