Skip to Main Content

Thyroid Disease

Thyroid Disease

Video Information

Thyroid Disease

Endocrinologist Dr. Emily T. Veeneman of Norton Healthcare discusses thyroid disease.
S14 E4 Length 27:21 Premiere: 10.28.18

Thyroid Disease: We Know It’s Important, But Why?

The thyroid gland located in the front of our neck is crucial in regulating metabolism, but exactly how this butterfly-shaped gland works is something that most of us don’t think much about – until it stops working properly. Then a multitude of complications can occur, ranging from fatigue and weight gain when the thyroid is not producing enough hormones to palpitations and nervousness when it is producing too much.

In this episode of Kentucky Health, host Dr. Wayne Tuckson welcomes a Louisville-based endocrinologist to learn more about the thyroid gland and how it affects overall health.

Dr. Emily Veeneman is an endocrinologist with Norton Healthcare in Louisville. She is a specialist in endocrinology, diabetes, and metabolism.

The thyroid gland is “one of the master glands in our body, and it really controls a lot of different things,” Veeneman says. “Until it goes too high or too low, you really don’t understand what your thyroid is doing for you.”

Thyroid Function
The thyroid gland produces two main hormones: triiodothyronine, or T3; and thyroxine, or T4. The thyroid gland is in turn regulated by the pituitary gland and the hypothalamus in the brain. The hypothalamus gives a signal to the pituitary gland, and the pituitary then signals the thyroid gland to produce these hormones. The entire process works as a sort of feedback loop, and Veeneman says that the T4 hormone is the main hormone that is replaced when a patient has poor thyroid function and takes medicine.

The best way to measure how well the thyroid is working is by measuring what is called Thyroid Stimulating Hormone or TSH, Veeneman says. Despite its name, this hormone is actually produced by the pituitary gland rather than the thyroid gland, and directs the thyroid gland to generate T4 and T3. If a person’s TSH levels are too high on a blood test, that means that the T4 and T3 hormones are too low and TSH production has increased in order to signal the thyroid to produce more. If the TSH levels are too low, that indicates that T4 and T3 production is too high.

As mentioned earlier, the thyroid produces hormones that are essential in maintaining metabolism. It affects our weight, regular bowel movements, and body temperature. Veeneman says that if thyroid hormone production is too low (hypothyroidism), the main symptoms are fatigue, weight gain, and heightened sensitivity to cold. If thyroid production is too high (hyperthyroidism), symptoms occur such as tachycardia or rapid heart rate, nervousness, palpitations, and, in women, osteoporosis or bone thinning.

“When we talk about fatigue, constipation, feeling cold, dry skin, hair loss, I always tell people that those are very non-specific symptoms, so the thyroid is going to be high on that list,” Veeneman says. “But we have to make sure that if the thyroid is not the problem that we look for other things like Vitamin D deficiency, anemia, iron deficiency, there can be a lot of other things.”

Veeneman says that thyroid problems occur roughly seven times more often in women than in men, and that she always screens her diabetic patients for thyroid problems as they can make symptoms such as high blood pressure, high cholesterol, and high blood sugar worse.

Veeneman recommends getting a TSH test if a patient has any of the above symptoms in order to rule out the thyroid as a cause. “We tell people, it’s an easy test, it’s not a very expensive test for a primary care to screen by drawing a TSH,” she says says. “And it’s very accurate.”

Thyroid Problems and Effective Treatment
A person who has either too low or too high thyroid hormone production may develop a diffusely shaped thyroid that can bulge into a goiter, Veeneman says. A goiter can be caused by either too much or too little thyroid hormone production.

One of the main causes of an enlarged thyroid gland is iodine deficiency. Veeneman explains that “iodine is one of the main ingredients” in thyroid hormone. “I tell patients that thyroid wants to take up iodine, it’s a main factor… It’s like if you’re baking a cake, it’s almost like the flour that you have to have to rise in the cake and make it work.”

Two thyroid diseases that can lead to goiters are Hashimoto’s disease and Graves’ disease. Veeneman says that Hashimoto’s disease is caused when the immune system attacks the thyroid gland, and is the most common cause of hypothyroidism in women.

“It’s an autoimmune type of disorder,” Veeneman says. “What’s happening is people’s bodies are making protein against their thyroid.” This protein is a blocking antibody that impedes normal thyroid function – leading to hypothyroidism and possibly a goiter.

Graves’ disease causes hyperthyroidism – too much thyroid hormone production – and occurs when the body’s immune system produces antibodies that mimic TSH and thus cause the thyroid gland to go into overdrive. A symptom of Graves’ disease is bulging eyes, Veeneman says. Often times, patients will come in for an exam and test after noticing this change, or after a relative or friend says something about it.

A thyroid can also have small bumps or nodules rather than a large, diffusely shaped goiter, Veeneman says. “Often times you can feel a definitive bump, or a knot on the thyroid. And in men, this often gets picked up if they’re shaving or if they’re tying a necktie. Something feels different for them.”

Back when Veeneman was finishing her residency in the mid-2000s, the American Thyroid Association recommended that any nodule growing on the thyroid gland that measured greater than a centimeter should be biopsied. But now, the guidelines have changed, Veeneman says, and lie within the range of 1.2 to 1.4 centimeters. “The larger a nodule is, the potential chance that it has cancer increases,” she says. “But I also tell people that only 10 to 15 percent of nodules are cancerous.”

Having a biopsy is safe and done on an outpatient basis, Veeneman says. The neck is numbed, a needle is inserted, and cells are extracted. Nodules can be present on normal thyroids, hyperactive thyroids, and underactive thyroids – “hot nodules” can lead to more thyroid hormone production, and “cold” ones can lead to less. She says that having an ultrasound is the best test for examining the thyroid gland rather than a MRI or CAT scan.

Veeneman says that there is a hereditary risk for thyroid cancer and that excessive exposure to radiation also increases risk. There are two main types of thyroid cancer – papillary and follicular – and they are very treatable.

“Usually people have surgery and have their thyroid taken out,” Veeneman says. “Often times, they choose to have iodine afterwards for treatment. And then, if they take their thyroid supplement for replacement, I always tell patients that you should feel just as well as somebody that has their whole thyroid intact.”

Overall, thyroid replacement medicine is very effective for treating patients, whether they have hyperthyroidism or hypothyroidism. The replacement medicine needs to be monitored closely, but Veeneman says that ultimately, the body just requires normal T4 and T3 hormone levels and it does not matter whether the hormones come from the gland or from a pill.

But Veeneman also cautions that a lot of people read about thyroid replacement medicine on the Internet and may think that they can take the medicine just to get an energy boost or lose weight.

“You don’t want to take thyroid medicine if you don’t have a thyroid problem, obviously,” she says. “I always tell people, if you’re deficient, we want to get you back to normal, but we don’t want to blast you out with too much, because you don’t want to run around with too much or too little, you’re sort of looking for that balance in the middle.”

Program Details

Kentucky Health

About Kentucky Health

Learn how to improve your health through education and increased awareness. Dr. Wayne Tuckson, a colorectal surgeon in Louisville, hosts.

TV Schedules

Jump to Recent Airdates

Upcoming

Rural Health Care Practices: It's More Than Just a Doc-in-a-Box - S15 E16

Dr. Tuckson speaks with Barry Martin, chief executive officer, and Dr. John Jones, DO, chief medical officer, of Primary Care Centers of Eastern Kentucky (PCCEK).

  • Friday February 21, 2020 1:30 pm ET on KETKY
  • Friday February 21, 2020 12:30 pm CT on KETKY
  • Friday February 21, 2020 6:00 pm ET on KET
  • Friday February 21, 2020 5:00 pm CT on KET
  • Sunday February 23, 2020 12:30 am ET on KETKY
  • Saturday February 22, 2020 11:30 pm CT on KETKY
  • Sunday February 23, 2020 9:00 am ET on KETKY
  • Sunday February 23, 2020 8:00 am CT on KETKY

Rehabilitation: Getting Back to the New Normal - S15 E14

Dr. Tuckson speaks with Dr. Lewis Hargett, a physical medicine and rehabilitation specialist.

  • Friday February 21, 2020 6:00 pm ET on KET
  • Friday February 21, 2020 5:00 pm CT on KET

Cystic Fibrosis: Improvements in Outcomes - S15 E3

Dr. Tuckson speaks with Dr. Jamshed F. Kanga, chief of the Division of Pediatric Pulmonology at Kentucky Children's Hospital.

  • Sunday March 8, 2020 5:30 pm ET on KETKY
  • Sunday March 8, 2020 4:30 pm CT on KETKY
  • Monday March 9, 2020 2:00 pm ET on KET2
  • Monday March 9, 2020 1:00 pm CT on KET2
  • Friday March 13, 2020 1:30 pm ET on KETKY
  • Friday March 13, 2020 12:30 pm CT on KETKY
  • Friday March 13, 2020 6:00 pm ET on KET
  • Friday March 13, 2020 5:00 pm CT on KET
  • Sunday March 15, 2020 12:30 am ET on KETKY
  • Saturday March 14, 2020 11:30 pm CT on KETKY
  • Sunday March 15, 2020 9:00 am ET on KETKY
  • Sunday March 15, 2020 8:00 am CT on KETKY

Taking Care of Patients with Intellectual and Developmental Disabilities - S15 E17

Guests are Dr. Henry Hood, DMD, chief clinical officer, and Dr. Matt Holder, MD, MBA, chief executive officer of Lee Specialty Clinic.

  • Sunday February 23, 2020 12:30 pm ET on KET
  • Sunday February 23, 2020 11:30 am CT on KET
  • Sunday February 23, 2020 5:30 pm ET on KETKY
  • Sunday February 23, 2020 4:30 pm CT on KETKY
  • Monday February 24, 2020 2:00 pm ET on KET2
  • Monday February 24, 2020 1:00 pm CT on KET2
  • Friday February 28, 2020 1:30 pm ET on KETKY
  • Friday February 28, 2020 12:30 pm CT on KETKY
  • Friday February 28, 2020 11:30 pm ET on KET
  • Friday February 28, 2020 10:30 pm CT on KET
  • Sunday March 1, 2020 12:30 am ET on KETKY
  • Saturday February 29, 2020 11:30 pm CT on KETKY
  • Sunday March 1, 2020 9:00 am ET on KETKY
  • Sunday March 1, 2020 8:00 am CT on KETKY

Pediatric Anesthesia: Making Surgery Easier for Kids and Docs - S15 E15

Dr. Tuckson's guest is anesthesiologist Dr. Kapauner Lewis.

  • Friday February 28, 2020 6:00 pm ET on KET
  • Friday February 28, 2020 5:00 pm CT on KET

Breast Cancer: Determining Your Risk and Improving Your Survival - S15 E4

Dr. Tuckson speaks with Janikaa Sherrod, MPH, cancer control specialist at the Kentucky Cancer Program, and Dr. Mounika Mandadi, an oncologist at the James Graham Brown Cancer Center.

  • Sunday March 1, 2020 5:30 pm ET on KETKY
  • Sunday March 1, 2020 4:30 pm CT on KETKY
  • Friday March 6, 2020 1:30 pm ET on KETKY
  • Friday March 6, 2020 12:30 pm CT on KETKY
  • Friday March 6, 2020 6:00 pm ET on KET
  • Friday March 6, 2020 5:00 pm CT on KET
  • Sunday March 8, 2020 12:30 am ET on KETKY
  • Saturday March 7, 2020 11:30 pm CT on KETKY
  • Sunday March 8, 2020 9:00 am ET on KETKY
  • Sunday March 8, 2020 8:00 am CT on KETKY

Filling Prescriptions: Why Can't I Just Buy Online? - S15 E18

Dr. Tuckson speaks with David Figg, CEO of Rice's Pharmacy in Beaver Dam, Kentucky.

  • Sunday March 15, 2020 12:30 pm ET on KET
  • Sunday March 15, 2020 11:30 am CT on KET
  • Sunday March 15, 2020 5:30 pm ET on KETKY
  • Sunday March 15, 2020 4:30 pm CT on KETKY
  • Monday March 16, 2020 2:00 pm ET on KET2
  • Monday March 16, 2020 1:00 pm CT on KET2
  • Friday March 20, 2020 1:30 pm ET on KETKY
  • Friday March 20, 2020 12:30 pm CT on KETKY
  • Friday March 20, 2020 6:00 pm ET on KET
  • Friday March 20, 2020 5:00 pm CT on KET
  • Sunday March 22, 2020 12:30 am ET on KETKY
  • Saturday March 21, 2020 11:30 pm CT on KETKY
Jump to Upcoming Airdates

Recent

Rural Health Care Practices: It's More Than Just a Doc-in-a-Box - S15 E16

  • Monday February 17, 2020 2:00 pm ET on KET2
  • Monday February 17, 2020 1:00 pm CT on KET2
  • Sunday February 16, 2020 5:30 pm ET on KETKY
  • Sunday February 16, 2020 4:30 pm CT on KETKY
  • Sunday February 16, 2020 12:30 pm ET on KET
  • Sunday February 16, 2020 11:30 am CT on KET

Pediatric Anesthesia: Making Surgery Easier for Kids and Docs - S15 E15

  • Sunday February 16, 2020 9:00 am ET on KETKY
  • Sunday February 16, 2020 8:00 am CT on KETKY
  • Sunday February 16, 2020 12:30 am ET on KETKY
  • Saturday February 15, 2020 11:30 pm CT on KETKY
  • Friday February 14, 2020 6:00 pm ET on KET
  • Friday February 14, 2020 5:00 pm CT on KET
  • Friday February 14, 2020 1:30 pm ET on KETKY
  • Friday February 14, 2020 12:30 pm CT on KETKY
  • Monday February 10, 2020 2:00 pm ET on KET2
  • Monday February 10, 2020 1:00 pm CT on KET2
  • Sunday February 9, 2020 5:30 pm ET on KETKY
  • Sunday February 9, 2020 4:30 pm CT on KETKY
  • Sunday February 9, 2020 12:30 pm ET on KET
  • Sunday February 9, 2020 11:30 am CT on KET

Rehabilitation: Getting Back to the New Normal - S15 E14

  • Sunday February 9, 2020 9:00 am ET on KETKY
  • Sunday February 9, 2020 8:00 am CT on KETKY
  • Sunday February 9, 2020 12:30 am ET on KETKY
  • Saturday February 8, 2020 11:30 pm CT on KETKY
  • Friday February 7, 2020 6:00 pm ET on KET
  • Friday February 7, 2020 5:00 pm CT on KET
  • Friday February 7, 2020 1:30 pm ET on KETKY
  • Friday February 7, 2020 12:30 pm CT on KETKY
  • Monday February 3, 2020 2:00 pm ET on KET2
  • Monday February 3, 2020 1:00 pm CT on KET2
  • Sunday February 2, 2020 5:30 pm ET on KETKY
  • Sunday February 2, 2020 4:30 pm CT on KETKY
  • Sunday February 2, 2020 12:30 pm ET on KET
  • Sunday February 2, 2020 11:30 am CT on KET

Microclinic: Simple Solutions for Complex Problems (Part 2) - S15 E13

  • Friday February 14, 2020 6:00 pm ET on KET
  • Friday February 14, 2020 5:00 pm CT on KET
  • Sunday February 2, 2020 9:00 am ET on KETKY
  • Sunday February 2, 2020 8:00 am CT on KETKY
  • Sunday February 2, 2020 12:30 am ET on KETKY
  • Saturday February 1, 2020 11:30 pm CT on KETKY
  • Friday January 31, 2020 6:00 pm ET on KET
  • Friday January 31, 2020 5:00 pm CT on KET
  • Friday January 31, 2020 1:30 pm ET on KETKY
  • Friday January 31, 2020 12:30 pm CT on KETKY
  • Monday January 27, 2020 2:00 pm ET on KET2
  • Monday January 27, 2020 1:00 pm CT on KET2
  • Sunday January 26, 2020 5:30 pm ET on KETKY
  • Sunday January 26, 2020 4:30 pm CT on KETKY
  • Sunday January 26, 2020 12:30 pm ET on KET
  • Sunday January 26, 2020 11:30 am CT on KET

Microclinic: Simple Solutions for Complex Problems (Part 1) - S15 E12

  • Sunday January 26, 2020 9:00 am ET on KETKY
  • Sunday January 26, 2020 8:00 am CT on KETKY
  • Sunday January 26, 2020 12:30 am ET on KETKY
  • Saturday January 25, 2020 11:30 pm CT on KETKY
  • Friday January 24, 2020 6:00 pm ET on KET
  • Friday January 24, 2020 5:00 pm CT on KET
  • Friday January 24, 2020 1:30 pm ET on KETKY
  • Friday January 24, 2020 12:30 pm CT on KETKY
  • Monday January 20, 2020 2:00 pm ET on KET2
  • Monday January 20, 2020 1:00 pm CT on KET2
  • Sunday January 19, 2020 5:30 pm ET on KETKY
  • Sunday January 19, 2020 4:30 pm CT on KETKY
  • Sunday January 19, 2020 12:30 pm ET on KET
  • Sunday January 19, 2020 11:30 am CT on KET

Changing Curriculum to Meet Unique Patient Needs - S15 E11

  • Sunday January 19, 2020 9:00 am ET on KETKY
  • Sunday January 19, 2020 8:00 am CT on KETKY
  • Sunday January 19, 2020 12:30 am ET on KETKY
  • Saturday January 18, 2020 11:30 pm CT on KETKY
Top

Season 14

2019 Legislative Review: Bills Related to Health and Health

S14 E25 Length 26:47 Premiere Date 5.12.19

Lead and Other Everyday Environmental Dangers

S14 E24 Length 26:59 Premiere Date 5.5.19

Tobacco Cessation: The Power of Group Education and Support

S14 E23 Length 28:46 Premiere Date 4.28.19

Quality and Safety in Healthcare: What's Important

S14 E22 Length 27:07 Premiere Date 4.21.19

Vaccinations: Who, What, When, and Why?

S14 E21 Length 26:33 Premiere Date 4.14.19

The Adolescent Brain and Substance Use

S14 E20 Length 27:09 Premiere Date 4.7.19

Epilepsy: Medical and Surgical Treatment

S14 E19 Length 27:33 Premiere Date 3.31.19

Community Health Workers: Care Away from the Clinic

S14 E18 Length 27:23 Premiere Date 3.24.19

The Flu: It's Not Just a Bad Cold

S14 E17 Length 26:56 Premiere Date 2.24.19

Financial and Mechanical Ways to Protect Our Teeth

S14 E16 Length 27:07 Premiere Date 2.17.19

Aging Optimally

S14 E15 Length 27:15 Premiere Date 2.10.19

Colon Cancer: To Screen or Not to Screen Is Not a Question

S14 E14 Length 27:16 Premiere Date 2.3.19

Autism

S14 E13 Length 26:34 Premiere Date 1.27.19

Leukemia and Lymphoma

S14 E12 Length 26:59 Premiere Date 1.20.19

Hypertension: The Silent but Consequential Disease

S14 E11 Length 26:57 Premiere Date 1.13.19

Genetic Testing: Not a Parlor Game

S14 E10 Length 27:01 Premiere Date 1.6.19

Trauma and Toxic Stress

S14 E9 Length 26:57 Premiere Date 12.16.18

Cancer and Immunotherapy

S14 E8 Length 27:10 Premiere Date 12.9.18

Intestinal Biome: We're in This Gut Together

S14 E7 Length 27:47 Premiere Date 11.18.18

Community Health Centers: Taking the Clinic to the Patient

S14 E6 Length 27:20 Premiere Date 11.11.18

Arthritis

S14 E5 Length 26:58 Premiere Date 11.4.18

Thyroid Disease

S14 E4 Length 27:21 Premiere Date 10.28.18

Breast Cancer

S14 E3 Length 27:05 Premiere Date 10.21.18

Weight Loss: Reasons, Options, Benefits

S14 E2 Length 28:48 Premiere Date 10.14.18

Chiropractic: A Good Back and Neck for a Healthy Body

S14 E1 Length 25:23 Premiere Date 10.7.18

Explore KET