Thyroid Cancer: Types, Symptoms, Diagnosis, and Treatment - Complete Guide on World Thyroid Awareness Day

Introduction

The thyroid gland plays a crucial role in regulating various bodily functions, from metabolism to hormone production. However, millions of people worldwide suffer from thyroid problems that can disrupt their overall health and well-being. To raise awareness about this prevalent issue, World Thyroid Awareness Day is observed globally. In this article, we will delve into the types of thyroid problems, their symptoms, and effective prevention methods.

What is World Thyroid Awareness Day?

World Thyroid Awareness Day, celebrated on the 25th of May each year, aims to educate individuals about thyroid disorders and promote early detection and treatment. This day serves as an opportunity to shed light on the impact of thyroid problems on people's lives and the importance of thyroid health.

Common Types of Thyroid Problems

Thyroid problems can arise due to various reasons, and understanding the different types is essential for effective management. Let's explore some of the most common thyroid problems:

1. Hypothyroidism: Causes, Symptoms, and Management

Hypothyroidism is a common thyroid disorder characterized by an underactive thyroid gland that fails to produce sufficient thyroid hormones. These hormones play a vital role in regulating metabolism, growth, and development throughout the body. When the thyroid gland functions below normal levels, it can lead to a variety of symptoms and health complications. In this section, we will explore the causes, symptoms, and management of hypothyroidism.

1.1. Causes of Hypothyroidism

There are several possible causes of hypothyroidism, including:

• Autoimmune Thyroiditis: The most common cause of hypothyroidism is an autoimmune disorder called Hashimoto's thyroiditis. In this condition, the immune system mistakenly attacks the thyroid gland, causing inflammation and impairing its ability to produce hormones.
• Treatment for Hyperthyroidism: Some individuals may develop hypothyroidism as a result of treatment for hyperthyroidism, which involves reducing thyroid function. Radioactive iodine therapy or surgical removal of the thyroid gland can inadvertently cause an underactive thyroid.
• Thyroid Surgery: Surgical removal of all or a significant portion of the thyroid gland, often performed to treat thyroid nodules or cancer, can lead to hypothyroidism.
• Radiation Therapy: Individuals who have received radiation therapy to the neck or upper chest, typically for the treatment of certain cancers, may develop hypothyroidism as a long-term side effect.
• Certain Medications: Certain medications, such as lithium and amiodarone, can interfere with thyroid hormone production and contribute to hypothyroidism.
• Congenital Hypothyroidism: In rare cases, infants are born with an underactive thyroid gland, known as congenital hypothyroidism. This condition requires immediate medical attention to prevent developmental issues.

1.2. Symptoms of Hypothyroidism

The symptoms of hypothyroidism can vary from person to person, and they may develop slowly over time, making them challenging to recognize. Some common symptoms include:

• Fatigue and Weakness: Individuals with hypothyroidism often experience persistent fatigue, weakness, and a lack of energy, even after getting adequate rest.
• Unexplained Weight Gain: A slowed metabolism due to hypothyroidism can lead to unexplained weight gain, despite proper diet and exercise.
• Dry Skin and Hair: Hypothyroidism can cause dry skin that may appear rough or flaky. Hair may become dry, brittle, and thin, leading to hair loss.
• Feeling Cold: Individuals with hypothyroidism may feel unusually sensitive to cold temperatures, experiencing cold hands and feet and having a lower tolerance for cold environments.
• Muscle and Joint Pain: Hypothyroidism can cause muscle aches, cramps, and joint pain, making it uncomfortable to engage in physical activities.
• Depression and Mood Changes: Thyroid hormones influence brain chemistry, and a deficiency can lead to mood swings, irritability, and depression.
• Memory Problems: Some individuals with hypothyroidism may experience difficulties with memory, concentration, and mental clarity.
• Constipation: Sluggishness in the digestive system can result in constipation and other digestive issues.
• Irregular Menstruation: Women with hypothyroidism may experience heavier or irregular menstrual periods, and fertility can be affected.

It is important to note that these symptoms can also be attributed to other medical conditions, so proper diagnosis by a healthcare professional is essential.

1.3. Management of Hypothyroidism

Hypothyroidism is a chronic condition that requires lifelong management. The primary treatment for hypothyroidism is hormone replacement therapy, typically in the form of synthetic thyroid hormones. The medication, usually levothyroxine, is taken orally to provide the body with the necessary thyroid hormones it is lacking.

Managing hypothyroidism also involves the following:

• Regular Thyroid Function Tests: Regular monitoring of thyroid hormone levels through blood tests is necessary to ensure proper dosage adjustments and optimal management.
• Consistent Medication Use: It is crucial to take thyroid hormone replacement medication as prescribed by the healthcare provider, consistently and at the recommended time of day.
• Balanced Diet: A well-balanced diet rich in essential nutrients, including iodine, selenium, and zinc, can support thyroid health. Consultation with a healthcare professional or a registered dietitian is beneficial for personalized dietary recommendations.
• Exercise and Physical Activity: Regular exercise can help boost metabolism, promote weight management, and improve overall well-being. Engaging in activities like brisk walking, swimming, or cycling is beneficial.
• Stress Management: Chronic stress can impact thyroid function. Implementing stress management techniques such as meditation, deep breathing exercises, or engaging in hobbies can help reduce stress levels.
• Avoidance of Goitrogens: Some foods, known as goitrogens, can interfere with thyroid function. These include cruciferous vegetables (e.g., broccoli, cauliflower) when consumed in large amounts. Cooking these vegetables can help reduce their goitrogenic properties.
• Regular Follow-ups: Regular follow-up appointments with a healthcare professional are necessary to assess progress, adjust medication dosages if needed, and address any concerns or changes in symptoms.

In conclusion, hypothyroidism is a common thyroid disorder characterized by an underactive thyroid gland. With proper diagnosis, medication, and lifestyle management, individuals with hypothyroidism can lead fulfilling lives. If you suspect you may have hypothyroidism or are experiencing symptoms, consult a healthcare professional for proper evaluation and guidance.

2. Hyperthyroidism: Causes, Symptoms, and Treatment

Hyperthyroidism is a condition characterized by an overactive thyroid gland, leading to excessive production of thyroid hormones. These hormones play a crucial role in regulating metabolism, growth, and development. When the thyroid gland becomes overactive, it can result in a variety of symptoms and health complications. In this section, we will delve into the causes, symptoms, and treatment options for hyperthyroidism.

2.1. Causes of Hyperthyroidism

Several factors can contribute to the development of hyperthyroidism, including:

• Graves' Disease: The most common cause of hyperthyroidism is an autoimmune disorder called Graves' disease. In this condition, the immune system produces antibodies that stimulate the thyroid gland to produce excessive amounts of thyroid hormones.
• Thyroid Nodules: Abnormal growths or nodules on the thyroid gland can produce excess thyroid hormones, leading to hyperthyroidism. These nodules may be noncancerous (benign) or cancerous (malignant).
• Thyroiditis: Inflammation of the thyroid gland, known as thyroiditis, can cause a temporary release of stored thyroid hormones, leading to a temporary episode of hyperthyroidism. This condition can be triggered by viral infections or autoimmune factors.
• Excessive Iodine Intake: Consuming large amounts of iodine, either through dietary sources or medications, can stimulate the thyroid gland and result in excessive production of thyroid hormones.
• Medications: Certain medications, such as amiodarone (used to treat heart rhythm disorders) and lithium (used to treat bipolar disorder), can interfere with thyroid function and lead to hyperthyroidism.

2.2. Symptoms of Hyperthyroidism

Hyperthyroidism can cause a wide range of symptoms, which may vary in severity from person to person. Some common symptoms include:

• Weight Loss: Individuals with hyperthyroidism often experience unexplained weight loss, despite maintaining a normal or increased appetite. This is due to the accelerated metabolism caused by excess thyroid hormones.
• Increased Heart Rate: Hyperthyroidism can lead to a rapid or irregular heartbeat (heart palpitations) and an increased sensitivity to the effects of adrenaline. Individuals may also experience elevated blood pressure.
• Anxiety and Irritability: Excess thyroid hormones can affect the nervous system, leading to feelings of anxiety, irritability, restlessness, and difficulty sleeping (insomnia).
• Heat Intolerance: Individuals with hyperthyroidism may feel unusually hot or experience increased sweating, even in normal temperature conditions. They may have a decreased tolerance for heat.
• Tremors and Shaking: Hyperthyroidism can cause trembling or shaking of the hands, which may be more noticeable during activities that require fine motor skills.
• Increased Appetite: Some individuals with hyperthyroidism may experience an increased appetite and food cravings, contributing to weight loss.
• Fatigue and Weakness: Despite experiencing increased metabolism, individuals with hyperthyroidism may also experience fatigue, muscle weakness, and a general sense of exhaustion.
• Changes in Menstrual Patterns: Women with hyperthyroidism may experience irregular menstrual periods or lighter flow.
• Enlarged Thyroid (Goiter): In some cases, the thyroid gland may become enlarged (goiter) due to increased activity and hormone production.

It is important to note that these symptoms can also be attributed to other medical conditions, so proper diagnosis by a healthcare professional is essential.

2.3. Treatment of Hyperthyroidism

The treatment of hyperthyroidism aims to reduce the production of thyroid hormones, alleviate symptoms, and restore normal thyroid function. The specific treatment approach depends on the underlying cause and individual factors. Treatment options may include:

• Antithyroid Medications: These medications, such as methimazole or propylthiouracil, work by inhibiting the production of thyroid hormones. They are often prescribed for individuals with Graves' disease or thyroid nodules.
• Radioactive Iodine Therapy: This treatment involves swallowing a radioactive iodine capsule or liquid, which is selectively taken up by the thyroid gland. The radiation destroys the overactive thyroid cells, reducing hormone production. This treatment is commonly used for Graves' disease or thyroid nodules.
• Beta-Blockers: Medications such as propranolol may be prescribed to manage symptoms like rapid heart rate, tremors, and anxiety while other treatments take effect. Beta-blockers help to block the effects of excess thyroid hormones on the body.
• Surgery (Thyroidectomy): In some cases, surgical removal of all or a portion of the thyroid gland may be recommended. This option is typically considered if antithyroid medications or radioactive iodine therapy are not suitable or if there is a concern for thyroid cancer.
• Lifestyle Modifications: Making certain lifestyle adjustments can support overall thyroid health. These include adopting a balanced diet, reducing stress levels, getting regular exercise, and avoiding excessive iodine intake.

Regular follow-up appointments with a healthcare professional are necessary to monitor thyroid hormone levels, adjust treatment as needed, and ensure optimal management of the condition.

In conclusion, hyperthyroidism is a condition characterized by an overactive thyroid gland and excessive production of thyroid hormones. With proper diagnosis, treatment, and ongoing management, individuals with hyperthyroidism can effectively control their symptoms and maintain good health. If you suspect you may have hyperthyroidism or are experiencing symptoms, consult a healthcare professional for proper evaluation and guidance.

3. Thyroid Nodules: Types, Diagnosis, and Treatment

Thyroid nodules are abnormal growths or lumps that develop within the thyroid gland, which is located in the front of the neck. These nodules can vary in size, from tiny to large masses, and they can be solid or filled with fluid. While most thyroid nodules are benign (noncancerous) and asymptomatic, some may require further evaluation and treatment. In this section, we will delve into the types of thyroid nodules, their diagnosis, and available treatment options.

3.1. Types of Thyroid Nodules

There are several types of thyroid nodules, including:

• Colloid Nodules: Colloid nodules are the most common type of thyroid nodules. They typically develop as a result of normal thyroid tissue overgrowth, resulting in a smooth, round nodule. Colloid nodules are usually benign and do not cause any symptoms.
• Thyroid Cysts: Thyroid cysts are fluid-filled nodules that can develop within the thyroid gland. These cysts can be small or large and may cause discomfort or difficulty swallowing if they grow large enough. Most thyroid cysts are benign.
• Follicular Adenomas: Follicular adenomas are solid nodules that arise from the follicular cells of the thyroid gland. While most follicular adenomas are benign, a small percentage may be cancerous (follicular carcinoma). Additional testing, such as a biopsy, may be needed to determine the nature of the nodule.
• Multinodular Goiter: Multinodular goiter refers to the presence of multiple nodules within the thyroid gland. This condition can cause enlargement of the thyroid gland and may be associated with an overactive or underactive thyroid function.
• Thyroid Cancer: In some cases, thyroid nodules may be cancerous. The most common types of thyroid cancer include papillary thyroid carcinoma, follicular thyroid carcinoma, medullary thyroid carcinoma, and anaplastic thyroid carcinoma. It is important to note that the majority of thyroid nodules are benign and not cancerous.

3.2. Diagnosis of Thyroid Nodules

The diagnosis of thyroid nodules typically involves a combination of the following:

• Physical Examination: A healthcare professional may perform a physical examination of the neck to assess the size, texture, and mobility of the thyroid gland and any palpable nodules.
• Thyroid Function Tests: Blood tests, such as measuring thyroid-stimulating hormone (TSH) and thyroid hormone levels, can help determine if the thyroid gland is functioning normally or if there is an underlying thyroid disorder.
• Imaging Studies: Imaging techniques, such as ultrasound, may be used to visualize the size, shape, and characteristics of thyroid nodules. Ultrasound can help differentiate between solid nodules, cystic nodules, and those that may require further evaluation.
• Fine Needle Aspiration (FNA) Biopsy: If a nodule is suspicious or shows certain characteristics, a fine needle aspiration biopsy may be performed. During this procedure, a small needle is inserted into the nodule to collect a sample of cells for analysis. The biopsy helps determine if the nodule is benign or potentially cancerous.

3.3. Treatment Options for Thyroid Nodules

The treatment of thyroid nodules depends on various factors, including the size, characteristics, and potential for malignancy. Treatment options may include:

• Observation: Small, benign nodules that do not cause symptoms or pose a risk may be monitored through regular follow-up appointments. If the nodule remains stable or shrinks over time, no further intervention may be necessary.
• Thyroid Hormone Suppression Therapy: In cases where the nodules are causing hyperthyroidism or goiter, thyroid hormone medication may be prescribed to suppress thyroid function and reduce the size of the nodules.
• Thyroid Nodule Ablation: This procedure involves using ethanol (alcohol) or radiofrequency energy to shrink or destroy the thyroid nodule. It may be considered for symptomatic or benign nodules.
• Surgery (Thyroidectomy): If a nodule is suspicious for cancer, is causing significant symptoms, or is enlarging rapidly, surgical removal of part (lobectomy) or all (total thyroidectomy) of the thyroid gland may be recommended. This allows for a thorough examination of the nodule and can provide definitive treatment.

It is important to consult with a healthcare professional to determine the appropriate treatment plan based on the specific characteristics of the thyroid nodule.

In conclusion, thyroid nodules are abnormal growths within the thyroid gland. While most nodules are benign, further evaluation is necessary to rule out potential malignancy and determine the appropriate treatment approach. Regular monitoring, thyroid hormone medication, nodule ablation, or surgical intervention may be recommended based on the characteristics of the nodules. If you have concerns or notice any abnormalities in your neck area, seek medical evaluation for proper diagnosis and guidance.

4. Thyroid Cancer: Types, Symptoms, Diagnosis, and Treatment

Thyroid cancer is a relatively rare form of cancer that originates in the cells of the thyroid gland, located in the front of the neck. The thyroid gland produces hormones that regulate metabolism and play a vital role in various bodily functions. Understanding the types, symptoms, diagnosis, and treatment options for thyroid cancer is crucial for early detection and effective management. In this section, we will explore thyroid cancer in detail.

4.1. Types of Thyroid Cancer

There are several types of thyroid cancer, including:

• Papillary Thyroid Carcinoma (PTC): This is the most common type of thyroid cancer, accounting for approximately 80% of cases. PTC arises from the follicular cells and typically grows slowly. It has a high survival rate and often affects individuals in their 30s or 40s.
• Follicular Thyroid Carcinoma (FTC): FTC accounts for about 10-15% of thyroid cancer cases. It also arises from the follicular cells but has a higher chance of spreading to distant sites compared to PTC. FTC is more common in individuals aged 50 and above.
• Medullary Thyroid Carcinoma (MTC): MTC originates from the parafollicular or C-cells of the thyroid gland. It constitutes around 5-7% of thyroid cancer cases. MTC can be hereditary (inherited genetic mutations) or sporadic (non-inherited). Genetic testing is often recommended for individuals diagnosed with MTC.
• Anaplastic Thyroid Carcinoma (ATC): ATC is the rarest and most aggressive form of thyroid cancer, accounting for less than 2% of cases. It rapidly spreads to surrounding tissues and organs, making it challenging to treat. ATC commonly affects individuals over the age of 60.
• Thyroid Lymphoma: Thyroid lymphoma is a rare type of thyroid cancer that originates in the immune system cells within the thyroid gland. It typically affects individuals aged 60 and older.

4.2. Symptoms of Thyroid Cancer

The symptoms of thyroid cancer may vary depending on the type and stage of the disease. Some common signs and symptoms include:

• Lump or Nodule in the Neck: The most noticeable symptom of thyroid cancer is the presence of a lump or nodule in the front of the neck. This lump is often painless but can cause discomfort or difficulty swallowing.
• Swollen Lymph Nodes: Thyroid cancer can cause the lymph nodes in the neck to become enlarged or tender.
• Hoarseness or Voice Changes: Cancerous nodules or tumors in the thyroid gland can affect the vocal cords, leading to hoarseness or voice changes.
• Difficulty Swallowing or Breathing: Large thyroid nodules or advanced thyroid cancer can exert pressure on the esophagus or windpipe, causing difficulty in swallowing or breathing.
• Neck Pain or Soreness: Some individuals with thyroid cancer may experience mild to moderate pain or discomfort in the neck area.
• Persistent Cough: A persistent cough that is not related to a respiratory infection or allergies may be a symptom of advanced thyroid cancer.
• Fatigue and Weakness: As with many types of cancer, thyroid cancer can cause general fatigue, weakness, and a feeling of overall malaise.

It is important to note that these symptoms can also be associated with noncancerous thyroid conditions. Consulting a healthcare professional is necessary for proper evaluation and diagnosis.

4.3. Diagnosis of Thyroid Cancer

The diagnosis of thyroid cancer involves several steps, including:

• Medical History and Physical Examination: A healthcare professional will review the patient's medical history and perform a physical examination to assess the thyroid gland and any palpable nodules or abnormalities.
• Ultrasound Imaging: Ultrasound imaging is commonly used to evaluate thyroid nodules. It helps determine the size, location, and characteristics of the nodules, providing valuable information for further evaluation.
• Fine Needle Aspiration (FNA) Biopsy: If a nodule is suspicious or shows concerning features on ultrasound, a fine needle aspiration biopsy may be performed. This procedure involves using a thin needle to collect a sample of cells from the nodule for microscopic analysis. The biopsy helps determine if the nodule is cancerous or benign.
• Blood Tests: Blood tests may be conducted to measure thyroid hormone levels and to assess thyroid function. Elevated levels of certain thyroid hormones may indicate an overactive thyroid or potential malignancy.
• Imaging Tests: Additional imaging tests, such as a computed tomography (CT) scan or magnetic resonance imaging (MRI), may be performed to assess the extent of cancer spread (metastasis) or involvement of nearby structures.
• Genetic Testing: In certain cases, genetic testing may be recommended, especially for individuals with a family history of thyroid cancer or specific types of thyroid cancer, such as medullary thyroid carcinoma.

4.4. Treatment Options for Thyroid Cancer

The treatment of thyroid cancer depends on various factors, including the type, stage, and aggressiveness of the cancer, as well as individual patient factors. Treatment options may include:

• Surgery: The primary treatment for thyroid cancer is often surgery. The extent of surgery may vary, ranging from the removal of only the cancerous lobe (lobectomy) to the complete removal of the thyroid gland (total thyroidectomy). Lymph node dissection may also be performed if cancer has spread to the lymph nodes.
• Radioactive Iodine Therapy: After surgery, radioactive iodine therapy may be administered to destroy any remaining thyroid tissue or cancer cells. This treatment is particularly effective for papillary and follicular thyroid cancer.
• External Beam Radiation Therapy: In some cases, external beam radiation therapy may be recommended, especially if the cancer is more aggressive or has spread to surrounding tissues or lymph nodes.
• Thyroid Hormone Replacement Therapy: Since the removal of the thyroid gland affects hormone production, lifelong thyroid hormone replacement therapy is usually necessary to maintain thyroid hormone levels and regulate metabolism.
• Targeted Drug Therapy: For advanced or metastatic thyroid cancer that does not respond to standard treatments, targeted drug therapies may be used to inhibit specific molecular targets involved in cancer growth and progression.

The choice of treatment depends on multiple factors and should be discussed with a healthcare professional to determine the most appropriate approach for each individual.

In conclusion, thyroid cancer is a rare form of cancer that originates in the cells of the thyroid gland. Prompt diagnosis and appropriate treatment are crucial for optimal outcomes. Understanding the types, symptoms, and available treatment options can aid in early detection and effective management. If you experience any symptoms or have concerns about your thyroid health, consult a healthcare professional for proper evaluation and guidance.

Symptoms of Thyroid Problems

Thyroid problems can manifest through various symptoms that may differ depending on the specific condition. Here are some common symptoms associated with thyroid problems:

1. Fatigue and Weight Changes 😨

Both hypothyroidism and hyperthyroidism can cause disruptions in energy levels and weight. With hypothyroidism, individuals often experience fatigue, sluggishness, and unexplained weight gain. Conversely, hyperthyroidism can lead to weight loss, even when eating a normal amount of food, along with increased energy levels.

2. Mood Swings and Anxiety 😖

Thyroid problems can impact mental well-being and lead to mood swings, irritability, and anxiety. Hypothyroidism is commonly associated with depression and a feeling of mental fog or confusion. On the other hand, hyperthyroidism may cause restlessness, nervousness, and an overall sense of unease.

3. Hair Loss and Skin Changes 😲

Changes in hair and skin health are common symptoms of thyroid problems. Hypothyroidism may cause dry, brittle hair, hair loss, and dry skin. In contrast, hyperthyroidism can result in excessive sweating, thinning hair, and oily skin.

4. Irregular Menstruation 🙇

Thyroid imbalances can affect the menstrual cycle in women. Hypothyroidism often leads to heavier and more prolonged periods, whereas hyperthyroidism can cause lighter or irregular periods. These disruptions can impact fertility and reproductive health.

Prevention and Management of Thyroid Problems

While some thyroid problems cannot be prevented, certain measures can help reduce the risk and manage the symptoms. Consider the following preventive strategies:

1. Balanced Diet and Nutrition

Maintaining a balanced diet rich in essential nutrients is crucial for thyroid health. Incorporate iodine-rich foods like seafood, dairy products, and iodized salt. Additionally, consume foods high in selenium, zinc, and vitamin D to support thyroid function.

2. Regular Exercise and Physical Activity

Engaging in regular physical activity can help regulate metabolism and maintain a healthy weight. Exercise also promotes overall well-being and reduces the risk of developing thyroid-related issues. Aim for at least 30 minutes of moderate-intensity exercise most days of the week.

3. Stress Management

Chronic stress can negatively impact the thyroid gland. Practice stress management techniques such as meditation, yoga, deep breathing exercises, or engaging in hobbies to reduce stress levels. Prioritizing self-care and finding healthy outlets for stress are essential.

4. Regular Thyroid Check-ups

Periodic thyroid check-ups are crucial for early detection and prompt treatment. Consult your healthcare provider for regular thyroid function tests and discuss any concerning symptoms or changes in your well-being. Early intervention can prevent complications and improve outcomes.

Conclusion

World Thyroid Awareness Day serves as a reminder of the importance of thyroid health and understanding the various thyroid problems individuals may face. By recognizing the symptoms and implementing preventive measures, individuals can take control of their thyroid health and overall well-being. Remember to prioritize regular check-ups, lead a healthy lifestyle, and seek medical advice when needed.

Frequently Asked Questions:

1. Are thyroid problems more common in women?

Yes, thyroid problems, particularly hypothyroidism and thyroid nodules, are more prevalent in women. Hormonal fluctuations and autoimmune factors contribute to the higher incidence among females.

2. Can stress cause thyroid problems?

Chronic stress can disrupt the delicate balance of thyroid hormones and contribute to the development of thyroid problems. It is important to manage stress effectively for optimal thyroid health.

3. Is it possible to prevent thyroid problems?

While not all thyroid problems can be prevented, adopting a healthy lifestyle, including a balanced diet, regular exercise, stress management, and regular check-ups, can help reduce the risk and manage symptoms effectively.

4. Can thyroid problems affect fertility?

Thyroid imbalances, especially hypothyroidism, can affect fertility and menstrual regularity in women. Seeking medical advice and maintaining thyroid health is crucial for reproductive well-being.

5. What should I do if I suspect I have a thyroid problem?

If you experience symptoms such as unexplained weight changes, fatigue, mood swings, or irregular menstruation, it is advisable to consult a healthcare professional. They can perform appropriate tests and provide guidance based on your specific situation.