Gabby Cinnamon (Host): Welcome back to the Well Within Reach podcast brought to you by Riverside Healthcare. I'm your host, Gabby Cinnamon, and today I am so excited to be joined by Dr. Sara Yap, an Endocrinologist at Riverside, to talk about thyroid disorders.

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Host: Thank you so much for joining us today, Dr. Yap.

Sara Yap, MD: Thank you, glad to be here.

Host: So, before we get into today's episode about thyroid disorders, can you tell us a little about yourself? I think it's your first episode with us.

Sara Yap, MD: It is. So, uh, my name is Sara Yap. As Gabby mentioned, I'm one of the Endocrinologists over here at Riverside. So happy to be here with the community. I did my residency training over at Cook County Hospital in Chicago and my endocrine fellowship training over at Emory University in Atlanta, Georgia. Now I'm back here at the Midwest.

Host: Awesome. Well, we're excited to have you here today. So can you talk about what role the thyroid plays in our body?

Sara Yap, MD: So the thyroid is an organ in the neck, it's a little bit on the lower part of the neck and it actually helps with regulation of metabolism, growth and development. It actually plays a role in certain organs in our bodies such as cardiac function, digestive function, bone health, as well as temperature regulation.

Host: So, so very, it plays a very important role. It sounds like.

Sara Yap, MD: It is, it is one of the important ones.

Host: So, what are some common thyroid disorders?

Sara Yap, MD: So generally the most common thyroid disorders we see, there are about three main things. One is called hyperthyroidism or excess thyroid hormone. The second one would be hypothyroidism or low thyroid function. And the third bucket would be thyroid nodules. And also a subset of that would be thyroid cancers too.

Host: So, can you talk about some of the symptoms associated with those disorders? I'm sure it varies from each one.

Sara Yap, MD: So hyperthyroid, you're thinking hyperactive function. That's one of the most common causes of that would be Graves disease. Patients would tend to have weight loss, palpitations, diarrhea, feelings of very hot all the time, of sweating, and in certain cases for Graves disease would be eye changes. Now on the other hand, for hypothyroidism, you're thinking low thyroid function. So that's fatigue, weight gain, swelling, constipation, or feeling cold all the time.

And in patients who have thyroid nodules or a goiter that would be swelling on the neck or feelings of lumps and bumps, difficulty swallowing or sometimes difficulty breathing when the nodule gets too large.

Host: I kind of want to talk about, just briefly, with thyroid nodules, are those cancerous or can they also be noncancerous?

Sara Yap, MD: So, the majority of thyroid nodules are benign and that means non-cancer, which is very reassuring. A lot of our patients get diagnosed with thyroid nodules when either they notice something on their neck that leads to an ultrasound or they go to the emergency room for a headache and they happen to notice some nodules on the thyroid. And usually depending on the size or the character of the nodules, we might send patients for biopsy to make sure it's not cancerous. But most of the thyroid nodules are benign.

Host: We're going to take a quick break to talk about primary care at Riverside. Riverside knows that health is your greatest asset and having regular appointments with your primary care provider helps you stay up to date with appropriate screenings for your gender and age. Don't have a primary care provider? Good news! Riverside has primary care providers throughout the community who are ready to partner with you on your health journey. Find a primary care provider at riversidehealthcare.org/pimarycare. Now back to the episode with Dr. Yap.

So can you talk about what causes thyroid disorders and is there anything that we can do to prevent them? One thing I know that, when we have providers on here, there are health things that are in your control and some things that are out of your control. Can you kind of talk about that, how it relates to thyroid disorders?

Sara Yap, MD: There are certain ways where the thyroid is out of our control. The things that are in control would be either medication. So amiodarone is a medication for the heart that can cause issues with the thyroid. Sometimes lithium can also cause issues with the thyroid, so better watch out for that. The other things, if patients have exposure to neck radiation, family history of thyroid disorders that predisposes them to have that later on in life. If patients also have thyroid surgeries, that can affect the thyroid disorders too.

Host: Unfortunately we can't control our genetics and, you know, sometimes there are medications that you have to take. Are there any factors in your control, like your lifestyle or anything like that that could affect you having a thyroid disorder?

 Hmm.

Sara Yap, MD: In terms of lifestyle, there's a lot of information out there, and a lot of them have not been officially proven, but definitely keeping a healthy, balanced lifestyle would be of great importance. If patients are on certain supplements, just check the back for instructions. Some weight loss supplements actually have thyroid medications or thyroid related ingredients on there that needs to be looked into.

So

Host: Wow, that's good to know. Can you talk about what some of the treatments are for these common thyroid disorders like hypo and hyperthyroidism?

Sara Yap, MD: In terms of hyperthyroidism, we have medications. The most common medications are propylthiouracil or methimazole, and these are pills. And also in some cases, we do recommend radioactive iodine ablation to burn out the thyroid, as well as thyroid surgery if need be. Now for hypothyroidism or low thyroid function, we have what we call levothyroxine. It's a medication for your thyroid. Other types of medications could also be Synthroid or Tirosint.

Host: . So let's say, you know, someone has maybe been experiencing some symptoms that you talked about earlier, maybe, you know, tired or weight loss, however it relates to one of these issues. What happens if these thyroid disorders go untreated?

Sara Yap, MD: So definitely better watch out. Keep yourself updated, make sure to watch how your body is doing. If the thyroid is not regulated, let's say someone has very uncontrolled hyperthyroidism, then that would lead to what we call a thyroid storm that can cause palpitations, sometimes heart arrhythmia, that definitely leads to hospital stay and intensive care unit admissions.

On the other hand, for hypothyroidism, if that gets uncontrolled, we have, what we call our myxedema coma, that leads to drowsiness, confusion, that also leads to hospital stays. And both of those are actually two endocrine emergencies that we don't want our patients to have. So, better take your medications.

Host: Yeah, and it sounds like to what you're kind of like what you're saying is, if you think something might be going on, like you are tired or you are losing weight unintentionally, to talk with your primary care provider about that or a doctor you trust to make sure that it's not one of these issues. It could be nothing, but you never know.

Sara Yap, MD: Our primary care providers are really great at screening thyroid disorders, and if you do have any of these symptoms, it's important for you to talk to your providers to have at least a thyroid checked. A lot of our patients do experience fatigue and weight gain, and it's important to know that it's not always the thyroid. There are other conditions that can lead to similar symptoms, such as anemia, lack of exercise, also increase in metabolism as we get older, sleep apnea, and also depression.

Host: It's good to talk with your doctor and not just go straight to WebMD and start Googling your symptoms because like you said, it could be any one of those things and you just don't know until you get those tests that you need.

Sara Yap, MD: You end up in a rabbit hole when you do the Google searches. Sometimes you can write down information, um, write down questions, uh, talk to your doctors.

Host: Yeah. So, you kind of touched on this, but can you remind us what should someone do if they think they might have a thyroid disorder or have been experiencing these symptoms that you've talked about?

Sara Yap, MD: So if anyone is experiencing these symptoms, it's important to seek care with your primary care provider to make sure everything is doing well in terms of your health.

Host: Awesome, and I will give a plug for our endocrinology team. Your primary, you know, maybe it's something that you need to get checked out by a specialist. We have an awesome team here with Dr. Yap, of course, who can help you with those things. You know, if someone does need a referral to you guys, that's also an option.

Sara Yap, MD: Yes, it is.

Host: Before we go today, is there anything else that you would like to add?

Sara Yap, MD: No, that's all. I think we've covered a lot for today.

Host: We have. Well, thank you so much for coming on the podcast, Dr. Yap. I hope we can do another episode again here soon.

Sara Yap, MD: You're welcome. Glad to be here.

Host: And thank you listeners for tuning in to Well Within Reach brought to you by Riverside Healthcare. For more information about endocrinology at Riverside, visit riversidehealthcare.org. Also, make sure to rate and leave a review for Well Within Reach on Apple, Spotify, or wherever you listen to podcasts.