All posts by Alexander Salerno, MD

About Alexander Salerno, MD

Salerno Medical Associates medical practice & founder of Urban Healthcare Initiative Program (UHIP) and Community Healthcare Outreach Program (CHOP) SalernoMedical.com UHIPNJ.org CHOPHealth.com

Viruses Carried by Ticks and Mosquitoes and Their Consequences

Mosquitoes and ticks have been a pesky problem for a long time, but the alarming news reports that diseases caused because of them have tripled from 2004 to 2016 in the US alone have highlighted the menace caused by them. This further indicates that it is time to deal with the issue head-on after gaining the requisite information.

Mosquitoes, ticks, and fleas spread diseases by being the carriers of various viruses. Infected ticks and mosquitoes bite various individuals, thus acting as vectors and spreading diseases. A steady rise has been seen in the number of cases of diseases caused by the viruses the mosquitoes and ticks carry owing to the increase in the number of ticks and mosquitoes as well as because they have now spread to a wider geographical area, thus infecting a greater number of people.

Types of viruses and diseases caused by the carrier mosquitoes and ticks
Viruses being carried by ticks and mosquitoes give rise to diseases, such as chikungunya, yellow fever, dengue, etc.

Chikungunya is caused by the Alphavirus and is transmitted to humans via the Aedes genus mosquito. This disease can often be confused with other diseases, and though its progression is favorable, in certain cases it can result in the death of patients. The best way to prevent this disease is to avoid being bitten by mosquitoes, since a vaccine is not yet available for the disease.

Dengue is caused by the Flavivirus and is transmitted by the mosquitoes of the Aedes genus, which usually breed in stagnant waters close to various habitations. The disease has recently seen a resurgence, as it has spread to a large part of the world.

Japanese encephalitis is another disease caused by the Flavivirus and transmitted via mosquitoes of the Culex genus. This disease is endemic in rural areas with rice fields and irrigation regions.

West Nile disease, also caused by Flavivirus, is spread via the Culex genus mosquito that thrives around birds.

Yellow fever is caused by yellow fever virus (part of the Flavivirus family) and is transmitted via Aedes genus mosquitoes.

Ticks cause diseases, such as Lyme, meningoencephalitis, and tick-borne relapsing and spotted fevers, most of which are due to various bacteria strains.

Measures to prevent the diseases caused by virus-carrying mosquitoes and ticks
Public health authorities can undertake serious health programs by listing the diseases caused in the area by the viruses and the mosquitoes and ticks that transmit them; undertaking vector control and prevention activities by developing a team; and educating the residents about the same. As citizens, individuals can also make use of repellents to deal with mosquitoes. They can wear covered, long-sleeved clothing as a form of prevention, and also avoid as well as treat ticks that might trouble their pets and which can spread in the house. They must also take care of the home and its surroundings to prevent infestation of mosquitoes and ticks. Items such as boots, pants, tents, and socks can also become infected, and must be treated by using permethrin.

Safety measures and knowledge regarding the diseases caused by viruses and carried by ticks and mosquitoes can help curb the rise in the number of cases.

What Is Cannabis and Why Is Cannabis Usage Termed as Abuse?

Marijuana, which is the popular term for cannabis, is a form of drug that comes from the plant cannabis sativa or the hemp plant. A drug is a substance that, when ingested, causes an alteration in the functioning of the body, either a physical change or a psychological change. Some of these drugs are legal whereas many are illegal. Cannabis is one such drug that is illegal in most parts of the world. Cannabis is often referred to as weed, pot, or hash and is ingested via a smoke or can be mixed into a drink. It can also be baked into foods and thus eaten. The effects after taking the drug are feelings of excitement, happiness, and a general high, and these are usually felt right after ingesting the drug and last up to 3 to 4 hours, depending on how the drug was consumed, that is—either eaten or smoked.

Drug use is often under scrutiny and illegal as well because of the ill effects that it has on the body. Usage of drugs over a period of time has short-term as well as long-term effects on the body. The effects might vary depending on the person’s age, health, fitness, gender, diet, mood, and physical size. It also depends on the kind of drug ingested and its quantity as well as purity.

The effects may include aggressiveness, anger, depression, feelings of being unmotivated, sleepiness, anxiousness, talkativeness, and feelings of paranoia. Emotional and social effects that negatively impact one’s relationship with family and friends are also often observed.

What is cannabis abuse?
The excess use or consumption of cannabis is termed as abuse.

Drug abuse is so termed because it is a patterned use of the substance by the user beyond normal levels, and this excessive usage can have a harmful impact on the user as well as on others. Cannabis abuse is often referred to as a pattern that causes a number of problems, both physical and mental. Often, users get into arguments with family and friends regarding their usage and can feel helpless if they are not experiencing the “high” after using the drug, which is a form of abuse.

What are the effects of cannabis on the body?
Marijuana abuse can affect work or even daily activities, such that one is unable to drive or take care of children, concentrate on work, or one must take leave from work entirely. Driving a vehicle under the influence of cannabis is dangerous for the driver and passengers as well as for those around the vehicle.

The medical effects on the body from cannabis abuse include increased risk of blood vessel disorder and heart disease. One’s immunity is also affected, making the body susceptible to infections and illnesses. The long-term use of cannabis can even increase the risk of developing cancer of the throat and lungs.

Mental illnesses are also more likely, because individuals tend to lose their judgment due to high usage of the drug and can develop schizophrenia, depression, psychosis, bipolar disorder, and anxiety. Also, chances of injuries increase due to a decrease in judgment.

Facts and Fiction Surrounding Cannabis and Its Use

Cannabis or marijuana is a popular drug, not just among those who use it, but also among those who do not use the drug, thanks to the misinformation surrounding the drug and the lack of clarity distinguishing fact from fiction. It would help to clear up the misconceptions regarding some myths and get clarity on the facts about cannabis.

Some myths surrounding cannabis and the facts:

Myth: Cannabis use can kill brain cells
There is a false notion that cannabis abuse can lead to the destruction of brain cells. However, research conducted by the University of Louisville has found that marijuana does not kill brain cells and a similar study published in the Journal of the International Neuropsychological Society in the year 2003 backs the research.

Myth: Use of marijuana leads to cancer
This statement is not clearly in the true or false category because the smoke of marijuana has been found to contain carcinogens, similar to those found in tobacco smoke. But the extent of harm done by smoking tobacco-laden cigarettes is much higher compared to the harm caused by the ingestion of weed, a popular name for cannabis. It has been found that more than marijuana, it is the act of smoking that is a risk factor with higher chances of leading to cancer.

Myth: Eating of weed in the raw form can give a “high”
Eating raw marijuana is like consuming stems that have no effect and definitely do not make one “high.” The effect of marijuana is felt when it is orally consumed after it has been heated and combined with a substance that has fatty substances, such as butter.

Myth: It is easier to quit smoking cannabis
Those who smoke pot (cannabis) casually and once in a while can quit it easily, but heavy smokers will find that marijuana is extremely addictive and very difficult to quit, requiring all the will power one can muster. Quitting becomes even more difficult due to withdrawal symptoms, such as loss of appetite, insomnia, and irritability. These symptoms are more severe for other drugs, but still make quitting pot difficult for users.

Myth: Marijuana can impact the memory
Cannabis use has been found to have no impact on the long-term memory of users or on existing memories. In fact, marijuana is found not to be linked with dementia, but it can cause short-term memory loss to some extent.

Myth: Marijuana can help improve focus
It is quite the opposite, as heavy use of marijuana can lead to impaired thinking and affect the attention span too, and the symptoms might be drastic in case of abuse or withdrawal.

Myth: Marijuana use is completely harmless (considering it has been given medicinal title in some places)
This is far from the truth because heavy use of marijuana is quite harmful. Those smoking marijuana are at risk of developing respiratory illnesses and bronchitis, which are usually seen in those smoking tobacco. Also, driving under the influence of weed is extremely dangerous.

What Are the Benefits of Marijuana, including Medical and Health Benefits?

The image of marijuana ingrained in the minds of many people is that it leads to addiction and its users are unemployed individuals who are always red-eyed and on the verge of turning into psychopaths. This image might exist thanks to several movies and commercial media materials which showcase marijuana users as psychopaths, but the truth is that marijuana is not that bad.

In fact, medical marijuana is a hot topic of discussion (though controversial and debatable), and studies and research have revealed that marijuana has quite a few medical benefits and is not so detrimental after all. Several states in the United States have lifted the ban on marijuana and made it legal, especially for medical purposes. (When cannabis is used for medical purposes it is termed as prescription marijuana).

Benefits of marijuana, including medical purposes:

Medical marijuana provides relief from pain
A lot of medical conditions cause pain, irrespective of the organ that has been affected. Chronic pain, apart from being uncomfortable and at times severe, can also interfere with daily activities such as physical movements, mobility, moods, emotions, and even job opportunities and leisure activities.

Cannabis is known to possess pain-killing properties, thanks to the cannabinoids present in them that connect with the brain and help to relieve the pain.

Cannabis helps treat mood disorders and anxiety
We know that physical pain can be relieved through cannabis, but emotional pain in the form of conditions such as depression, anxiety, insomnia, post-traumatic stress disorder, etc., can also take a toll on the well-being of individuals, straining relationships and affecting performance at work. Cannabis has been found to work well on patients with mood disorders, especially those currently taking psychiatric medications. Prescription cannabis is also known to have close to zero negative side effects and is thus highly recommended for serious emotional health conditions.

Cancer cells have been found to be killed by cannabis
The U.S. government’s website has admitted (in a bid to rationalize the legalization of cannabis) that marijuana has been found to shrink cancer cells. However, this result has mostly been seen in rodents, and further studies are needed for it to be used in humans as well.

Lung function is improved with marijuana
As compared to the lungs of a chain smoker, the lung function of those smoking marijuana is significantly improved. In fact, lung function is even better than that of non-smokers, and researchers believe that cannabis might be having an effect on the lungs, thus “training” them to work more efficiently.

Cannabis improves creativity
Creativity has been found to increase in those using marijuana, especially in terms of the use of language. Verbal fluency was significantly improved in those with high creativity as well as those with comparatively lower creativity.

Performance of athletes is improved by cannabis
A study shows that some athletes have revealed that marijuana use has been found to improve their performance, quicken recovery, and help fight soreness, too, especially after workouts.

These are some of the benefits of prescription marijuana.

Dr. Alexander G. Salerno

The Economic Benefits of Legalizing Cannabis Usage

Cannabis is a drug obtained from the cannabis plant that is considered to be a psychoactive drug, and until recently cannabis was only considered to have recreational use. However, cannabis, also known as weed or marijuana, has been found to have various benefits, especially of a medical nature, thus aiding in removing some of the stigma associated with it. Cannabis was illegal in a number of states in the United States of America, but that too is changing as the benefits of medical marijuana are being highlighted.

Benefits of marijuana including medical purposes
Before listing the economic benefits of legalizing marijuana, first its benefits in terms of medical purposes must be noted. Marijuana is known to cure all kinds of chronic pain including those associated with certain illnesses. Cannabis is even being researched further as it has been shown to kill cancer cells, and this use can be tapped further for tremendous benefits. The lung function is also said to improve after smoking pot, and it has been found to improve mood as well. Glaucoma and spasms have also been treated with marijuana. In the case of seizures, medical marijuana use has been found to reduce their intensity or to control them altogether; a reduction in overall symptoms has also been noted.

Economic benefits of legalizing marijuana
Legalizing marijuana means that it would be legally allowed for adults who are 21 years of age and older.

Contrary to the belief that legalizing marijuana would lead to an increase in the rates of unemployment and homelessness or a greater number of youth using marijuana or becoming addicted to it, marijuana legalization would in fact actually help the economy. States such as California, Colorado, and Washington have legalized the use of recreational as well as medicinal marijuana, and these measures have caused a drastic improvement in their economy even as other states are still contemplating the issue.

Legalizing cannabis production would give rise to a lot of employment opportunities, even for individuals who grow the crop over several acres and cultivate it. There is the cost of cultivation involved as well as the cost involved in legalizing cannabis, such as law enforcement and various social services, but still the net profit is comparatively higher. The steady rise in income for the state upon legalizing marijuana shows that apart from helping the economy, surplus funds can be used for various other sectors, such as education, rehabilitation facilities, better health care, and scholarships for deserving students, to name a few.

Legalizing thus seems to be beneficial, but there are a few things that need to be kept in mind which include:

  • The laws must be clear, thoroughly researched, and spelled out for all citizens.
  • The enforcement of the law must also be done strictly in order to curb illegal growing or use of cannabis.
  • The laws must be very clear and stable so as to keep law enforcement officers from getting confused or having to keep updating themselves on ever-changing laws, rules, and regulations.

Dr. Alexander G. Salerno

Comparison of the Side Effects, Benefits, and Pros and Cons of Cannabis with Those of Alcohol and Tobacco

Cannabis usage, especially for recreational purposes, is still under a lot of scrutiny, as many consider it the worst kind of abuse, with drastic effects on the body. In fact, cannabis is known to be the most commonly abused illegal substance in the whole world. It is still considered an illegal drug in many parts of the world. However, marijuana, as cannabis is popularly known, has several medicinal benefits as well, apart from its use as a recreational drug. It is effective for the treatment of chronic pain, glaucoma, seizures, and lung function and is even believed to kill cancer cells.

The myth that marijuana consumption is worse than drinking alcohol or smoking tobacco has not been completely researched, and the truth is in fact just the opposite.

Alcohol is more addictive than marijuana
There have been no instances reported of overdose due to marijuana consumption, the only complaints being of constipation and lethargy, indicating that cannabis is the least toxic of all drugs. But the same cannot be said about alcohol, with a rising number of deaths being reported due to excessive alcohol consumption. Anyone who consumes ten times the regular dose of alcohol runs the risk of dying sooner.

Cannabis has cell protective properties that alcohol does not
Contrary to the belief that marijuana can lead to the death of brain cells, studies have revealed that marijuana has neuroprotective properties, thus showing less brain damage than that done by alcohol consumption. Fewer signs of damage to the white blood cells are observed in teenagers who used weed along with alcohol than with those who consumed alcohol alone.

Depression is commonly seen in alcoholics
Those who consume alcohol are susceptible to becoming patients of clinical depression. Avid drinkers are in fact most likely to be victims of dementia and psychosis and are also more at risk of harming themselves or even committing suicide, especially regular drinkers.

Side effects with alcohol users are commonly seen
There are no hangovers with marijuana or any hangover symptoms or headaches the next morning. Side effects and hangovers are the norm with regular alcohol drinkers. Bar brawls, drunken driving, and violent behavior are some common negative behaviors seen in regular drinkers.

Smoking causes more harm than weed
Smoking tobacco has a negative impact on the lungs and is considered to be 140 times more harmful than marijuana.

Summing up
Alcohol and smoking have a number of deleterious effects in comparison to marijuana. In fact, marijuana has certain medical benefits as well. Also, marijuana seldom causes addiction or overdose or leads to side effects. But still marijuana is considered illegal while alcohol is considered an integral part of many societies and there are no strict laws against smoking either. It is time to rethink and re-evaluate the harms caused by alcohol and smoking and restructure the existing laws.

By: Dr. Alexander G. Salerno

What Are the Pros and Cons of Chronic Care Management?

It is a growing cause for concern that the number of patients suffering from chronic ailments is steadily rising, along with an increased prevalence of patients suffering from chronic conditions, and sometimes even multiple chronic diseases. This scenario is not limited to developing countries; in fact, developed countries are also facing this situation and are equally concerned about a plan of healthcare and management for those suffering from chronic conditions.

Need for a disease management program
From a worldwide as well as a country-specific perspective, physicians and specialists have seen the need to have a chronic care management program in place to provide proper and systemic treatment to chronic condition sufferers. In fact, disease management is termed as the “system of coordinated healthcare interventions and communication for conditions where the patient self-care efforts are an integral part of the treatment.”

A disease management program must have –

  • A process to identify the population
  • Practice guidelines that are based on evidence
  • Practice models that are collaborative and include support service providers along with physicians
  • Education for the patient about self-management
  • A program process and outcome that can easily be measured, evaluated, and managed
  • Presence of a feedback loop and routine reporting

These are the standards on the basis of which the chronic care management or CMS program was based.

There has also been a disease management program put in place, the validity of which has led to chronic care management, which has been conceived by taking into account clinical findings, peer reviews, and literature.

Pros and cons of chronic care management
Such a program, like most others, has its share of advantages and disadvantages.

The pros include –

  • The program will be systematic and streamlined and will be the same for chronic condition sufferers, whether of one condition or more, in any location.
  • The program has a proper division of labor in terms of responsibility, which includes a team rather than a one-on-one approach.
  • The CMS is helpful for specialists too, as they can see a greater number of patients in an organized fashion and reach out to more patients overall.
  • Caregivers and other staff also benefit, apart from the specialists, because this program is a collaborative one in which everyone, not just the specialist, has an inclusive role to play.
  • Patients can also learn self-management, which is useful for them.

The cons of the chronic care management program from the doctors’ as well as patients’ perspective are as follows –

  • The program and plan is for chronic conditions only and is a CCM plan and not a disease management (DM) program, which can be inclusive of other conditions.
  • There is a lack of proper guidelines, and clear instructions have not yet been instituted.
  • The consent form is a bone of contention, as without the proper rules and instructions in place, doctors (specialists and others) are hesitant to sign up for the management program.
  • Patients are also not happy about paying a small contribution out of the total that goes towards the chronic care management fund for the treatment of each patient.

These are just the basic pros and cons of the CCM plan, which is still under consideration.

By: Dr. Alexander G. Salerno

Small Intestine Bacterial Overgrowth (SIBO) vs. Irritable Bowel Syndrome (IBS)

There is usually a low quantity of bacteria present in our guts that helps the body with digestion. However, when this amount of bacteria becomes excessive within the small intestine, it is called small intestine bacterial overgrowth or SIBO. This is often caused by a digestive illness or anatomical abnormality, which further leads to malnutrition as the bacteria uses up the nutrients of the body.

Irritable bowel syndrome, often referred to as IBS or spastic colon, is a condition in which trouble with bowel habits is experienced, where either the kind of stool is different or the patient goes either more often or less than normal. And this is accompanied by abdominal pain or discomfort in the belly.

Recently, it has been suggested that SIBO can lead to IBS. Before examining the connection, it is best to understand the symptoms, diagnosis, and treatment for each of the diseases.

SIBO
The symptoms of SIBO include abdominal pain, especially after consuming food, bloating, diarrhea, indigestion, constipation, cramps, gas, and a feeling of fullness. The cause of SIBO could be anatomic abnormalities in the small bowel, pH changes, small intestine muscular action malfunction, or malfunction of the immune system. Those suffering from chronic conditions, such as Crohn’s disease, hypothyroidism, Parkinson’s, diabetes, HIV, etc., or those who have undergone GI tract surgery, are also prone to SIBO. The diagnosis of SIBO is done via a physical examination of the abdomen and by a breath test since the excess bacteria release hydrogen and methane gases. A sample study of the small intestine is also done for further testing. Treatment of SIBO includes antibiotics, such as rifaximin, metronidazole, and ciprofloxacin, along with diet changes which include a balanced diet, smaller portions at frequent intervals, avoiding gluten if suffering from celiac disease, an elemental diet, or even including probiotics.

IBS
IBS is a chronic condition that needs to be managed over a longer period of time that affects the large intestine. The symptoms include excessive gas, abdominal bloating, cramps and pain (which is relieved after passing stool), constipation or diarrhea, and mucus in stools. It is a cause for concern when there is weight loss, rectal bleeding, unexplained vomiting, and diarrhea at night, difficulty in swallowing, anemia, and persistent pain. IBS can be caused by muscle contractions of the intestines being too strong or weak, inflammation in the intestine, abnormalities of the nervous system sending poorly coordinated signals to the intestine and muscles, infection or inflammation of the intestines, or also possibly changes in the gut bacteria. Stress, food, and hormones often act as triggers for IBS; women under 50 who have a family history of IBS or a mental health problem are at greater risk. To diagnose the disease, after the first basic checkup is done to rule out other diseases, tests such as colonoscopy, flexible sigmoidoscopy, CT scan or X-ray, upper endoscopy, breath test, and lactose intolerance test or stool test are carried out. As part of treatment, gluten-high, FODMAPS, and high gas food must be avoided.

SIBO and IBS
Because the symptoms of both the diseases are similar, researchers have found that SIBO could be an underlying cause of IBS. Also, antibiotic treatment for SIBO worked for IBS as well, thus suggesting a connection between the two.

Dr. Alexander G. Salerno

Pelvic Inflammatory Disease

Pelvic pain and pelvic diseases can often take longer to diagnose and the pain is usually chronic, experienced over a period of six months or longer. Women are found to suffer more often from pelvic disorders; one such disease is pelvic inflammatory disease, commonly referred to as PID. Mainly females are prone to this reproductive organ infection. When bacteria (sexually transmitted) spreads to the fallopian tubes, ovaries, and uterus from the vagina, the disease occurs. The disease can often go undetected because it does not have any immediate signs as such, thus delaying the treatment.

Causes of PID and risk factors
There are probably a number of causative bacteria responsible for PID, but gonorrhea and chlamydia infections are most common. These enter the body during unprotected intercourse. During miscarriage, childbirth, or abortion, the bacteria can cross the barrier of the cervix and enter the vagina too.

The risk for PID increases if one is sexually active before turning 25, has multiple partners, is not using a condom, or is douching regularly. The risk also increases if one has a partner who has sex with more than one person or has a previous history of the disease.

The disease can further lead to conditions such as ectopic pregnancy, chronic pelvic pain, infertility, and tubo-ovarian abscess if untreated.

Signs and symptoms
The signs of PID include heavy vaginal discharge accompanied by a foul odor, pelvic pain along with pain experienced in the lower abdomen, and abnormal uterine bleeding between menstrual cycles and after or during sexual intercourse. Symptoms also include difficulty during urination along with pain and fever accompanied by chills and painful intercourse along with bleeding.

When the pain in the lower abdomen turns severe, or there is heavy vaginal discharge, fever accompanied by a high temperature, or vomiting and nausea with an inability to keep anything down, it is time to visit the doctor.

Diagnosis, Treatment, and Prevention
Diagnosis includes carrying out a pelvic exam plus urine tests and analysis of the cervical culture and vaginal discharge by taking a sample using a cotton swab. Blood and urine tests are conducted to check the white blood cell count, which can further indicate the presence of an infection. Tests to look for HIV can also be carried out. Ultrasound and laparoscopy are further ways to diagnose the disease.

Treatment includes antibiotics to help with the infection and prevent any further complications. Abstinence and treatment of the partner are also suggested by doctors. The treatment is usually outpatient, unless the abscess has ruptured or the infection is further complicated. Pregnant or seriously ill patients might require hospitalization along with those who do not show improvement post antibiotic treatment.

Prevention
The disease can be prevented, primarily by opting for safe sex, using protection during intercourse, discussing ways of contraception with the doctor, and using the most suitable one. Other elements of prevention include avoiding douching as it disrupts the balance of bacteria in the body, and getting regularly tested along with one’s partner for sexually transmitted infections.

Dr. Alexander G. Salerno

Thyroid Cancer and Thyroid Nodules

Cancer is one of the deadliest diseases that has seen a sharp rise in the number of incidents over the years. With rising number of incidences, awareness about various types of cancers and information regarding the prevention of the same has also seen a rise. So, most individuals are aware of commonly occurring cancers, but little is known about thyroid cancer.

Thyroid Cancer
Thyroid is the organ found in the lower front part of the neck. It secretes hormones which direct and channelize various functions in the body, such as production of heat, utilization of energy, and consumption of oxygen.

When cells in the thyroid change or mutate and start to multiply, it finally causes a tumor and this tumor is known as thyroid cancer.

Four types of thyroid cancers have been identified, namely, papillary thyroid cancer, medullary cancer, follicular thyroid cancer, and anaplastic thyroid cancer.

Cause
The exact cause of thyroid cancer is still not clear, but it could be due to inherited genetic syndrome (where an abnormal inherited gene can cause the cancer) or because of exposure to radiation in the head and neck area as a child. It can also be caused due to iodine deficiency.

Detection
Thyroid cancer is difficult to detect in the early stages because there are hardly any signs or symptoms in the beginning. As the cancer escalates, symptoms include presence of a lump in the neck, pain in the throat and neck, cough, difficulty in swallowing, and changes in vocals including hoarseness.

It has been seen that women are more likely to develop thyroid cancer as compared to men, especially follicular thyroid, which is found to be more likely in white women when compared to black women.

Treatment
Treatment is easily available for thyroid cancer, once it is detected. Even if the disease has advanced to a huge stage, surgery or treatment can completely cure the patient.

Thyroid Nodules
Thyroid nodules are small lumps, which are either solid or filled with fluid, present in the thyroid gland. Usually, these nodules are harmless and do not even cause symptoms, but a small percentage of these nodules result in thyroid cancer.

Usually, the nodules are small and are barely even noticeable unless checked by a doctor. But when they are big they can easily be felt, and seen as a swelling at the base of the neck; they might even cause shortness of breath and difficulty in swallowing as the nodules press on the windpipe and esophagus respectively. The nodules can even lead to extra production of the thyroxine hormone which can further lead to weight loss, nervousness, tremors, irregular heartbeat, and perspiration.

Causes
Causes of thyroid nodules can either be due to iodine deficiency or to losing a cyst, inflammation of the gland, goiter, overgrowth of normal thyroid tissues, and even thyroid cancer.

Treatment
Treatment options for the nodules depend on the type of the nodules, where benign ones are treated with hormone doston therapy, surgery, or just left as is. Hyperthyroidism-causing nodules are treated with iodine therapy, anti-thyroid medication, or surgery; cancerous nodules are treated with surgery or alcohol ablation.

However, timely detection and diagnosis by a doctor would help and regular checkups would prevent any advancements or computations.

Alexander G. Salerno