Why We Believe Regular Thyroid Ultrasound Is So Important.

The thyroid is a small gland with an extraordinary reach.

It sits quietly in the lower part of the neck, but the hormones it produces travel throughout the body and influence virtually every organ system.

That is one of the reasons we believe the thyroid deserves attention throughout life.

Not simply when you feel a lump.

Not simply when a blood test becomes abnormal.

And not simply when you begin experiencing symptoms.

We believe there is value in understanding the health and structure of your thyroid throughout your lifetime.

The Thyroid Reaches Throughout the Body.

Thyroid hormones influence an extraordinary number of functions.

The Heart and Circulation.

Thyroid hormones influence:

• Heart rate

• Heart rhythm

• Strength of heart contraction

• Cardiac output

• Blood pressure

• Blood vessel resistance

• Circulation and blood flow

• The body's demand for oxygen

Changes in thyroid function can sometimes be associated with a racing heart, palpitations, changes in blood pressure or other cardiovascular symptoms.

The Brain and Nervous System.

Thyroid hormones influence:

• Brain development

• Mental alertness

• Concentration

• Memory

• Thinking and processing

• Mood

• Reflexes

• Nerve function

• Sleep and wakefulness

Changes in thyroid function can sometimes be associated with brain fog, difficulty concentrating, nervousness, anxiety, changes in mood or unusual fatigue.

Energy and Metabolism.

The thyroid helps regulate:

• Metabolic rate

• Energy production

• Energy expenditure

• Oxygen consumption

• Calorie utilization

• Fat metabolism

• Carbohydrate metabolism

• Protein metabolism

• Body weight

This is one reason changes in thyroid function can sometimes be felt throughout the entire body.

Body Temperature.

Thyroid hormones influence:

• Heat production

• Temperature regulation

• Sensitivity to heat

• Sensitivity to cold

• Sweating

Feeling unusually cold or unusually hot can sometimes accompany changes in thyroid function.

The Skin.

Thyroid function can influence:

• Skin temperature

• Skin moisture

• Skin texture

• Sweating

• Skin-cell turnover

Dryness and changes in skin texture can sometimes accompany thyroid dysfunction.

Hair.

Thyroid hormones are involved in:

• Hair growth

• Hair-growth cycles

• Hair thickness

• Hair shedding

Hair thinning or excessive shedding can sometimes be associated with thyroid dysfunction.

Nails.

Thyroid health can influence:

• Nail growth

• Nail strength

• Nail texture

Muscles.

Thyroid hormones influence:

• Muscle strength

• Muscle contraction

• Muscle metabolism

• Muscle energy

• Physical endurance

Thyroid dysfunction can sometimes be associated with muscle weakness, aching, cramping or fatigue.

Bones.

Thyroid hormones influence:

• Bone growth

• Skeletal development

• Bone remodeling

• Bone formation

• Bone breakdown

• Bone density

Joints and Connective Tissues.

Thyroid disorders can sometimes be associated with:

• Joint discomfort

• Joint stiffness

• Muscle and joint aching

• Swelling

• Changes involving connective tissues

• Changes in mobility and physical comfort

The Digestive System.

Thyroid hormones influence:

• Gastrointestinal movement

• Intestinal motility

• Digestion

• Bowel movement frequency

• Movement of food through the digestive tract

• Appetite

• Energy utilization

Too much or too little thyroid hormone can affect how quickly the digestive system moves.

The Liver.

Thyroid hormones influence:

• Liver metabolism

• Cholesterol metabolism

• Fat metabolism

• Carbohydrate metabolism

• Protein metabolism

Cholesterol and Lipids.

The thyroid plays an important role in:

• LDL cholesterol

• Triglyceride metabolism

• Lipid processing

• Lipid clearance

Changes in thyroid function can sometimes be reflected in cholesterol levels.

Blood Sugar and Carbohydrate Metabolism.

Thyroid hormones influence:

• Glucose production

• Glucose utilization

• Carbohydrate metabolism

• The body's overall energy balance

The Kidneys and Fluid Balance.

Thyroid hormones influence:

• Blood flow to the kidneys

• Kidney filtration

• Water balance

• Sodium handling

• Fluid balance

The Respiratory System.

Thyroid hormones influence:

• The body's oxygen requirements

• Respiratory drive

• Respiratory muscles

• The body's response to metabolic demand

The Reproductive System.

Thyroid health can influence:

• Menstrual cycles

• Ovulation

• Fertility

• Pregnancy

• Libido

• Sexual function

• Male reproductive function

Menstrual and Hormonal Health.

Thyroid dysfunction can sometimes be associated with:

• Irregular periods

• Changes in menstrual bleeding

• Changes in ovulation

• Fertility difficulties

• Changes in reproductive function

Pregnancy and Fetal Development.

Thyroid hormones are particularly important for:

• Early fetal development

• Brain development

• Nervous-system development

• Normal growth and maturation

Growth and Development in Children.

Thyroid hormones are essential to:

• Physical growth

• Skeletal development

• Brain development

• Neurologic development

• Normal maturation

This is one reason thyroid health matters throughout the lifespan, not simply in middle age or later adulthood.

Blood.

Thyroid hormones interact with:

• Red blood cell production

• Oxygen utilization

• Blood-cell metabolism

Thyroid dysfunction can also be associated with some forms of anemia.

The Immune System.

The thyroid and immune system have an important relationship.

Autoimmune diseases can directly target the thyroid, including:

• Hashimoto thyroiditis

• Graves disease

Inflammatory and autoimmune processes can also change the appearance of thyroid tissue.

The Eyes.

Thyroid disease, particularly Graves disease, can affect:

• Tissues surrounding the eyes

• Eye movement

• Eyelids

• Tear production

• Eye comfort

• Vision in severe thyroid eye disease

Mental and Emotional Well-Being.

Changes in thyroid function can sometimes be associated with:

• Anxiety

• Nervousness

• Irritability

• Depression

• Changes in mood

• Difficulty concentrating

• Brain fog

• Changes in sleep

• Changes in energy

Weight and Appetite.

Thyroid hormones influence:

• Energy expenditure

• Metabolic rate

• Appetite

• Weight

• How the body uses and stores energy

That Is an Extraordinary Amount of Responsibility for Such a Small Gland.

And that is why we believe looking at the thyroid itself is important.

A thyroid ultrasound allows us to actually see the structure of the gland.

We can evaluate:

• The size of the thyroid

• The shape of the gland

• The appearance of the thyroid tissue

• Enlargement

• Asymmetry

• Cysts

• Solid lesions or tumors

• Calcifications

• Changes in the texture of the thyroid

• Structural changes that may be associated with inflammation

• Other abnormalities that may deserve additional medical evaluation

And none of this requires ionizing radiation.

Bloodwork and Ultrasound Are Not the Same Thing.

This distinction is extremely important.

TSH, T3, T4 and other thyroid laboratory tests provide information about thyroid function.

Ultrasound provides information about thyroid structure.

Someone can have thyroid laboratory results within the expected range and still have a cyst, lesion, tumor or other structural finding within the gland.

Likewise, an abnormal thyroid blood test does not necessarily mean that there will be an abnormality visible on ultrasound.

They answer different questions.

Bloodwork asks: How is the thyroid functioning?

Ultrasound asks: What does the thyroid actually look like?

We believe both kinds of information can matter.

Radiation Exposure Is Part of Why We Think Looking Matters.

The thyroid is particularly sensitive to ionizing radiation, especially during childhood, when the developing thyroid is more vulnerable to radiation-related effects.

And radiation exposure is cumulative.

Throughout a lifetime, people may receive radiation from many different sources.

One source that begins remarkably early for many people is dental imaging. Children may begin receiving dental X-rays at a young age, and depending upon their individual dental needs, some may undergo dental imaging repeatedly over the years.

That raises a question we think is worth asking, particularly when it comes to very young children.

Many of the teeth being X-rayed during early childhood are primary teeth. They are temporary teeth that will eventually fall out and be replaced by permanent teeth.

Of course, temporary does not mean unimportant. There are legitimate reasons to X-ray primary teeth, including concerns about decay, infection, trauma or the development of the permanent teeth underneath them.

But we believe that makes the question of necessity more important, not less.

If a dental X-ray is necessary and will help guide a child's care, there is a reason to take it.

But should ionizing radiation ever be used routinely in a young child simply because taking dental X-rays has become routine?

We don't think radiation exposure at such a young age should ever be automatic.

Every exposure should have a reason.

And when that exposure occurs around the mouth, jaw and neck of a developing child, we think it is worth remembering what else is nearby.

The thyroid.

The mouth, jaw and teeth are anatomically very close to the thyroid.

Ionizing radiation exposure to the head and neck is an established risk factor for thyroid cancer. Research has also reported an association between repeated dental X-ray exposure and thyroid cancer, particularly with historical dental imaging when radiation doses were considerably higher and thyroid protection was less common.

Modern dental X-ray equipment generally delivers substantially lower radiation doses than older equipment, and dental imaging can provide important medical information.

We are not suggesting that people avoid medically or dentally necessary X-rays.

We are asking a different question:

If the thyroid is sensitive to radiation, exposure accumulates over a lifetime, and many of us begin receiving imaging around the head and neck when we are young, why wouldn't we pay attention to the thyroid throughout our lives?

That is part of our philosophy.

Thyroid ultrasound itself uses no ionizing radiation. It uses sound waves to provide a direct structural look at the gland.

What We Have Learned From People Who Never Knew They Had Thyroid Cancer.

There is another reason we believe this conversation is important.

Thyroid cancer can exist without a person knowing it is there.

In one study of 408 consecutive autopsies, researchers carefully examined the thyroid glands and discovered previously unsuspected papillary thyroid carcinoma in 11.3% of the people examined.

These were cancers that had not been recognized during those people's lives.

Other autopsy research has similarly demonstrated that small, previously undetected papillary thyroid cancers are not unusual when thyroid glands are examined very carefully.

That does not mean that 11.3% of the general population is living with dangerous thyroid

cancer. Autopsy prevalence cannot simply be converted into the percentage of living people with clinically significant cancer. Many occult papillary thyroid cancers are extremely small, and some may never grow enough to cause illness during a person's lifetime.

But we believe the finding raises an extraordinary question:

How much do we really know about what is inside our thyroid if we never look?

A person can have a small thyroid cancer without feeling a lump in the neck and without knowing it is there.

For us, that is worth thinking about.

Thyroid Cancer Can Travel Beyond the Thyroid.

Most thyroid cancers do not develop distant metastases.

But thyroid cancer can spread beyond the thyroid.

When differentiated thyroid cancer spreads to distant organs, the lungs are among the most common locations. Because the lungs are within the chest, thyroid cancer can therefore become disease involving the chest even though it originated in the thyroid.

The bones are another important site of distant spread.

Metastatic thyroid cancer has also been documented in less common locations.

And that includes the breast.

What About the Breast?

Thyroid cancer metastasis to the breast is considered rare.

But rare does not mean impossible.

And we find ourselves asking another question:

Could part of the reason we consider it so rare be that we simply aren't looking at the thyroid often enough?

We don't know the answer to that question. But we think it is a question worth asking.

Cases of thyroid cancer metastatic to breast tissue have been documented in the medical literature.

There is also an important distinction that can easily become confusing.

If thyroid cancer cells travel to the breast, the disease does not become breast cancer. It remains metastatic thyroid cancer because the malignant cells originated in the thyroid.

Likewise, breast cancer can metastasize to other organs, including, in rare circumstances, the thyroid.

Determining where a cancer actually originated requires appropriate diagnostic evaluation and, when indicated, tissue sampling and pathology.

We are not suggesting that most breast cancers originate in the thyroid. The evidence does not support that conclusion.

But the fact that thyroid cancer can reach the breast leads us to another question that we believe deserves consideration:

When someone is dealing with breast disease or breast cancer, why shouldn't the thyroid also be part of the conversation?

For us, the larger question is even simpler:

Why wait for another part of the body to give us a reason to wonder about the thyroid?

Why not know what is happening in the thyroid too?

This is part of the reason we encourage people to become interested in their thyroid before there is a problem somewhere else.

The Skin.

The thyroid and the skin have an important relationship.

Thyroid hormones influence skin temperature, moisture, texture, sweating and skin-cell turnover. Changes in thyroid function can sometimes become visible in the skin.

But there is another connection that I find particularly interesting.

Thyroid cancer can spread to the skin.

When thyroid cancer metastasizes to the skin, the cancer doesn't suddenly become skin cancer. It is still thyroid cancer. The malignant cells originated in the thyroid and traveled somewhere else.

That gives us an important lesson before we even start talking about melanoma:

Where we find a cancer isn't necessarily where it began.

And melanoma raises some questions of its own.

Let's Talk About Melanoma.

When we talk about melanoma, we talk a lot about ultraviolet radiation and the sun.

First, something that many people may not realize:

UV is radiation.

Sunlight contains ultraviolet radiation.

But the word radiation covers an enormous spectrum of energy, and not all radiation is the same.

Radio waves are radiation.

Microwaves are radiation.

Visible light is radiation.

Ultraviolet light is radiation.

X-rays are radiation.

Gamma rays are radiation.

That does not make them equivalent.

The UVA and UVB that reach us from the sun are classified as non-ionizing radiation.

X-rays are ionizing radiation.

That distinction matters.

X-ray photons have enough energy to ionize atoms and molecules. UVA and UVB do not damage tissue through that same ionization process. UV can absolutely damage DNA and increase the risk of skin cancer, but it does so through different biological and photochemical mechanisms.

So when we're talking about radiation from the sun and radiation from an X-ray, we are not talking about the same exposure.

And there is something else about the sun that I think deserves to be remembered.

We Need the Sun.

The sun isn't some foreign thing our bodies suddenly encountered.

It is our star.

Life on Earth depends on energy from the sun.

Plants use sunlight for photosynthesis. That energy moves through our food chain. The sun drives fundamental processes that make Earth habitable.

And human biology uses sunlight too.

UVB reaching our skin initiates the production of vitamin D.

Vitamin D is essential for normal calcium and phosphate metabolism and healthy mineralization of our bones. Severe vitamin D deficiency in children can cause rickets.

There was even a time when light itself became medicine.

In 1903, Niels Ryberg Finsen received the Nobel Prize in Physiology or Medicine for demonstrating the therapeutic effects of concentrated light radiation in the treatment of disease.

So the story of sunlight and human health has never been as simple as sun equals bad.

Too much UV exposure can absolutely cause harm.

Sunburn causes damage.

UV can damage DNA.

UV exposure is an established risk factor for melanoma and other skin cancers.

But human beings also need sunlight and the biological processes it supports.

Both things can be true.

And then we get to the part that makes me wonder.

What About the Places the Sun Doesn't Reach?

Melanoma doesn't only occur on sun-exposed skin.

People can develop melanoma on the bottoms of their feet.

Between their toes.

Under their nails.

In genital areas.

On mucosal surfaces.

And yes, even in the butt crack.

Yep. I said it.

Because think about what that means.

If a melanoma develops on a piece of tissue that has essentially never been exposed to sunlight, direct sunlight on that tissue cannot explain why that particular melanoma developed there.

That doesn't mean UV doesn't cause melanoma.

It means UV cannot explain every melanoma.

And medicine already recognizes this complexity. Acral melanomas develop on places such as the soles, palms and nail regions. Mucosal melanomas develop on internal mucosal surfaces where sunlight isn't the conventional explanation at all.

So I think we should be asking a bigger question:

What else causes a melanocyte to become malignant?

Maybe there isn't one answer.

Maybe different melanomas develop through different pathways.

But when something doesn't fit the explanation we are accustomed to hearing, I don't think we should force it to fit.

We should get curious.

And That Brings Me Back to the Thyroid.

Because here is what we already know.

The thyroid influences the skin.

Thyroid disease can change the skin.

Thyroid cancer can spread to the skin.

And a person can have a structural abnormality in the thyroid while thyroid bloodwork remains normal.

In fact, every patient I have personally examined with documented thyroid cancer has had thyroid laboratory values within the normal range.

That is my clinical observation. It isn't a claim that everyone with thyroid cancer has normal thyroid labs.

But it is one of the reasons I keep coming back to the same distinction:

Bloodwork tells us how the thyroid is functioning.

Ultrasound shows us what is actually there.

So when someone has melanoma, particularly a melanoma occurring somewhere that doesn't fit the usual sun-exposure explanation, I find myself wondering:

Did anybody look at their thyroid?

Not just their TSH.

Not just their T3 and T4.

Their actual thyroid.

Because I am not saying that thyroid cancer causes melanoma. We don't have evidence to make that claim, and metastatic thyroid cancer in the skin is not melanoma.

I am asking a different question.

If the thyroid has such an important relationship with the skin, if thyroid cancer can reach the skin, and if some melanomas occur in places where direct sunlight doesn't provide an obvious explanation:

Why wouldn't the thyroid be part of the conversation?

Maybe we would look and find absolutely nothing.

But we won't know what we aren't looking for.

Why Regularly?

Our philosophy at Nussbaumer Health is simple.

We believe there can be value in knowing what your thyroid looks like and observing its structural health over time.

One ultrasound provides a picture of the thyroid at that moment.

When imaging is performed again later, previous imaging can provide something else that can be extremely useful:

comparison.

Has a cyst remained unchanged?

Has a lesion changed in size?

Has its appearance changed?

Has the thyroid tissue changed?

Has the gland become larger?

Is something visible today that was not visible previously?

Those are questions that become possible when previous imaging is available for comparison.

That is why our interest is not limited to looking at the thyroid only after someone develops a symptom.

We believe in getting to know the thyroid.

We believe in paying attention to it.

And we believe there can be value in following its structural health over time.

Why We Believe Thyroid Health Is Part of Overall Health.

Think again about everything connected to thyroid hormones.

The heart.

The brain.

The nervous system.

Metabolism.

Energy.

Body temperature.

Skin.

Hair.

Nails.

Muscles.

Bones.

Joints.

Connective tissues.

Digestion.

The liver.

Cholesterol.

Blood sugar.

The kidneys.

Fluid balance.

The respiratory system.

Menstrual cycles.

Ovulation.

Fertility.

Pregnancy.

Sexual health.

Growth.

Childhood development.

The immune system.

The eyes.

Mood.

Memory.

Concentration.

Sleep.

Weight.

Appetite.

A symptom that appears somewhere else in the body may not immediately make someone think about their thyroid.

That is exactly why we believe thyroid health deserves greater attention.

What Are We Really Asking People to Do?

We are asking people to become curious about their thyroid.

Know what it looks like.

Understand the difference between its function and its structure.

Pay attention to it throughout life.

A thyroid ultrasound cannot tell us everything about thyroid health, and it does not replace thyroid laboratory testing, pathology, medical evaluation or appropriate follow-up.

But it can tell us something incredibly fundamental:

What is actually there.

Is the gland structurally normal?

Is it enlarged?

Is there a cyst?

Is there a solid lesion or tumor?

Are there calcifications?

Are there changes in the thyroid tissue?

Has something changed since the last examination?

Is there something that deserves a closer look?

For such a small gland, the thyroid reaches remarkably far.

It influences systems throughout our bodies. It can contain structural abnormalities without obvious symptoms. Previously unsuspected thyroid cancers have been found in people who never knew they had them. The thyroid is sensitive to ionizing radiation, and radiation exposure accumulates throughout our lives. And although distant spread is uncommon, thyroid cancer can travel beyond the thyroid, including into the chest and, rarely, the breast.

All of that leads us back to one very simple idea:

We think the thyroid is worth looking at.

Not because we assume something is wrong.

Because we believe knowing what is there is an important part of knowing your health.

I think this now captures the whole philosophy rather than making the cancer statistics the reason for screening. The cancer, radiation and breast discussion support the larger idea you started with: this tiny gland affects an enormous amount of the body, so why don't we pay more attention to it?

Fifteen Minutes. $50. A Look at Your Thyroid.

We spend so much of our lives wondering why we are tired, why our hair is changing, why our heart is racing, why our joints hurt, why our weight has changed, why we feel anxious, why we cannot concentrate, or simply why we don't feel like ourselves.

Sometimes there are many possible answers.

We believe the thyroid deserves to be part of the conversation.

A thyroid ultrasound takes approximately 15 minutes, costs $50, uses no ionizing radiation, and gives you something you may never have had before:

A look at your thyroid.

Maybe everything looks completely normal.

Maybe we see a cyst.

Maybe we see inflammation or structural changes.

Maybe we find a solid lesion or tumor that deserves further evaluation.

Whatever we see, you have learned something about a gland that influences systems throughout your entire body.

Fifteen minutes. $50. One small gland.

And information that could change everything.