Thyroid Associates

Overview

A Comprehensive Patient Experience

Thyroid Associates physicians, part of the Massachusetts General Hospital Endocrine Unit, have extensive experience and expertise in diagnosing all aspects of thyroid disease. Consequently, the diagnosis and therapy of thyroid disorders are achieved in the most accurate and efficient manner.  When appropriate, we collaborate with other Mass General physicians. In conjunction with your referring physician, we will establish an individualized care plan, designed to minimize the number of visits needed to complete your diagnostic and therapeutic program.

Leaders in Thyroid Treatment

At Massachusetts General Hospital Thyroid Associates, we care for patients with thyroid problems, including:

• Hyperthyroidism (overactive thyroid)
• Thyroid nodules and goiters (enlarged thyroid)
• Typical and advanced thyroid cancer
• Disorders of thyroid function during pregnancy, including hyperthyroidism, hypothyroidism (underactive thyroid), thyroid nodules and thyroid cancer

Specialists at Thyroid Associates are experienced in using ultrasound equipment and ultrasound-guided biopsies to diagnose thyroid problems. We also conduct testing to evaluate patients with genetic conditions that may lead to benign and malignant thyroid tumors.

In addition to treating patients, our thyroid physicians regularly conduct basic and clinical research. When appropriate, patients are encouraged to enroll in clinical trials, which often provide leading-edge treatment for advanced thyroid disease. Our clinical trials in thyroid cancer are under the direction of Lori Wirth, MD, of the Center for Endocrine Tumors at the Mass General Cancer Center.

Our physicians are also members of the Center for Endocrine Tumors. This comprehensive, multidisciplinary program specializes in treating benign (noncancerous) and malignant (cancerous) endocrine tumors.

The Mass General Endocrine Surgery Program has great expertise and experience in thyroid surgery and performs more thyroid surgery than any other hospital in New England and is among the national leaders in thyroid surgery.

A History of Leadership

• The first thyroid unit in the United States was founded at Mass General in 1913
• Radioactive iodine was first evaluated and used in the Mass General Thyroid Unit in the late 1930s and early 1940s and remains one of the standard therapies for hyperthyroidism and thyroid cancer
• Our unit pioneered the development of thyroid biopsies in the 1950s
• Thyroid Associates is currently staffed by five thyroid specialists who are internationally known for their expertise in researching, diagnosing and treating thyroid conditions. Gilbert H. Daniels, MD and Douglas S. Ross, MD are co-directors of Thyroid Associates

As part of a world-class academic medical center, the Mass General Thyroid Unit and Thyroid Associates are committed to training the next generation of doctors and scientists. Dozens of the world's foremost thyroid specialists have trained in the Thyroid Unit over the past four decades. The Thyroid Unit also participates in the Mass General Endocrinology Fellowship Program, in which clinical fellows are trained by senior thyroid physicians. Our thyroid physicians also teach in the annual Mass General Endocrine Post-Graduate course and lecture on thyroid disease at the local, national and international level.

What to Expect

Your Thyroid Associates physician manages all aspects of your care and coordinates with surgeons and other colleagues at Mass General for specialized services. For example, we work in close collaboration with ophthalmologists to treat the eye problems of patients with Graves’ disease, an autoimmune disorder that is the most common form of hyperthyroidism.

Prior to your first visit, we ask that you or your referring physician send us all information relevant to your thyroid condition, such as medical records, medication list and any previous test results. If radiology studies have been performed, we would like a CD of those studies to review. If a biopsy or surgery has been performed, we would like to review the actual slides. Having this information before your first visit allows us to use your appointment time more efficiently. If we do not have radiology studies or pathology slides at the time of your appointment, we might ask for them with your permission.

Conditions & Diseases

Hyperthyroidism (Overactive Thyroid)

The key to treating hyperthyroidism is identifying the type of overactive thyroid that is present. Your thyroid physician will make the appropriate diagnosis based on a medical history, physical examination, blood tests and, in many cases, imaging tests such as radioiodine thyroid scans and thyroid ultrasound examinations. The radioiodine scans are performed in our unit.

While some types of hyperthyroidism disappear without therapy, most types require treatment. The most common treatments include:

• Oral medication, which prevents the thyroid from producing too much hormone
• Radioactive iodine therapy, an oral therapy that gradually destroys the overactive portion of the thyroid

Surgery to remove the thyroid or the overactive portion of the thyroid is the least common treatment.

Thyroid Nodules and Goiters

Thyroid nodules are very common. At your first visit, your thyroid physician will likely perform an ultrasound-guided fine needle aspiration biopsy to determine if the nodules are benign (non-cancerous). If a biopsy has already been performed, we will have the slides reviewed by Mass General cytologists. Your thyroid physician may also recommend blood tests, thyroid ultrasounds, radionuclide scans or other diagnostic imaging procedures.

Most thyroid nodules are benign and simply require careful follow-up. Some nodules are indeterminate and may require surgery for a definitive diagnosis. For malignant nodules, please see our approach to treating thyroid cancer below. A goiter is an enlarged thyroid and often consists of multiple nodules. Goiters are generally evaluated the same way as thyroid nodules. Some large goiters require surgery.

View frequently asked questions about thyroid nodules and goiters

Thyroid Cancer

Our physicians have extensive experience and great expertise in diagnosing and treating thyroid cancer. We offer the latest diagnostic and therapeutic options, including molecular testing. We have expertise and extensive experience in managing both typical and advanced forms of thyroid cancer.

If you are a patient with thyroid cancer, your thyroid physician will manage your care in close collaboration with Mass General’s thyroid surgeons, endocrine pathologists, radiologists with expertise in thyroid disorders, endocrine oncologists and radiation oncologists. Your multidisciplinary team is able to offer the latest diagnostic advances and treatment options including surgery, radioactive iodine therapy, external beam radiation, radiofrequency ablation, targeted chemotherapy and innovative clinical trials.

All of our thyroid physicians are part of the multidisciplinary Center for Endocrine Tumors, a subdivision of the Mass General Cancer Center. In some patients with advanced thyroid cancer, endocrine oncologists share in patient management. Treatment for most forms of thyroid cancer begins with surgery. Radioactive iodine therapy may be necessary to destroy remaining thyroid tissue. We administer radioactive iodine in our unit.

Thyroid Disorders and Pregnancy

If you experience a thyroid condition during pregnancy, our thyroid physicians will work with you and your obstetrician to diagnose the problem and develop the best treatment for you and your child.

• Hyperthyroidism: Options during pregnancy include observation, medication or surgery (the least common option). The choice depends on the cause and severity of the overactive thyroid
• Hypothyroidism (underactive thyroid): It is typically treated with an oral thyroid hormone
• Thyroid nodules: Treatment options include observation as well as further assessment with a fine needle aspiration biopsy
• Thyroid cancer: It may be observed, treated with thyroid hormone, or treated surgically. It is infrequently diagnosed during pregnancy

More Conditions & Diseases

• Hashimotos Thyroiditis
  
  • Thyroiditis is the inflammation of the thyroid gland. Hashimoto's thyroiditis is the most common form of thyroiditis.
• Hypothyroidism
  
  • Hypothyroidism is the condition in which the thyroid is underactive (i.e., it is producing an insufficient amount of thyroid hormones).
• Thyroid Disorders in Women
  
  • The thyroid gland, which plays an important role in the body's metabolism, secretes several hormones: thyroxine (T4), triiodothyronine (T3), and calcitonin.
• Thyroid Tumors
  
  • Thyroid tumors are either benign (noncancerous) or malignant (cancerous) growths.