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Interview

Dr. Ziad Zakaria

MD, FACS, Endocrine Surgery at Clemenceau Medical Center - Beirut

“Treatment of thyroid nodule depends on its type and the level of the thyroid hormones in the blood”

The thyroid gland is part of the endocrine system, which is made up of glands that secrete various hormones into the bloodstream. Thyroid nodule refers to an abnormal growth of thyroid cells. “Hospitals” Magazine met Dr. Ziad Zakaria, MD, FACS, Endocrine Surgery at Clemenceau Medical Center – Beirut, who talked about thyroid nodules.

What are thyroid nodules?

Thyroid nodules are solid lumps that form within the thyroid, a gland located in the neck.

The thyroid gland is part of the endocrine system, which is made up of glands that secrete various hormones into the bloodstream. The thyroid resembles a butterfly located on the front of the neck. The thyroid gland, which is made up of a right lobe and a left lobe, produces thyroid hormones that control many organs like the heart, the skin, the central nervous system, liver and bones.

What causes thyroid nodules?

Nodules develop more often in people who have a family history of nodules, people lacking  iodine in their diet, people exposed to radiation, air pollutants or chemicals.

When there are many nodules in the thyroid, we call it multinodular goiter, the nodules can have different sizes or shapes, they can harbor what we call microcalcifications. Cancer is the biggest concern when nodules form, and we may request a biopsy to differentiate between benign or cancerous nodules.

What about the symptoms?

Neck discomfort, sensation of shortness of breath, lump showing on the neck, increase in size over time, trouble swallowing 

Hyperthyroidism: Sometimes the nodules produce excessive thyroid hormone what we call hyperthyroidism. Hyperthyroidism can cause rapid heart rate, hypertension, high blood pressure, eye protrusion, nervousness, sweating and other medical problems.

Hypothyroidism: Sometimes the thyroid nodules present within an underactive thyroid gland which means  the levels of the thyroid hormone are low. Hypothyroid status  can cause fatigue, hair loss, unable to concentrate, memory problems, weight gain, constipation and other medical problems.

How are thyroid nodules diagnosed?

  • Thyroid ultrasound 
  • Blood test to check the thyroid hormone level
  • Biopsy of the thyroid gland in order to determine the nature of a nodules and to have an accurate diagnosis
  • Thyroid scan

Treatment:

Treatment depends on the type of nodule and of the level of the thyroid hormones in the blood. 

  1. Surgery: We perform surgery if the nodules are causing  symptoms or if a nodule is  cancerous on biopsy or shows atypical cells                            (suspicious).
  2. No treatment If the nodules are small not causing any symptoms and not cancerous, we follow the patient on a regular basis to look for any changes in the nodules.
  3. Hyperthyroidism, excess thyroid hormone secretion: Antihormone medication is prescribed or sometimes radioactive iodine, if the thyroid is not responding to the usual medication.
  4. Hypothyroidism, underactive thyroid gland: We prescribe thyroid hormone replacement tablets. 

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