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Zhang Li
Endocrinology
About me
An attending physician in the Department of Endocrinology at the Affiliated Hospital of Binzhou Medical University in Shandong Province, holding a Master's degree in Clinical Endocrinology.
A youth member of the Diabetes Prevention and Treatment Branch of the Shandong Provincial Preventive Medicine Association, a member of the Health Rehabilitation Professional Committee of the Shandong Provincial Geriatric Medical Association, and a member of the Endocrine and Metabolic Diseases Professional Committee of the Binzhou Medical Association.
Graduated from Jining Medical College, subsequently obtained a Master's degree in Clinical Endocrinology from Weifang Medical College, and completed a one-year clinical endocrinology fellowship at the Chinese People's Liberation Army General Hospital. Working in the front line of clinical practice since graduation, dedicated to clinical treatment and research in endocrine and metabolic diseases. Serving as a part-time clinical teacher at Binzhou Medical College, responsible for annual clinical theoretical teaching of internal medicine and diagnostic medicine, as well as intern teaching tasks. Assisting graduate supervisors in conducting clinical teaching for graduate students. Serving as the secretary of the drug clinical trial base, assisting in managing multiple drug clinical trials.
Participated in multiple teaching and research projects and published over 10 clinical and research papers at home and abroad.
Proficient in diseases
Specializes in the diagnosis and treatment of diabetes and its acute and chronic complications, hyperthyroidism, hypothyroidism, and thyroid cancer. Familiar with adrenal diseases, pituitary diseases, primary osteoporosis, obesity, dyslipidemia, endocrine hypertension, and disorders of sexual development. Engaged in long-term management of chronic diseases such as diabetes, hypothyroidism, and primary osteoporosis.
Voices
Differences between Thyroid Cysts and Nodules
Thyroid cysts and thyroid nodules are different. Generally, thyroid nodules are classified into solid nodules, mixed nodules, and cystic nodules. Most thyroid cysts refer to cystic nodules of the thyroid, meaning that the nodules primarily contain fluid components. Usually, these thyroid cysts are nonfunctional. That is, they contain some fluid, which could be exudate or bloody fluid, but these fluids generally do not cause hormonal level changes. Nodules, on the other hand, often involve functional changes; they can be nodules that produce thyroid hormones or could be cancerous nodules. Therefore, in these respects, thyroid cysts and nodules are different.
Does thyroid cyst affect pregnancy?
Thyroid cysts generally do not affect pregnancy because they are merely morphological changes, meaning enlarged cystic nodules found in the thyroid. These nodules are typically fluid-filled and often non-functional, so they do not significantly impact pregnancy. However, since the thyroid can develop such cystic nodules or cysts, there might also be some functional manifestations. In other words, there could be both cysts and other thyroid function issues concurrently, which might affect pregnancy. Therefore, when thyroid issues are detected, it is necessary to undergo thyroid function tests before planning a pregnancy to determine whether it is safe to conceive and if there will be any impact on pregnancy.
The Differences between Thyroiditis, Hyperthyroidism, and Thyroid Cancer
Thyroiditis, hyperthyroidism, and thyroid cancer are clinically distinct conditions. Thyroiditis refers to inflammatory changes in the thyroid, either autoimmunity-related, suppurative or due to inflammation. Hyperthyroidism broadly refers to a functional change, which can result from various thyroid changes caused by diseases, including external damage and inflammation, leading to symptoms of hyperthyroidism. However, these manifestations should not be confused with each other, with the latter more closely related to autoimmune thyroiditis. Thyroid cancer, on the other hand, is a malignant alteration that also occurs in the thyroid gland but is not closely related to thyroiditis or hyperthyroidism. Generally, thyroid cancer is malignant, while thyroiditis and hyperthyroidism are benign, chronic conditions.
Do thyroid cysts need treatment?
Thyroid cysts generally do not require special treatment, as most thyroid cysts are quite small, and even larger ones usually do not cause significant clinical symptoms. However, treatment may be necessary in some cases, such as when a thyroid cyst becomes large enough to cause compressive symptoms, leading to difficulty breathing or swallowing, in which case puncture or surgery might be considered. On the other hand, if a thyroid cyst is accompanied by abnormalities in thyroid function, it is important to assess whether there is hyperthyroidism or hypothyroidism and treat according to the specific functional state. Additionally, in a small number of cases where a thyroid cyst may have a tendency to worsen, a puncture biopsy is needed to make a diagnosis, and if confirmed, surgery and appropriate treatment should be carried out.
What causes thyroid cysts?
Thyroid cysts currently have no definitive cause identified. Previously, most believed they were possibly related to iodine deficiency, as such deficiency leads to thyroid hyperplasia and an increase in thyroid cysts. However, it was later discovered that in some high-iodine coastal areas, the incidence of thyroid cysts remains high. This suggests that variations in iodine levels, such as switches from low to high iodine or from high to low iodine, can also lead to the occurrence of thyroid cysts. Additionally, it is currently believed that there might be some connection with radiation and the use of mobile phones and computers, but there is no definitive conclusion. Regardless, once thyroid cysts occur, it is important on one hand to eliminate the possibility of malignant features, ruling out thyroid cancer, and on the other hand to ensure thorough thyroid function tests to understand if there are any abnormalities in function and whether treatment is needed.
Where is the best place to perform moxibustion for thyroiditis?
Thyroiditis is relatively common in clinical practice, but we have not yet found that moxibustion directly helps with thyroiditis, so we do not recommend using moxibustion for treatment. Especially for types of thyroiditis that may cause an increase in thyroid hormone release, such as the acute phase of subacute thyroiditis. If moxibustion is applied directly near the thyroid region, it could potentially cause an increase in thyroid hormone release, exacerbating existing symptoms and hindering recovery. When we suffer from thyroiditis, we should choose appropriate treatment plans according to different types. For autoimmune thyroiditis, we can use treatments that regulate immunity, provide symptomatic relief, and supplement or replace hormone levels. Some painless thyroiditis may only require regular follow-ups. For cases of thyroiditis that also involve thyroid enlargement, treatment options like iodine-131 or surgery can be considered depending on the functional status.
Do thyroid cysts require surgery?
Thyroid cysts are relatively common in clinical practice. Whether surgery is necessary depends on two factors. On one hand, it depends on whether the cyst is malignant. If the ultrasound reveals small calcifications within the cyst, or other signs of malignancy, then a fine needle aspiration of the thyroid should be carried out for a pathological examination. If the cyst is confirmed to be malignant, surgery is generally recommended. However, if the examination indicates that the thyroid cyst is benign with a low malignancy level, surgery is usually not required. However, if the thyroid cyst is large, affects appearance, causes significant swallowing difficulties or hinders neck movement, surgery can also be considered.
What are the symptoms of thyroid cysts?
Thyroid cysts generally refer to a cystic mass found in the thyroid, typically containing a mixture of fluid or semi-solid fluid. The mass usually has clear boundaries and is painless. It can move up and down with swallowing, which distinguishes it from some subcutaneous nodules. Thyroid cysts generally do not show obvious symptoms or clinical signs and are mostly discovered when looking in the mirror or during a physical examination. However, larger thyroid cysts may cause compression symptoms, such as pressing backward against the trachea or esophagus, leading to symptoms like breathlessness and discomfort swallowing. A small portion may also exhibit signs of thyroid dysfunction, such as hyperthyroidism or hypothyroidism, although this is relatively rare in clinical settings.