如果你问很多医生，他们会告诉你，“甲状腺疾病很容易诊断和容易治疗。”名人赞助的药品广告提示，以“一丸，一日”是一个放之四海而皆准的解决办法来对待你的甲状腺。事实是，有时，甲状腺疾病可以很容易地诊断并与丸，一日处理，但对许多人来说，现实是更具挑战性。无论您是初诊还是你已经有好几年甲状腺条件，要知道，在恢复健康的关键基础，是对你的甲状腺健康的积极倡导者是很重要的。
什么是倡导你的甲状腺健康的样子在实践中？让我们探索的基础知识。
了解你的病情
You may be tempted to trust that your practitioner knows best, and accept a diagnosis, test result, or prescription without researching on your own, or asking questions. After all, your practitioner is the one with a medical education; they should know what’s best for you. This can be a mistake with thyroid conditions.
您需要首先确保你知道你的具体诊断和你的甲状腺状况的细节。例如，如果你是甲减，是它被称为桥本氏甲状腺炎的自身免疫性疾病的结果？如果你有甲状腺癌，你需要知道甲状腺癌的类型，分期。是你的甲状腺肿大是由于桥本氏，Graves’病，或甲状腺结节？
一旦你的具体情况，你的下一个步骤是阅读和学习。您可以通过探索可靠来源网上，看书，并与其他病人交流信息和经验连接扩展知识。
了解你的治疗方案
在你作出治疗决定之前,你绝对的ly need to research the options.
For example, when exploring treatment options for hypothyroidism, conventional physicians may offer only levothyroxine (synthetic T4) treatment, prescribing a drug such as Synthroid, Levoxyl, orTirosint。有，但是，另外两个关键的治疗方案可供选择：
- 左甲状腺素加上加T3 drug像三碘甲状腺氨酸（商品名：Cytomel）
- Natural desiccated thyroid drugs (NDT), like Nature-throid or Armour Thyroid, which contain both T4 and T3 hormones
有迹象表明人们对甲状腺功能减退症治疗的一个子集有他们的症状更好的分辨率与包括T4和T3治疗研究。
When it comes to treatment options for Graves’ disease and hyperthyroidism, conventional doctors may push you to accept radioactive iodine (RAI) ablation treatment — which involves taking a liquid or pill form of radioactive iodine that destroys your thyroid, and leaves you permanently hypothyroid. There are, however, other options, including:
- 抗甲状腺药物，如他巴唑或PTU，有时可以把你带入缓解
- 手术,能迅速缓解症状,which allow women of child-bearing age to avoid the one-year waiting period after RAI that is recommended before getting pregnant
Another important example is with thyroid nodules. Only a small percentage of nodules are cancerous, but when you have a suspicious nodule, your doctor will typically order a fine needle aspiration (FNA) biopsy for diagnosis. Until recently, if yours was malignant, or the results were inconclusive — considered “indeterminate” — your next step would automatically be a thyroidectomy to surgically remove your entire thyroid gland. Unfortunately, many of the indeterminate nodules were, after surgery, found to be benign, but those patients were left hypothyroid for life and dependent on thyroid hormone replacement drugs. A test called theAfirma Thyroid Analysis testcan make FNA results conclusive in almost all cases, and eliminate most unnecessary surgery. Many patients with indeterminate but ultimately benign nodules still end up having needless surgery, however, because their doctors don’t know about the Afirma test.
Review and understand your lab tests
当甲状腺状况被怀疑，是很常见的一个医生只测试你的促甲状腺激素（TSH）水平。如果你的结果是在参考范围内，有时也被称为“正常范围”，你可能会得到一个电话或明信片说：“你的甲状腺是正常的。”这是没有足够的信息。你需要知道的实际数量和实验室的TSH参考范围，因为有争论的关于此范围和代表甲状腺疾病的水平很大。例如，一些医生认为超过3.0 MIU / L的水平 - 仍在基准范围内 - 为边界线或亚临床甲状腺功能减退的证据。另一些人认为你的TSH水平必须高于10.0 MIU / L，一个水平，许多患者有显著症状，您的治疗开始前。
You should also know about the free T4 and free T3 tests, which evaluate your actual circulating thyroid hormone levels. Increasingly, integrative and holistic physicians look at the results of these tests in making a diagnosis. Some doctors consider levels at both ends of the reference range to be evidence of borderline thyroid conditions and warranting treatment.
You also need to know about thyroid antibodies tests, mainly the thyroid peroxidase (TPO) antibodies test, and the thyroid stimulating immunoglobulin (TSI) test. The TPO test can identify antibodies found in autoimmune Hashimoto’s disease, the main cause of hypothyroidism in the United States. The TSI test detects antibodies that are common in autoimmune Graves’ disease. Some physicians believe that when the TSH, free T4, and Free T3 are normal, and especially when you have thyroid symptoms, you may warrant treatment.
之前要特别注意，期间和怀孕后
When you are planning to conceive, are pregnant, or have just had a baby, you need to pay extra attention to advocating for yourself. There are a number of challenges that thyroid issues pose for fertility, pregnancy, and the postpartum period.
- If you are undergoing生育检查或治疗，甲状腺评价莫名其妙地不被许多诊所和从业人员，会影响你的怀孕能力时甲状腺功能和自身已知因素包括在内。
- According to推荐和公认的准则，最佳的生育能力，并防止早期流产，专家建议您的TSH水平是在怀孕前小于2.0 MIU / L，并在第一孕期。
- You need to supplement with iodine之前，期间和怀孕后，以帮助支持你的甲状腺功能。许多医生，但未能作出这一建议，许多产前维生素，包括处方药配方，不包括碘。
- If you are already on thyroid hormone replacement medication for hypothyroidism, you need to have a plan in place with your doctor to increase your dosage as soon as you confirm your pregnancy.
- 怀孕后，甲状腺失衡可以促进或引起问题，母乳喂养，以及产后抑郁症。
Don’t assume your doctors will know this critical information. Research has shown that the majority of obstetricians are not up to date on managing thyroid disease during pregnancy, or following the latest guidelines. And many endocrinologists are not informed about managing pregnancy in their thyroid patients. It may be up to you to maximize your chance at a successful pregnancy and healthy baby.
Partner with the right practitioner
最后，当它涉及到的从业者，请确保您使用的通知，积极健康的专业合作。如果你的医生拒绝谈论诊断和治疗方案，仅仅着眼于你的测试结果，或不考虑解决您的症状的主要目标，那么它的时间去寻找另一个医生。Keep in mind that while endocrinologists — considered specialists in thyroid disease — are important for hyperthyroidism, thyroid nodules, and thyroid cancer diagnosis and treatment — you may find that the diagnosis and treatment of your Hashimoto’s disease and hypothyroidism would be better managed by a nurse practitioner, physician’s assistant, naturopathic physician, or doctor specializing in hormonal balance.