Thyroid Health

Patients that visit Advanced Health and Wellbeing, PC are discerning health consumers, and are proactive, interested in participating in their health. They come prepared and knowledgeable regarding their thyroid condition. But, thyroid disease can be very elusive. It is well known that a patient may have had thyroid disease for about 5 years prior to the day of their diagnosis.

Integrative thyroid health incorporates cutting edge medical research and the latest technology with the patient’s detailed medical history and clinical exam. Making a diagnosis of thyroid disease requires full understanding of the patient’s complaints, nutritional state, as well as their gut function and absorption of micronutrients (such as iodine). When addressing thyroid health in an integrative way, it is important to carefully look at other endocrine organs such as the adrenals, the ovaries and the gut. Disturbances in these complementary glands may complicate or exacerbate the thyroid situation.

At Advanced Health and Wellbeing, PC, we use specialized testing of all thyroid parameters available. We regularly test TSH, free T3, free T4, Reverse T3, and antibody testing such as TPO antibodies, Thyroglobulin antibodies, Thyroid Stimulating Immunoglobulin if needed. We also have our state of the art ultrasound department to further evaluate  the size and anatomy of the thyroid gland.

Dr. Margarita Ochoa-Maya, MD, is able and willing to consider a much wider variety of treatment options that include the use of iodine, selenium, among other minerals, and prescription thyroid medicine that can include T4, and T3, or both as commercial prescriptions or compounded medication at the local compounded pharmacy.

Advanced Health and Wellbeing, PC wishes to be a leader in the diagnosis and treatment of thyroid nodules and thyroid cancer. We don’t just do simple thyroid biopsies; we use The Afirma® Thyroid FNA Analysis. We use Veracyte Laboratory, Inc. (www.Veracyte.com) and the Afirma®  test when performing thyroid biopsies. Veracyte is a diagnostics company pioneering the field of molecular cytology to improve patient outcomes and lower healthcare costs. When using Afirma® as part of the work up for thyroid nodules, unnecessary thyroid surgery can be avoided by performing the Gene Expression Classifier (GEC) test that will give 100% certainty if the nodule is benign as part of thyroid nodule assessment. It is a comprehensive solution that employs a 142-gene signature evaluation to preoperatively determine whether thyroid nodules previously classified by cytopathology as indeterminate and can be reclassified as benign for cancer. A study published in the New England Journal of Medicine has demonstrated the validity of this test.

Advanced Health and Wellbeing, PC is proud to provide leadership during this time of healthcare change, and provides traditional values with a contemporary approach to medicine. Dr. Margarita Ochoa-Maya, MD demonstrates the importance of the doctor-patient relationship by embracing healing modalities that go beyond practical care, by motivating patients, providing education and self-awareness, while fully understanding the spiritual dimensions of healing.

What is a Thyroid Ultrasound?

Thyroid UltrasoundAn ultrasound is a painless procedure. It uses sound waves to make images of the inside of your body. A doctor uses an ultrasound to obtain images of a fetus during pregnancy.

A thyroid ultrasound is used to examine the thyroid for abnormalities such as:

  • Cysts
  • Nodules
  • Tumors

Why is thyroid ultrasound performed?

Established indications for thyroid ultrasound include the following:

  1. Goiter  (enlarged thyroid gland)
  2. Thyroid nodule (lump or mass felt in the thyroid gland during a physical examination)
  3. Thyroid incidentaloma (thyroid nodule discovered incidentally during other imaging tests, commonly CT neck, MRI neck, PET scan and carotid ultrasound)
  4. Monitoring size of thyroid nodules
  5. Prior to thyroid cancer resection (preoperative evaluation)
  6. Monitoring for disease recurrence in patients with thyroid cancer
  7. Along with radioactive iodine uptake scans in establishing the diagnosis of Grave’s disease
  8. Management of drug-induced hyperthyroidism
  9. Diagnosis of a neck mass
  10. Guidance of fine needle aspiration biopsy
  11. Drainage and ethanol ablation of thyroid cysts
  12. Hyperparathyroidism

How Can a Thyroid Ultrasound Help with Diagnosis?

An ultrasound can give your doctor a lot of valuable information. It can show:

  • if a growth is fluid-filled or solid
  • the number of growths
  • where the growths are located
  • whether a growth has distinct boundaries
  • blood flow to the growth

Thyroid Nodule Biopsy

Thyroid Nodule BiopsyIf you’ve been diagnosed with one or more thyroid nodules, your healthcare provider will want to make sure it isn’t cancerous. The easiest way to do this is by taking a small sample – called a biopsy – of the nodule’s tissue. This is done with a procedure known as fine needle aspiration, or FNA.

During an FNA, a very thin needle (even smaller than one used to draw blood) is inserted into your thyroid to collect cells from one or more nodules. An FNA biopsy is very precise thanks to the needle being so small and your doctor being able to monitor the location of the nodule and the needle with an ultrasound machine. This simple procedure is quick and usually is no more painful than a pinch. Bleeding is uncommon from the biopsy and most people don’t require any special steps afterward. Some doctors suggest an over-the-counter pain killer and applying ice for people that have discomfort.

This FNA tissue sample is sent to a specialist called a cytopathologist – who is trained at recognizing diseases by examining cells under a microscope. The cytopathologist’s goal is to determine if the nodule is likely benign (not cancer) or malignant (cancer). However, sometimes the diagnosis is “indeterminate” – the cytopathologist cannot tell if the nodule’s cells are benign or malignant.

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