Thyroid Disorders

At Montefiore Einstein Otorhinolaryngology – Head and Neck Surgery, you can access exceptional care for thyroid disorders. As a global leader in otorhinolaryngology and head and neck surgery, we are an academic-based, national and international referral site for the most complex and high-risk cases. For over a century, we have been at the forefront of innovation, research and clinical care for ear, nose and throat (ENT) and head and neck conditions.

Ranked in the top 1% of all hospitals in the nation for complex specialty care according to U.S. News & World Report, Montefiore Einstein continues to make advances in the diagnosis and treatment of ENT and head and neck conditions. Our multidisciplinary team of world-renowned specialists has pioneered many of the otorhinolaryngological techniques used today and is passionate about uncovering the latest diagnostic approaches and treatments that can improve outcomes.

At Montefiore Einstein Otorhinolaryngology – Head and Neck Surgery, you can expect compassionate, personalized, research-driven treatment plans that meet the highest standards for quality and safety.

When you need thyroid disorder care, turn to our dedicated multidisciplinary team for a personalized treatment plan.

The thyroid gland, a small butterfly-shaped gland located in the front of the neck, plays an important role in regulating your body’s metabolic functions. The thyroid produces and secretes thyroid hormones that control your metabolic rate and your body’s conversion of food into energy. The pituitary gland also plays a role in thyroid hormone production by releasing TSH. Pituitary gland abnormalities may disrupt the proper release of TSH and can either increase or decrease thyroid hormone production. A disorder originating in the thyroid gland is called a primary thyroid disorder. A disorder caused by a pituitary gland issue is called a secondary thyroid disorder.

Some of the most common thyroid conditions include:

• Hypothyroidism (underactive thyroid): In this condition, the thyroid does not produce or release enough hormone. Several underlying causes can lead to hypothyroidism, including:
  • Congenital conditions resulting in a nonfunctional thyroid
  • Inflammation of the thyroid
  • Iodine deficiencies
  • Hashimoto’s disease, an autoimmune disease
  • Overtreatment of hyperthyroidism
  • Pituitary gland disorders
• Hyperthyroidism (overactive thyroid): In this condition, the thyroid produces and releases too much hormone. Several underlying causes can lead to hyperthyroidism, including:
  • Excess iodine in the body
  • Grave’s disease, an autoimmune disease
  • Inflammation of the thyroid
  • Overtreatment of hypothyroidism
  • Pituitary gland disorders
  • Thyroid nodules
• Goiter (enlarged thyroid): Goiters may be caused when the thyroid grows larger in order to increase hormone production, often due to hypothyroidism. Some goiters may result from an iodine deficiency, a reaction to certain medications or an unknown cause.
• Thyroid nodules: The exact cause of thyroid nodules sometimes cannot be determined, but factors such as age, genetics or an iodine deficiency may play a role. In rare cases, cancerous cell growth is the cause of thyroid nodule formation.

With the exception of a noticeably enlarged goiter, symptoms of thyroid disorders may be subtle and attributed to other health conditions. Some signs of a possible thyroid condition include:

• Change in the ability to tolerate heat or cold
• Changes in heart rate (slower or faster than usual)
• Difficulty swallowing
• Irregular menstrual periods
• Unexplained changes in mood (depression or anxiety)
• Unexplained weight gain
• Unexplained weight loss

Your physician will conduct a comprehensive physical examination and typically touch or manipulate your neck and thyroid gland to see if there are any abnormal masses. Other diagnostic tests may be used to understand more about the condition of your thyroid, including:

• Blood tests to check hormone levels
• Ultrasound scan of your neck and thyroid
• Fine needle aspiration to remove a small amount of thyroid tissue to check for cancer
• Biopsy

In selected circumstances,

• Magnetic resonance imaging (MRI)
• Computed tomography scan (CT)
• Radioactive thyroid scan

Medications are commonly used to treat thyroid disorders and are tailored to the specific underlying cause.

Hypothyroidism: Thyroid hormone supplements, which are biologically identical to thyroid hormones, can be used to boost hormone levels and speed up metabolic processes.

Hyperthyroidism: Anti-thyroid medicines are used to decrease the effects of excess thyroid hormone in the body and slow down metabolic processes. In some cases, radioactive iodine may be used to damage or destroy some of the thyroid cells, thereby decreasing overall hormone production. Surgery is another treatment for hyperthyroidism and is used to remove over functioning nodules or the entire thyroid gland. Surgery is recommended to patients who cannot tolerate medical management and/or do not wish to have radioactive iodine treatment. It is very effective and also often used in patients with Grave’s disease.

Thyroid nodules: These masses or lumps are typically benign and may need no treatment. Surgery is recommended for large nodules which are symptomatic, swallowing problems, breathing problems, or voice changes, or if the nodules have concerning biopsy results.

Thyroid cancer: The surgical removal of the entire thyroid gland (thyroidectomy) or part of the gland (lobectomy) is the first line of treatment for most thyroid cancers. This may also include removing lymph nodes in the neck under certain circumstances. In select patients, observation of thyroid cancer with close follow-up is also offered. Your ear, nose and throat specialist will work with you to develop the most effective therapeutic treatment plan.

Your healthcare provider may recommend surgically removing your thyroid (thyroidectomy). This will stop it from creating hormones. Thyroid surgery, also known as a thyroidectomy, is a procedure that removes part or all of the thyroid gland. It’s used to treat a number of thyroid disorders, including cancer, goiter, and hyperthyroidism.

Types of thyroid surgery:

• Total thyroidectomy: Removes all or most of the thyroid gland
• Hemithyroidectomy: Removes one lobe of the thyroid gland
• Isthmusectomy: Removes the bridge of tissue connecting the two lobes of the thyroid gland