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Dr. Salerno: How to Identify & Treat Thyroid Disease

Dr. Salerno: How to Identify & Treat Thyroid Disease - Upper West Side - Activities & Health - NYC

arrow stock 3If you have unexplained

  • chills
  • fatigue
  • hair loss
  • brain fog
  • depression
  • hot flashes
  • cold hands
  • cold feet
  • constipation
  • nervousness
  • mood swings
  • loss of appetite
  • anxiety attacks
  • weight changes
  • irregular heart rate
  • bouts of low energy
  • high blood pressure
  • slight burning sensations
  • side effects from your meds

-then your thyroid might be trying to tell you something.

Any one or a combination of the above could mean that your thyroid is not producing enough thyroid hormone, which is called hypothyroidism.

salerno checkbox bullet 3Yes, any one of these can mean anything, (and for you women, these even sound like menopause, don’t they?), but if you have tried just about everything out there, and you are still a medical mess, your thyroid could be trying to whisper something in your ear.

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The most common cause of hypothyroidism is inflammation of the thyroid gland, which damages the gland’s cells.

Autoimmune or Hashimoto’s thyroiditis, in which the immune system attacks the thyroid gland, is the most common example of this.

Some women develop hypothyroidism after pregnancy (often referred to as “postpartum thyroiditis”).

baby bullet arrow 4Other common causes of hypothyroidism include:

  • Congenital (birth) defects
  • Heavy metal toxicity such as (aluminum, beryllium, cadmium, lead and mercury).
  • Radiation treatments to the neck to treat different cancers, which may also damage the thyroid gland
  • Radioactive iodine used to treat an overactive thyroid (hyperthyroidism)
  • Surgical removal of part or all of the thyroid gland, done to treat otherthyroid problems
  • Viral thyroiditis, which may cause hyperthyroidism and is often followed by temporary or permanent hypothyroidism

baby bullet arrow 4Certain drugs can cause hypothyroidism, including:

  • Amiodarone
  • Drugs used for hyperthyroidism (overactive thyroid), such as propylthiouracil (PTU) and methimazole
  • Lithium
  • Radiation to the brain
  • Sheehan syndrome, a condition that may occur in a woman who bleeds severely during pregnancy or childbirth and causes destruction of the pituitary gland.


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If not, consider having this done, rather than the traditional Thyroid Stimulating Hormone (TSH) test.

baby bullet arrow 4The TRH test is a much more accurate test that will tell you:” yes, you are right, you do indeed have a low thyroid.”

Many times the traditional TSH test will tell your doctor that your thyroid level is   fine, when it really isn’t!

Basically, a TSH test is just a simple blood test – and many times it is inaccurate.

The TSH test measures the serum levels of thyroid related hormones. This is a static test because it measures the hormones at the instant in time that the blood is drawn.

salerno checkbox bullet 3But, as an endocrine regulatory organ, hormone levels are constantly changing as the body requires. In fact, the hallmark of endocrine health is the ability to change hormone levels for moment to moment physiologic needs.


With a static blood test, we do not know if the results represent the usual state of the hormone levels.

Depending on the timing of the tests, the health condition of the individual at the time, or even psychological stressors, one may miss significant underlying imbalances.

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arrow stock 3The TRH Stimulation Test, however, is a much more sensitive test because it evaluates how well the hypothalamus, pituitary and thyroid glands are functioning and communicating together at the same time, and in in real bullet arrow 4The test:

  1. Begins by baseline thyroid and pituitary hormone levels being drawn.
  2. Then you are given an injection of a tiny amount of thyrotropin releasing hormone, which stimulates the pituitary to release TSH, a hormone which signals the thyroid to release thyroxine, the main thyroid hormone.
  3. A second blood sample is drawn 20 to 30 minutes later, and the TSH level is retested. Low thyroid conditions will result in an exaggerated response, and excessive thyroid function and pituitary insufficiency states will result in a depressed response.


Ask for that TRH test!

Now, to better understand the thyroid itself…

…so you can see if there could be a connection between it and the way you are feeling right now, let’s start with some of the most asked questions.

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Your thyroid gland is in your neck, just below your Adam’s apple. It’s fairly flat, so you normally can’t feel it, unless there’s a problem.


arrow stock 3To make this less complicated, the main job of your thyroid is to put out a hormone to control your metabolism.

Think of your thyroid putting out hormones as a car that needs gas to run. Gas gets burned in the engine, which ultimately turns the wheels of the car so you can drive over here to see us at the Salerno Center.

The speed of the car depends on how much gas is let in the engine to be burned. The more gas, the more the engine revs. The carburetor, or the fuel injectors, are the parts of the car that control the amount of gas going to the engine, telling the engine how high to rev.

In the same way, the body needs fuel for you to do things, like getting out of your car to yell at the other driver (ok, maybe not that).

It also needs energy to keep the heart beating, the lungs breathing, and the spleen, well, spleening away. The burning of energy to do all of these things is called the – metabolism.

Thyroid hormone is much like the carburetor. Low thyroid hormone levels make the body burn less energy, whereas high levels make the body burn more energy.

tired man

Now, we know what some of you are thinking…

…but that does NOT mean that high thyroid levels help you run faster! Oh, don’t you wish.

But it does mean that,…



salerno checkbox bullet 3People with overactive thyroid glands tend to have:

  1. higher heart rates,
  2. their muscles shake,
  3. and they lose weight without explanation.


Sound familiar?

This is called hyperthyroidism

salerno checkbox bullet 3People with under-active thyroid glands, on the other hand, have:

  1.  slower heart rates,
  2. are fatigued (“chronic fatigue syndrome”),
  3. and gain weight.


That is called hypothyroidism.

Children use much of their energy to grow, so children with hypothyroidism don’t grow well.

Well, some doctors do give extra thyroid hormone supplements to help people lose weight, but that is a big mistake because hyperthyroidism is actually more dangerous than hypothyroidism. Besides, what do you think the pituitary gland does when you take extra thyroid hormone? It lowers the TSH, which makes the thyroid gland put out less of its own hormones.

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Hormones are a liquid chemical that are produced by glands. Much like sweat secreting from our pores, the hormones secrete from these glands.

They drip, if you will, into the bloodstream where they travel to the distant tissues and organs, where they then bind to the tissues’ and organs’ specific cell sites called receptors.

arrow stock 3By binding to receptors, hormones send messages (commands, if you will) to your body to do certain functions, to keep itself healthy:

  • stimulation or inhibition of growth
  • mood swings
  • cells in our skin, hair, nails, organs…
  • induction or suppression of apoptosis (programmed cell death)
  • activation or inhibition of the immune system
  • regulation of metabolism
  • preparation of the body for mating, fighting, fleeing, and other activity
  • preparation of the body for a new phase of life, such as puberty, parenting, and menopause
  • control of the reproductive cycle
  • hunger cravings
  • Sexual arousal

baby bullet arrow 4Simply put, think of hormones as the “prime movers” of your physical and mental well-being.

Every time you:

  • get angry,
  • become tired,
  • laugh,
  • cry,
  • have sex,
  •  wake up,
  • feel hungry,
  • or fall asleep,
  • your body is responding to hormones.

That’s because hormone levels can impact virtually every major system and organ in your body.

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arrow stock 3Many of you already know how hard it is to find a good doctor: One who will listen to you without thinking it’s all in your head. One who thinks outside the box in figuring out what exactly is wrong with you. One who will not give up on you after just so many visits…

In fact, Dr. Salerno asks all his patients the following questions, especially if you feel you’ve already adopted a healthy lifestyle.

baby bullet arrow 4Questions such as:

1. Are my symptoms consistent with having a bad thyroid?

2. Could my symptoms be the result of anything else?

3. What investigations do I need to have performed to make a diagnosis?

4. How safe are these investigative tests and procedures?

5. If I do have thyroid disease, how do we treat it?

6. If I need medications, what are the potential side effects?

7. If I need medication, is there any special way I should be taking it?

8. Do we need to monitor blood levels for thyroid function? If so, how often?

9. Do you do a TRH test?

10. Do you have any information on alternative methods, like diet and supplements?

Foods to Avoid!

salerno checkbox bullet 3Did you know that consuming to many cruciferous vegetables, and soy products, to your diet can actually cause more harm than good to your existing thyroid problems?

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arrow stock 3This simple at home self-help thyroid check may help identify if your thyroid   is trying to tell you something – a possibly good sign that you may need further examination by a doctor.

  1. Hold the mirror so that you can see the area of your neck just below the Adam’s apple and right above the collarbone. This is the general location of your thyroid gland.
  2. Tip your head back, while keeping this view of your neck and thyroid area in your mirror.
  3. Take a drink of water and swallow.
  4. As you swallow, look at your neck. Watch carefully for any bulges, enlargement, protrusions, or unusual appearances in this area when you swallow.
  5. Repeat this process several times.
  6. If you see any bulges, protrusions, lumps or anything that appears unusual, see your doctor right away. You may have an enlarged thyroid, or a thyroid nodule, and your thyroid should be evaluated.

Your thyroid could be trying to tell you something – listen!


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