Imagine a tiny butterfly-shaped gland quietly regulating your body's energy levels and overall health. Your thyroid, which uses iodine to make thyroid hormones, helps control blood pressure, body temperature, heart rate, metabolism, and the reaction of your body to other hormones. Thyroid disorders occur when the gland becomes overactive (hyperthyroidism) or underactive (hypothyroidism). When the thyroid is not working as it should, it can result in serious health problems.

The American Thyroid Association (ATA) estimates that more than 12% of the U.S. population will experience a thyroid condition at some point in their lives. One in eight women will also develop a thyroid disorder during their lifetime. Hypothyroidism is more common than hyperthyroidism. However, despite the prevalence and impact of thyroid diseases on health, there are many misconceptions surrounding it, often leading to confusion, misinformation, and sometimes unnecessary fear.

This article shares some expert insights to bust the common misconceptions about thyroid function to foster clarity and awareness about thyroid disease. This is important to understand and navigate this aspect of health more effectively.

10 Common Misconceptions Linked with Thyroid Conditions

Here are 10 common misconceptions linked to thyroid disease and the truth behind them:

1. Misconception: Treating thyroid disease requires the expertise of an endocrinologist in every case.

Fact: Various healthcare providers play a role in managing thyroid issues. Your primary care provider can manage simpler cases, but complex conditions may require an endocrinologist or a specialist. Situations where you might need specialized care include pregnancy, thyroid problems in children, nodules, goiter, or any form of hyperthyroidism, including Graves' disease.

2. Misconception: Thyroid disease is easy to diagnose and treat.

Fact: One prevalent misconception is that diagnosing thyroid disease is straightforward. However, the varied and uncertain symptoms associated with these illnesses make their diagnosis challenging. Also, treating thyroid problems is a personalized journey that evolves over a lifetime, with treatment plans differing among individuals. The process demands careful monitoring and collaboration with a specialist to determine the most effective treatment approach and medication dosage for you.

3. Misconception: You should take iodine supplements if you have hypothyroidism.

Fact: The Institute of Medicine has set the Recommended Dietary Allowance (RDA) for iodine intake in adult men and women at 150 micrograms per day. While iodine deficiency is one cause of hypothyroidism, taking iodine supplements isn't recommended for all cases of hypothyroidism. You usually don't need iodine supplements if you live in the United States and other developed countries where iodine is added to salt and other foods.

"If the underactive thyroid isn't caused by iodine deficiency, then iodine supplements give no benefit and shouldn't be taken. In fact, for some people with an underactive thyroid, too much iodine can cause or worsen their condition," opines Todd B. Nippoldt, M.D. (www.mayoclinic.org).

4. Misconception: Once you start taking thyroid medication, your symptoms will disappear.

Fact: Treatment for hypothyroidism involves a daily replacement thyroid hormone taken on an empty stomach. Thyroxine is slow acting; it can take weeks or even months for levels of this hormone to rise to the target level. Factors affecting improvement include dosage, timing, health conditions, and absorption concerns. Duration for hyperthyroidism treatment varies based on its cause, and discovering the right dose is a personalized journey.

5. Misconception: You can stop taking medication once the thyroid stimulating hormone (TSH) value is normal.

Fact: Typically, if thyroid medication effectively maintains the TSH at the normal level, there's no need to discontinue it. In fact, stopping the medication or not maintaining the correct dosage might lead to the reappearance of hypothyroidism symptoms.

6. Misconception: If you have a thyroid condition, you need to take medication for life.

Fact: Thyroid conditions often require lifelong medication, but there are exceptions. Temporary factors like pregnancy or specific medications might necessitate only temporary medication. After pregnancy, hormone levels stabilize, restoring normal thyroid function. Also, prescriptions can change as those with an underactive thyroid may require increased hormone supplementation during pregnancy.

7. Misconception: You shouldn’t eat cruciferous vegetables if you have a thyroid disorder.

Fact: Cruciferous vegetables include broccoli, cauliflower, cabbage, kale, bok choy, arugula, Brussels sprouts, collards, watercress, and radish. While eating cruciferous vegetables is good for your health, they are thought to interfere with the way your thyroid uses iodine.

The truth is that they may induce or exacerbate hypothyroidism only if you eat very large quantities.

"Cruciferous vegetables are part of a healthy and balanced diet, and I encourage patients with thyroid disorders to continue eating them in moderation," says Northwestern Medicine Endocrinologist Ayla Bakar, M.D. (www.nm.org). You would have to consume an excessive and unrealistic amount of these vegetables for them to interfere with iodine and thus hormone production in the thyroid, she notes.

8. Misconception: Thyroid disorders only affect women.

Fact: Hypothyroidism can affect a person of any age and gender. While women are much more likely to be affected by thyroid disease than men, about two out of every ten cases are men. Their common symptoms include feeling cold, fatigue, constipation, depression, erectile dysfunction, weight changes, hair loss, dry skin and brittle nails, and sore muscles.

9. Misconception: Thyroid cancer is not curable.

Fact: The majority of thyroid cancers are curable, especially if they haven't spread extensively. Treatment options include surgery, chemotherapy, radiation, hormone therapy, and radioiodine therapy. If a cure isn't possible, treatment aims to minimize cancer growth, spread, or recurrence by removing or controlling it as effectively as possible for as long as possible (American Cancer Society).

10. Misconception: If you have a thyroid condition, you’d recognize the symptoms.

Fact: Symptoms of both an underactive thyroid and a hyperactive thyroid are vague and easy to ignore. According to the American Thyroid Association, an estimated 20 million Americans have some form of thyroid disease, and of this number, up to 60 percent are unaware of their condition.

Why is that? Thyroid issues share symptoms with various health conditions like anemia, fatigue, and mental health disorders. Talking to your doctor about these symptoms, including whether you need a thyroid disorder blood test, is crucial. The most reliable way to diagnose thyroid disorders is through timely testing.

Coding for Thyroid Diseases

While navigating the complexities of thyroid disorders, understanding the relevant medical codes can demystify the diagnostic process. Reporting the correct codes ensures appropriate reimbursement for medical services rendered while maintaining precise and consistent clinical documentation.

The ICD-10 codes for disorders of thyroid gland fall in the range E00-E07:

• E00 - Congenital iodine-deficiency syndrome
• E01 - Iodine-deficiency related thyroid disorders and allied conditions
• E02 - Subclinical iodine-deficiency hypothyroidism
• E03 - Other hypothyroidism
• E04 - Other nontoxic goiter
• E05 - Thyrotoxicosis [hyperthyroidism]
• E06 - Thyroiditis
• E07 - Other disorders of thyroid

Some of the most frequently used ICD-10 codes for hypothyroidism and hyperthyroidism include the following:

• Hypothyroidism
o E03.9 - Hypothyroidism, unspecified
o E03.3 - Postinfectious hypothyroidism
o E03.4 - Atrophy of thyroid (acquired)
o E03.5 - Myxedema coma
o E03.8 - Other specified hypothyroidism
o E07.9 - Disorder of thyroid, unspecified

• Hyperthyroidism
o E05.00 - Thyrotoxicosis with diffuse goiter without thyrotoxic crisis or storm
o E05.01 - Thyrotoxicosis with diffuse goiter with thyrotoxic crisis or storm
o E05.20 - Thyrotoxicosis with toxic multinodular goiter without thyrotoxic crisis or storm
o E05.21 - Thyrotoxicosis with toxic multinodular goiter with thyrotoxic crisis or storm
o E05.30 - Thyrotoxicosis from ectopic thyroid tissue without thyrotoxic crisis or storm
o E05.31 - Thyrotoxicosis from ectopic thyroid tissue with thyrotoxic crisis or storm

Conclusion

It is important to debunk misconceptions clouding public understanding of thyroid disease. Busting myths and promoting awareness paves the way for informed discussions and proactive healthcare decisions. Accurate medical coding is pivotal for accurately representing thyroid diseases. Providers of medical coding services can ensure precise coding and sequencing based on physician documentation within medical records and adherence to the Official Coding Guidelines for inpatient care. Moreover, they leverage references such as the AHA Coding Clinic for ICD-10-CM and the American Medical Association CPT Assistant to ensure comprehensive and precise coding for thyroid disorders.

Natalie Tornese, CPC, is a Director Of RCM, responsible for Practice and Revenue Cycle Management at MOS. She brings 25 years of healthcare management experience to the company. Natalie has worked in varied leadership roles with practices and specialties. Her primary focus is revenue cycle management with an emphasis on Medical Billing, Coding, and Insurance Verification Management. Natalie also holds a CPC certification by the American Academy of Professional coders (AAPC). She has written numerous articles on all aspects of Practice Management, and presently manages a large team focused on Medical Billing, Medical Coding, Verification and Authorization services for MOS (www.outsourcestrategies.com).