3 solutions that can improve conversations with your thyroid patients
Are you a doctor with thyroid patients? These tools can help you assess morphology, genetics, and your patients’ daily well-being
Thyroid patients usually experience a multitude of symptoms of varying intensities. Some of them are attributed to thyroid function, while for others there’s more research needed to draw a definitive connection.
Here are three solutions to make your clinical flow easier as a doctor and to facilitate shared decision making towards individualized patient health management.
Using a thyroid ultrasound to assess the state of thyroid health, immune cell infiltration, presence of thyroid nodules, as well as a followup to thyroid cancers.
Ultrasounds can immensely help with diagnoses before any invasive treatment. They’re great for catching early diagnoses, which means the beginning of timely health management.
It’s relatively inexpensive and non-invasive. If used by a well trained individual, it can be very accurate.
Although the ultrasound was initially used by a radiologist or trained sonographer, a trained endocrinologist can perform a diagnostic ultrasound—making it easier for patients to get all steps of their check-ups in one place. By using an ultrasound you will be more likely to detect the cause of an enlarged thyroid.
If you would like to have an ultrasound in your practice and need training, you can find more information and training through these resources:
Radiological Society of North America, the American Institute of Ultrasound in Medicine and Canadian Association of Radiologists (for North America)
The European Federation of Societies for Ultrasound in Medicine and Biology (for Europe)
Royal College of Radiologists, Society of Endocrinology and Royal College of Physicians (for the UK)
2. Genetic and molecular screening
If you want to dig deeper into the genetic causes of your patients’ thyroid problems caused by Hashimoto’s and the risk of co-developing another autoimmune condition, running a test to uncover risk is helpful.
The use of molecular screening in thyroid diagnostics is increasingly used beyond thyroid malignancies, but there are still missing large prospective studies to demonstrate the benefit of wider use of molecular tests in clinical practice.
There are gene, protein, and cellular level analytics that you can use to identify markers specific to a certain disease course or health pathway.
This can enable you to deeply and individually understand your patients, know their prognoses, and decide what treatment option they might benefit from.
Some of these techniques include:
Mass cytometry - using multiple antibodies and measuring their binding to cells (the advantage is using many different antibodies on one single sample)
Protein arrays - this one is specifically good for early detection, since in many autoimmune conditions (including Hashimoto’s) the presence of serum antibodies predates diagnosis and the development of clinical disease. This analysis is equally good for diagnosis and prognosis.
miRNAs - specific miRNA signatures have been described autoimmune diseases, knowing which specific miRNA is activated, can enable you to predict the intensity and the duration of the inflammatory response.
High throughput sequencing of T-cell receptors and immunoglobulins - can help measure V, D, and J rearrangements, junctional properties; the pattern of amino acid usage in the CDR3 region; evidence of receptor editing; heavy-chain isotype usage and hypermutation of rearranged gene segments; and the number of distinct sequences present, which can be used to estimate repertoire diversity.
Genomic analyses - including (I) analysing candidate genes (genes hypothesized to play a role in the genetic susceptibility to autoimmune diseases); (II) whole genome linkage screening (it enables scanning the entire human genome for a disease gene without any prior assumptions on disease pathogenesis); (III) genome-wide association study (GWAS -association analysis is highly sensitive and may detect minor genes contributing to the development of the disease); (IV) whole genome sequencing
Most of the above technologies are not yet a part of a clinical routine practice, but they are used increasingly in collaboration with research.
By using analyses as such, you will have a more comprehensive view of your patients immune system. This should help in choosing the best preventive treatment.
Each test has its strengths and limitations—it’s helpful to take several factors into account when deciding which test to use:
Cost and the benefit of each evaluation - all of these tests are still more costly than a regular blood test, but can give you much more information and determine the course of treatment
Which type of test is the best for your patients
Which test will increase your and patients knowledge of the condition and lead to more successful health management
3. BOOST Thyroid app
You’ll be able to see your patients’ health journeys through their detailed tracking—this will give you further insight into understanding the condition on a case-by-case basis.
The BOOST Thyroid app goes deep into each symptom a patient might experience, allowing patients to:
Log their symptoms on a 5-point intensity scale - patients can select up to 16 symptoms to track
Track medication compliance - as well as have a log of the medication dose, type, and changes
Tracking factors that may influence symptoms - such as lifestyle factors, supplements, diet, exercise, cold, allergies, and menstrual cycle.
Enter their lab tests - patients can have a detailed graphical overview of their thyroid test values
Export symptom tracking data into a simple overview for a doctor report
Receive scientifically vetted information on autoimmune conditions - all texts are written by scientists and medical doctors.
All of this will enable you to develop a comprehensive image of your patients’ health.
Using an app as a tool to extend and improve conversations can have a positive impact on patient care and wellbeing.
If you’re interested in a research collaboration, or to have our product specifically catered to your needs, contact us at firstname.lastname@example.org
Johnstone PA, et al. The use of thyroid ultrasound by non-radiologists for the assessment of the thyroid nodules, 2017
Chang SD, et al. The Changing Landscape of Radiology: Ultrasound Training for Nonradiologists, 2014
Derchi LE. Ultrasound: a strategic issue for radiology, 2019
Hu R, et al. MicroRNA control in the development of systemic autoimmunity, 2013
Qu Z, et al. MicroRNAs in Autoimmune Diseases, 2014
Singh RP, et al. The role of miRNA in inflammation and autoimmunity, 2013
Maecker HT, et al. New tools for classification and monitoring of autoimmune diseases, 2012