Thyroid Disorders and Surgery Serving Gurnee, IL and Surrounding Areas

Dr. Angelique Cohen practices the full specialty of Otolaryngology- Head and Neck Surgery in Libertyville, IL, serving Lake County and the Northern Suburbs of Illinois, and treats adult and pediatric patients. However, she has a special interest in endocrine head and neck surgery, which includes the surgical treatment for diseases of the thyroid and parathyroid glands. Her experience allows for use of the standard historical surgical approach intertwined with advanced modalities in achieving excellent outcomes for her patients.

The thyroid is a butterfly-shaped gland that resides at the base of the neck and produces hormones that regulate metabolism (how the body converts food into energy). Abnormal growth of the thyroid, such as a generalized enlargement of the thyroid gland or development of nodules is common. Abnormal production of thyroid hormones also results in thyroid disease. You can have normal or abnormal thyroid function in the face of enlargement or nodules.  Two main causes of abnormal function of  the thyroid are overproduction of thyroid hormones, known as hyperthyroidism, and underproduction of thyroid hormones, known as hypothyroidism. The care of thyroid disorders may fall under surgical or nonsurgical treatment. Most nonsurgical thyroid disorders are treated by medical thyroid specialists, Endocrinologists. We will be focusing on surgical thyroid care, as that falls under the realm of head and neck surgery, Otolaryngology.  We strongly believe in team care for the thyroid patient and will work closely with your Endocrinologist or Primary Care Physician for best care for you. 

Thyroid Nodules/Goiter

A thyroid nodule is a growth on the thyroid. A goiter is a swelling or enlargement of the thyroid gland itself. Thyroid nodules are often benign – only 10-15 out of every 100 thyroid nodules are cancerous. Most thyroid nodules are small and difficult to detect on a general exam.  However, bigger nodules may lead to swelling of the neck and problems with breathing or swallowing. Thyroid nodules can, on occassion, secrete extra thyroid hormone " hot nodules".  Overactive thyroid glands and overactive thyroid nodules can lead to hyperthyroidism. However, many more enlarged thyroid glands and nodules are not related to hyperthyroidism. In fact with an enlarged gland and nodules, hypothyroidism can still be present. Thyroid disorders can diagnosed with a combination of blood tests to evaluate how well the thyroid is functioning; a thyroid scan, which uses a radioactive material and a camera to visualize the thyroid; ultrasound to see the number, size and placement of nodules; or fine needle biopsy, where a piece of tissue is removed from the nodule to determine if it is benign or malignant. In cases where cancerous or pre-cancerous cells are present, surgical removal is generally recommended. Surgery is also frequently recommened for very large thyroid glands that cause difficulty in swallowing or a tightness around the neck. Surgery is also an option for overactive thyroid glands. 

Thyroid Cancer

Thyroid cancer is usually asymptomatic and  recognized finding a nodule by palpation of the neck or by finding nodules on imaging. Remember most thyroid nodules are benign whether found on imaging or exam, but there is a risk of malignancy. This is why all thyroid nodules need to be reviewed by your physician for appropriate work up.  Diagnostic techniques used to identify thyroid cancer may include:  ultrasound, fine needle biopsy, nuclear medicine and sometimes CT scan. Most thyroid cancers are asymptomatic, but may include: hoarseness, difficulty breathing or swallowing, neck pain, swollen lymph nodes, weight loss or coughing. In addition to surgery to remove the cancerous tissue, your doctor may recommend removal of associated lymph nodes and a radioactive iodine treatment. In more serious cases, external beam radiation and/or chemotherapy may be required. Note that if any or all of the thyroid is surgically removed, you will have to take replacement thyroid hormones in pill form for the remainder of your life to keep your metabolism functioning at an optimal level for your good health.

Hyperthyroidism

Hyperthyroidism can be caused by Grave’s Disease (overproduction of the thyroid hormones),  toxic multinodular goiter (hot nodules), inflammation of the thyroid (some forms of thyroiditis), use of some medications such as Amiodarone,  and, in rare cases, pituitary gland malfunction or cancer. It is very rare to have cancer in a hot thyroid nodule, but not impossible. Symptoms of hyperthyroidism  include a feeling of speeding up or nervousness, shaky hands, fast heartbeat, sweatiness, red or itchy skin, frequent bowel movements, weight loss and weakness or tiredness. Treatment may be  antithyroid medicine, radioactive iodine or surgery depending on patient factors, disease involved, severity and other associated comorbid conditions. 

Hypothyroidism

Hypothyroidism is caused by underproduction of thyroid hormones. This can be related to inflammatory conditions of the thyroid, such as Hashimoto's thyroiditis, lack of iodine (unusual in the United States as we have iodinated salt), high levels of lithium and removal of the thyroid gland. Symptoms usually appear gradually over time and may include feeling tired, weak or depressed, lower energy level, brittle nails, dry skin, constipation, memory problems and feeling cold more often. For women, it may also cause heavy or irregular menstrual periods. Hypothyroidism is treated with thyroid hormone pills and is treated by an Endocrinologist or your Primary Care Physician. Hypothyroidism is not treated by surgery unless associated with other reasons to remove the gland, such as concerning nodules, cancer, or a large goiter. 

If you have trouble swallowing or breathing, feel a lump in your throat or experience ongoing swelling in the neck, please contact our office and schedule an appointment with one of our otolaryngologists.