Atherosclerosis of the aorta is the gradual buildup of plaque in your aorta. It’s a common condition that happens silently over many years. You may not have symptoms until the disease leads to a medical emergency. These include heart attack, stroke or sudden loss of blood flow to your organs and tissues. Treatments help slow disease progression.

What is atherosclerosis of the aorta?

Atherosclerosis of the aorta is a progressive buildup of plaque in the largest artery in your body, called your aorta. This condition is also known as aortic atherosclerosis. Plaque is a sticky substance made of fat, cholesterol and other components. Plaque starts forming in your arteries during childhood, and it gradually builds up more as you get older.

Plaque can form anywhere in your aorta, which is more than 1 foot long and extends from your heart to your pelvis. However, severe plaque buildup is most likely to occur in your abdominal aorta. This is the section of your aorta that runs through your belly.

People who have aortic atherosclerosis may also have plaque in other arteries throughout their body. These include the arteries that supply blood to your heart (coronary arteries) and brain (carotid arteries). That’s because atherosclerosis is a systemic disease, meaning it affects your entire body. So, plaque buildup in one artery often signals you have plaque in other arteries, too.

How does atherosclerosis of the aorta affect my body?

Atherosclerosis of the aorta leads to plaque buildup in your aorta. This is the major pipeline that sends out blood to your entire body. Many smaller arteries branch off your aorta to carry oxygen-rich blood in different directions (like up to your brain and down to your legs). Atherosclerosis in your aorta disrupts the normal flow of blood through your aorta and to the rest of your body. So, it raises your risk of ischemia (lack of oxygen-rich blood) in many different organs and tissues.

When you think of plaque buildup in your artery, you probably imagine a piece of plaque getting bigger until it blocks blood flow. While this can happen in some of your arteries, it’s less likely to happen in your aorta. That’s because your aorta has a wide diameter. So, blood can still flow through even if there’s plaque along your aorta’s walls.

The main problem with plaque buildup in your aorta is that it raises the risk of an embolus. An embolus is any object that travels through your bloodstream until it gets stuck and can’t go any further. When an embolus is stuck in one of your arteries, it immediately blocks your blood flow.

Plaque growth is gradual, like soap scum building up in the pipe below your bathroom sink. But an embolus is a sudden blockage. It’s as if you dropped the cap to your toothpaste straight down into the drain. The cap would become lodged in the pipe and block water flow.

Atherosclerosis of the aorta can trigger two different types of emboli (the plural form of “embolus”):

• Thromboembolism, which is made of blood. Blood clots can form on the plaque’s surface. One of these blood clots can then break away from the plaque and travel through your bloodstream.
• Atheroembolism, which is made of cholesterol crystals from the plaque. The plaque itself can rupture (break open). A piece of the plaque can then break away and travel through your bloodstream. Atheroembolisms are less common than thromboembolisms.

In either case, an object is traveling through your blood when it shouldn’t be. These emboli are the main complication of aortic atherosclerosis.

How an embolus affects your body depends on where it ends up getting stuck. The embolus blocks blood flow to that area, leading to ischemia (lack of oxygen-rich blood). Without enough oxygen, the organ and tissues in that area quickly become damaged.

How serious is atherosclerosis of the aorta?

Atherosclerosis of the aorta can lead to a life-threatening medical emergency. This happens when an embolus breaks away from the plaque and travels somewhere else in your body, blocking blood flow there.

Atherosclerosis of the aorta raises your risk of medical emergencies, including:

• Acute ischemic colitis: Blocked blood flow to your colon.
• Acute limb ischemia: Blocked blood flow to your limbs, usually your legs.
• Myocardial infarction (heart attack): Blocked blood flow to your heart.
• Renal infarction: Blocked blood flow to your kidneys.
• Splenic infarction: Blocked blood flow to your spleen.
• Stroke or transient ischemic attack (TIA): Blocked blood flow to your brain.

Plaque buildup in your aorta can also weaken its walls and raise your risk for an aortic aneurysm. Aneurysm ruptures and dissections can be fatal and require immediate medical attention.

Who does atherosclerosis of the aorta affect?

Atherosclerosis of the aorta can affect anyone. It’s a common condition. Your risk goes up as you get older.

What are the symptoms of atherosclerosis of the aorta?

Plaque can build up in your aorta for many years without you noticing any symptoms. In fact, you may not have any symptoms until an embolism travels through your blood to another part of your body. In that case, your symptoms depend on where the embolism is lodged and what part of your body is deprived of oxygen.

An embolism can lead to several different medical emergencies, each with specific symptoms.

Call 911 or your local emergency number if you experience any of the symptoms listed below.

Symptoms of a heart attack

• Anxiety or a feeling of “impending doom.”
• Chest pain.
• Dizziness or fainting.
• Heart palpitations.
• Nausea or vomiting.
• Pain or discomfort in your shoulder, arm, neck or jaw.
• Sweating.

Women and people designated female at birth (DFAB) may also experience:

• Fatigue.
• Shortness of breath.

Symptoms of a stroke

• Dizziness or loss of balance.
• Slurred or confused speech.
• Sudden numbness or weakness in your face, arms or legs. This may occur on one side of your body.
• Sudden, severe headache.
• Sudden trouble speaking or understanding others.
• Trouble seeing in one or both eyes.
• Trouble walking.

Symptoms of acute limb ischemia

• Cool skin.
• Gangrene.
• Mottled skin. This means you can see a blotchy pattern of red, purple or brown lines.
• Numbness or tingling.
• Pale or blue skin.
• Weak pulse or no pulse in the affected limb.

Symptoms of blocked blood flow to organs in your belly

• Blood in your poop.
• Diarrhea.
• Nausea.
• Pain or tenderness in your belly.

Symptoms of an abdominal aortic aneurysm (AAA)

Atherosclerosis of the aorta is also associated with abdominal aortic aneurysms (AAAs). That means the plaque buildup may not directly cause the AAA, but the two conditions share similar risk factors and often occur together. Many people don’t have symptoms of an AAA until it’s close to rupturing. If you do have early symptoms, they may include:

• Back, leg, or belly pain that doesn’t go away.
• Pulsing sensation in your belly, like a heartbeat.

Signs of a ruptured AAA include:

• Clammy, sweaty skin.
• Dizziness or fainting.
• Fast heart rate.
• Nausea and vomiting.
• Shortness of breath.
• Sudden, severe pain in your belly, lower back or legs.

What causes atherosclerosis of the aorta?

Damage to your aorta’s inner lining (endothelium) causes atherosclerosis to begin. This damage occurs gradually, over many years.

Certain conditions damage your endothelium and raise your risk of developing atherosclerosis. These include:

• Smoking or using tobacco products.
• Hyperlipidemia (high cholesterol).
• Hypertension (high blood pressure).
• Hyperglycemia (high blood sugar).
• Autoimmune diseases and inflammation, especially large vessel vasculitis.

How is atherosclerosis of the aorta diagnosed?

Healthcare providers use imaging tests to diagnose aortic atherosclerosis and see how far it’s progressed. These tests include:

• Computed tomography (CT) scan.
• Magnetic resonance imaging (MRI).
• Transesophageal echocardiogram.

What is the treatment for atherosclerosis of the aorta?

Aortic atherosclerosis treatment focuses on:

• Lowering your risk of complications.
• Slowing down disease progression.

Medications and lifestyle changes can help with both of these goals. Your provider may recommend medications including:

• Anticoagulants or antiplatelet medications to lower your risk of blood clots.
• Antihypertensive medication to manage your blood pressure.
• Statins to manage your cholesterol.

Lifestyle changes are also important. Your provider may recommend you:

• Avoid foods high in saturated fat and cholesterol.
• Avoid foods and drinks high in sugar.
• Exercise more often.
• Lower your salt intake.
• Quit smoking or using tobacco products.

If aortic atherosclerosis has led to complications, your provider will treat those conditions. Treatments vary widely based on where and how damage occurred and may include:

• Amputation.
• Dialysis.
• Medications.
• Minimally invasive procedures.
• Surgery.

Talk with your provider about the best treatment options for you and why they’re needed.

How can I reduce my risk of developing atherosclerosis of the aorta?

You can’t always prevent aortic atherosclerosis. But you can slow down the progression and lower your risk of serious complications by taking the following steps.

• Avoid smoking and all tobacco products. These include vaping and smokeless tobacco.
• Eat a heart-healthy diet. Choose foods low in saturated fat and cholesterol.
• Keep a healthy weight. Ask your provider what your ideal range should be.
• Keep moving. Add planned exercise to your day, and find ways to get in more movement during your daily routine.
• Manage blood pressure, cholesterol and blood sugar. Talk with your provider about lifestyle changes that can help. Plus, take your medications as prescribed.
• Visit your provider every year for a checkup. Keep all your other medical appointments and follow-ups.

What can I expect if I have atherosclerosis of the aorta?

Everyone’s prognosis is different. Your outlook depends on many factors, including:

• The severity of plaque buildup. Aortic plaque larger than 4 millimeters in diameter has a higher risk of triggering an embolism. Plaque smaller than 1 millimeter in diameter is considered “mild” and carries a lower risk of complications. Talk with your provider about how the severity of plaque buildup in your aorta and what that means for you.
• Plaque buildup in other arteries. Plaque buildup in your other arteries can further increase your risk of complications like a heart attack or stroke.
• Your overall health. If you have other conditions like high blood pressure, or if you use tobacco, you face a higher risk of complications.

Talk with your provider about your outlook and how best to manage your condition.

Is atherosclerosis of the aorta curable?

There’s no cure for atherosclerosis of the aorta, and it can’t be reversed. But lifestyle changes and medications can help you manage your condition and reduce your risk of complications.

How do I take care of myself if I have atherosclerosis of the aorta?

If you have aortic atherosclerosis, you face a higher risk of other conditions like coronary artery disease. So, it’s important to do whatever you can to keep your heart and blood vessels as healthy as possible. Follow your provider’s guidance on:

• Diet.
• Exercise.
• Lifestyle changes.
• Medications.

When should I see my healthcare provider?

Visit your provider for yearly check-ups. Your provider will tell you if you need to come in more often or see any specialists, like a cardiologist.

Call your provider if you experience new or changing symptoms, or if you have questions or concerns at any time. If you have symptoms of a medical emergency, you should seek immediate medical attention.

When to seek immediate medical attention

Call 911 or your local emergency number immediately if you have symptoms of:

• Abdominal aortic aneurysm (AAA).
• Acute limb ischemia.
• Heart attack.
• Stroke.
• Thoracic aortic aneurysm.
• Transient ischemic attack (TIA).

What questions should I ask my provider?

Talk with your provider about your outlook and what you can expect going forward. Some questions to ask include:

• How severe is my condition?
• How can I slow down its progression?
• What lifestyle changes are most important for me to make?
• What medications do I need to take? What are the side effects?

If you need heart surgery or a catheter-based procedure, talk with your provider about your risk for complications. Aortic atherosclerosis raises your risk of complications during some heart and vascular procedures. Ask your provider what risks you face and what your care team can do to reduce those risks.

A note from QBan Health Care Services

If you have atherosclerosis of the aorta, you may be wondering how serious the condition is and what’ll happen down the road. Aortic atherosclerosis can lead to serious complications. But the good news is that your provider can help you manage the condition to slow down its progression. Talk with your provider about your outlook and what changes you can make in your daily life.

Coronary artery disease (CAD) is a condition that affects your coronary arteries, which supply blood to your heart. With CAD, plaque buildup narrows or blocks one or more of your coronary arteries. Chest discomfort (angina) is the most common symptom. CAD can lead to a heart attack or other complications like arrhythmia or heart failure.

What is coronary artery disease?

Coronary artery disease (CAD) is a narrowing or blockage of your coronary arteries, usually due to plaque buildup. Your coronary arteries supply oxygen-rich blood to your heart. Plaque buildup in these arteries limits how much blood can reach your heart.

Picture two traffic lanes that merge into one due to construction. Traffic keeps flowing, just more slowly. With CAD, you might not notice anything is wrong until the plaque triggers a blood clot. The blood clot is like a concrete barrier in the middle of the road. Traffic stops. Similarly, blood can’t reach your heart, and this causes a heart attack.

You might have CAD for many years and not have any symptoms until you experience a heart attack. That’s why CAD is a “silent killer.”

Other names for CAD include coronary heart disease (CHD) and ischemic heart disease. It’s also what most people mean when they use the general term “heart disease.”

Forms of coronary artery disease

There are two main forms of coronary artery disease:

• Stable ischemic heart disease: This is the chronic form. Your coronary arteries gradually narrow over many years. Over time, your heart receives less oxygen-rich blood. You may feel some symptoms, but you’re able to live with the condition day to day.
• Acute coronary syndrome: This is the sudden form that’s a medical emergency. The plaque in your coronary artery suddenly ruptures and forms a blood clot that blocks blood flow to your heart. This abrupt blockage causes a heart attack.

How common is coronary artery disease?

Coronary artery disease is very common. Over 18 million adults in the U.S. have coronary artery disease. That’s roughly the combined populations of New York City, Los Angeles, Chicago and Houston.

In 2019, coronary artery disease killed 360,900 people in the U.S. That’s enough people to fill Yankee Stadium more than seven times.

Who does coronary artery disease affect?

Coronary artery disease is the leading cause of death in the U.S. and around the world. This is true for men and people assigned male at birth (AMAB), as well as women and people assigned female at birth (AFAB).

In the U.S., coronary artery disease affects nearly 1 in 10 people aged 40 to 80. About 1 in 5 deaths from CAD occur in people under age 65.

How does coronary artery disease affect my body?

The main complication of coronary artery disease is a heart attack. This is a medical emergency that can be fatal. Your heart muscle starts to die because it’s not receiving enough blood. You need prompt medical attention to restore blood flow to your heart and save your life.

Over the years, CAD can also weaken your heart and lead to complications, including:

• Arrhythmias (like atrial fibrillation).
• Cardiac arrest.
• Cardiogenic shock.
• Heart failure.

What are the symptoms of coronary artery disease?

You may have no symptoms of coronary artery disease for a long time. CAD is a chronic condition. Plaque buildup takes many years, even decades. But as your arteries narrow, you may notice mild symptoms. These symptoms indicate your heart is pumping harder to deliver oxygen-rich blood to your body.

Symptoms of chronic CAD include:

• Stable angina: This is the most common symptom. Stable angina is temporary chest pain or discomfort that comes and goes in a predictable pattern. You’ll usually notice it during physical activity or emotional distress. It goes away when you rest or take nitroglycerin (medicine that treats angina).
• Shortness of breath (dyspnea): Some people feel short of breath during light physical activity.

Sometimes, the first symptom of CAD is a heart attack. Symptoms of a heart attack include:

• Chest pain or discomfort (angina). Angina can range from mild discomfort to severe pain. It may feel like heaviness, tightness, pressure, aching, burning, numbness, fullness, squeezing or a dull ache. The discomfort may spread to your shoulder, arm, neck, back or jaw.
• Shortness of breath or trouble breathing.
• Feeling dizzy or lightheaded.
• Heart palpitations.
• Feeling tired.
• Nausea, stomach discomfort or vomiting. This may feel like indigestion.
• Weakness.

Women and people AFAB are more likely to have additional, atypical symptoms that include:

• Shortness of breath, fatigue and insomnia that began before the heart attack.
• Pain in their back, shoulders, neck, arms or belly.
• Heart racing.
• Feeling hot or flushed.

What causes coronary artery disease?

Atherosclerosis causes coronary artery disease. Atherosclerosis is the gradual buildup of plaque in arteries throughout your body. When the plaque affects blood flow in your coronary arteries, you have coronary artery disease.

Plaque consists of cholesterol, waste products, calcium and fibrin (a substance that helps your blood clot). As plaque continues to collect along your artery walls, your arteries become narrow and stiff.

Plaque can clog or damage your arteries, which limits or stops blood flow to a certain part of your body. When plaque builds up in your coronary arteries, your heart muscle can’t receive enough blood. So, your heart can’t get the oxygen and nutrients it needs to work properly. This condition is called myocardial ischemia. It leads to chest discomfort (angina) and puts you at risk for a heart attack.

People who have plaque buildup in their coronary arteries often have buildup elsewhere in their body, too. This can lead to conditions like carotid artery disease and peripheral artery disease.

What are the risk factors for coronary artery disease?

There are many risk factors for coronary artery disease. Some you can’t control. Others you may be able to control by making lifestyle changes or taking medications. Talk with your provider about the risk factors listed below and how you can manage them.

Risk factors you can’t control (non-modifiable risk factors)

• Age: As you get older, your risk for CAD goes up. Men and people AMAB face a higher risk after age 45. Women and people AFAB face a higher risk after age 55.
• Family history: You have a higher risk if your biological family members have heart disease. It’s especially important to learn if they have premature heart disease. This means they were diagnosed at a young age (father or brother before age 55, mother or sister before age 65).

Lifestyle factors that raise your risk

• Diet high in saturated fat or refined carbohydrates.
• Lack of physical activity.
• Sleep deprivation.
• Smoking, vaping or other tobacco use.

Cardiovascular conditions that raise your risk

• Atherosclerosis.
• High blood pressure.
• High LDL (“bad”) cholesterol.
• High triglycerides (hypertriglyceridemia).

Other medical conditions that raise your risk

• Anemia.
• Autoimmune diseases, including lupus and rheumatoid arthritis.
• Chronic kidney disease.
• Diabetes.
• HIV/AIDS.
• Metabolic syndrome.
• Overweight/obesity.
• Sleep disorders like sleep apnea.

Risk factors that affect women and people assigned female at birth

• Early menopause (before age 40).
• Endometriosis.
• History of gestational diabetes, eclampsia or preeclampsia.
• Use of hormonal birth control.

How is coronary artery disease diagnosed?

Healthcare providers diagnose coronary artery disease through a physical exam and testing.

During your physical exam, your provider will:

• Measure your blood pressure.
• Listen to your heart with a stethoscope.
• Ask what symptoms you’re experiencing and how long you’ve had them.
• Ask you about your medical history.
• Ask you about your lifestyle.
• Ask you about your family history. They’ll want to know about heart disease among your biological parents and siblings.

All of this information will help your provider determine your risk for heart disease.

Tests that help diagnose coronary artery disease

Your provider may also recommend one or more tests to assess your heart function and diagnose CAD. These include:

• Blood tests: Check for substances that harm your arteries or increase your risk of CAD.
• Cardiac catheterization: Inserts tubes into your coronary arteries to evaluate or confirm CAD. This test is the gold standard for diagnosing CAD.
• Computed tomography (CT) coronary angiogram: Uses CT and contrast dye to view 3D pictures of your heart as it moves. Detects blockages in your coronary arteries.
• Coronary calcium scan: Measures the amount of calcium in the walls of your coronary arteries (a sign of atherosclerosis). This doesn’t determine if you have significant blockages, but it does help determine your risk for CAD.
• Echocardiogram (echo): Uses sound waves to evaluate your heart’s structure and function.
• Electrocardiogram (EKG/ECG): Records your heart’s electrical activity. Can detect old or current heart attacks, ischemia and heart rhythm issues.
• Exercise stress test: Checks how your heart responds when it’s working very hard. Can detect angina and blockages in your coronary arteries.

What is the treatment for coronary artery disease?

Treatment for CAD often includes lifestyle changes, risk factor management and medications. Some people may also benefit from a procedure or surgery.

Your healthcare provider will talk with you about the best treatment plan for you. It’s important to follow your treatment plan so you can lower your risk of serious complications from CAD.

Lifestyle changes

Lifestyle changes play a big role in managing CAD. Such changes include:

• Don’t smoke, vape, or use any tobacco products.
• Eat a heart-healthy diet that’s low in sodium, saturated fat, trans fat and sugar. The Mediterranean diet has been proven to lower your risk of a heart attack or stroke.
• Exercise: Aim for 30 minutes of walking five days a week, or find activities you enjoy.
• Limit alcohol.

Be sure to talk with your provider before starting any new exercise program. Your provider can also offer guidance on lifestyle changes tailored to your needs. Your provider may recommend meeting with a dietitian to discuss healthy eating plans and smoking cessation options.

Risk factor management

Managing your risk factors for CAD can help slow down the progression of your disease. Work with your provider to manage the following conditions:

• Diabetes.
• High blood pressure.
• High cholesterol.
• High triglycerides (hypertriglyceridemia).
• Overweight/obesity.

Medications

Medications can help you manage your risk factors plus treat symptoms of coronary artery disease. Your provider may prescribe one or more of the medications listed below.

• Medications to lower your blood pressure.
• Medications to lower your cholesterol.
• Medications to manage stable angina. These include nitroglycerin and ranolazine.
• Medications to reduce your risk of blood clots.

Procedures and surgeries

Some people need a procedure or surgery to manage coronary artery disease, including:

• Percutaneous coronary intervention (PCI): Another name for this procedure is coronary angioplasty. It’s minimally invasive. Your provider uses a small balloon to reopen your blocked artery and help blood flow through it better. Your provider may also insert a stent to help your artery stay open.
• Coronary artery bypass grafting (CABG): This surgery creates a new path for your blood to flow around blockages. This “detour” restores blood flow to your heart. CABG helps people who have severe blockages in several coronary arteries.

Your provider will recommend which of these treatment options would be best in your unique case.

How can I prevent coronary artery disease?

You can’t always prevent coronary artery disease. That’s because some risk factors are out of your control. But there’s a lot you can do to lower your risk. Many strategies to lower your risk also help manage your condition once you’re diagnosed.

You can lower your risk of coronary artery disease and help prevent it from getting worse by doing the following:

• Commit to quitting smoking and all tobacco use. Quitting an addictive substance isn’t easy, and it’s not just a matter of willpower. That’s why it’s important to connect with resources and support groups that can help. Ask your provider for recommendations in your community.
• Eat a heart-healthy diet. This means avoiding foods high in saturated fat, trans fat, sodium and sugar. It also means limiting refined carbohydrates (like white bread and pasta). Replace such foods with whole grains (like wheat bread and brown rice). It’s also important to learn how nutrition affects your cholesterol levels.
• Get enough sleep. Most adults need seven to nine hours of quality sleep per night. But many people might find this goal difficult, if not impossible. Work schedules, parenting and other obligations may prevent you from getting enough rest. Talk with your provider about strategies for getting the quality sleep you need to support your heart health.
• Keep a healthy weight. Talk with your provider about what your ideal weight should be. Work with your provider to set manageable goals until you reach your ideal weight. Avoid short-term diets that are very restrictive. Instead, adopt lifestyle changes that are reasonable for you to keep up for a long time to come.
• Learn your risk for heart disease. Visit your provider for a risk screening starting at age 20 (or sooner if your provider recommends it). Your provider will take some basic measurements, like your blood pressure and BMI. They may also use a risk calculator to predict your future risk of heart disease.
• Limit alcohol use. Drinking too much alcohol can harm your heart. Men and people AMAB should consume no more than two drinks per day. Women and people AFAB should limit their intake to one drink per day. But drinking less is even better.
• Move around more. Exercise is planned and intentional. It’s important to try to exercise for 150 minutes per week (for example, 30-minute walks on five days of the week). But you can also build in extra movement. Park farther away from the door. Put your laundry away in small batches so you get in more steps. Walk a lap around your house each time you go to the bathroom. Or even just walk in place. The more you move, the better for your heart. Of course, check with your provider about what level of activity is safe for you.
• Keep up with recommended medications. Medications are essential in reducing your risk for CAD and preventing heart attacks if you’ve already been diagnosed with CAD. Many of these medications are prescribed lifelong. It’s important to understand what they do and how they prevent events and even prolong your life.

What can I expect if I have coronary artery disease?

Your provider is the best person to ask about your prognosis. Outcomes vary based on the person. Your provider will look at the big picture, including your age, medical conditions, risk factors and symptoms. Lifestyle changes and other treatments can improve your chances of a good prognosis.

Can coronary artery disease be cured?

Coronary artery disease can’t be cured. But you can manage your condition and prevent it from getting worse. Work with your healthcare provider and follow your treatment plan. Doing so will give you the strongest possible chance of living a long and healthy life.

How do I take care of myself if I have coronary artery disease?

The most important thing you can do is keep up with your treatment plan. This may include lifestyle changes and medications. It may also involve a procedure or surgery and the necessary recovery afterward.

Along with treatment, your provider may recommend cardiac rehab. A cardiac rehab program is especially helpful for people recovering from a heart attack or living with heart failure. Cardiac rehab can help you with exercise, dietary changes and stress management.

Coronary artery disease and mental health

A CAD diagnosis may cause you to think about your heart and arteries more than ever before. This can be exhausting and overwhelming. You may worry a lot about your symptoms or what might happen to you. It’s not surprising that many people with coronary artery disease experience depression and anxiety. You’re living with a condition that can be life-threatening. It’s normal to worry.

But the worry shouldn’t consume your daily life. You can still thrive and live an active, happy life while having heart disease. If your diagnosis is affecting your mental health, talk with a counselor. Find a support group where you can meet people who share your concerns. Don’t feel you need to keep it all inside or be strong for others. CAD is a life-changing diagnosis. It’s OK to devote time to processing it all and figuring out how to feel better both physically and emotionally.

When should I see my healthcare provider?

Your provider will tell you how often you need to come in for testing or follow-ups. You may have appointments with specialists (like a cardiologist) in addition to your primary care visits.

Call your provider if you:

• Experience new or changing symptoms.
• Have side effects from your medication.
• Have questions or concerns about your condition or your treatment plan.

What questions should I ask my doctor?

If you haven’t been diagnosed with coronary artery disease, consider asking:

• What are my risk factors for coronary artery disease?
• What can I do to lower my risk?
• What lifestyle changes are most important for me?
• What medications would lower my risk, and what are the side effects? How long do I need to stay on these medications?

If you have coronary artery disease, some helpful questions include:

• What can I do to slow down disease progression?
• What’s the best treatment plan for me?
• What lifestyle changes should I make?
• What medications do I need, and what are the side effects?
• Will I need a procedure or surgery? What does the recovery look like?
• Are there support groups or resources you can recommend?

When should I go to the emergency room?

Call 911 or your local emergency number if you have symptoms of a heart attack or stroke. These are life-threatening medical emergencies that require immediate care. It may be helpful to print out the symptoms and keep them where you can see them. Also, share the symptoms with your family and friends so they can call 911 for you if needed.

A note from QBan Health Care Services

Learning you have coronary artery disease can cause a mix of emotions. You may feel confused about how this could happen. You may feel sad or wish you’d done some things differently to avoid this diagnosis. But this is a time to look forward, not backward. Let go of any guilt or blame you feel. Instead, commit to building a plan to help your heart, beginning today.

Work with your provider to adopt lifestyle changes that feel manageable to you. Learn about treatment options, including medications, and how they support your heart health. Tell your family and friends about your goals and how they can help you. This is your journey, but you don’t have to do it alone.

Atherosclerosis is a hardening of your arteries due to gradual plaque buildup. Risk factors include high cholesterol, high blood pressure, diabetes, tobacco use, obesity, lack of exercise and a diet high in saturated fat. Atherosclerosis develops over time and may not show symptoms until you have complications like a heart attack or stroke.

What is atherosclerosis?

Atherosclerosis is the gradual buildup of plaque in the walls of your arteries. Arteries are blood vessels that carry oxygen-rich blood to organs and tissues throughout your body. Plaque (atheroma) is a sticky substance made of fat, cholesterol, calcium and other substances.

As plaque builds up, your artery wall grows thicker and harder. This “hardening of the arteries” is usually a silent process in the early stages. You may not notice symptoms for a long time. But eventually, as the plaque grows, the opening (lumen) of your artery narrows, leaving less room for blood to flow. This means less blood can reach your organs and tissues. Plus, the constant force of blood flow can lead to plaque erosion or rupture, causing a blood clot to form.

A narrowed artery is like a highway reduced to one lane. But a blood clot is like a barricade in the middle of the road. It blocks blood flow to certain organs or tissue the artery normally feeds. The effects on your body depend on where the blood clot forms. For example, blockages in a coronary artery deprive your heart of oxygen-rich blood, leading to a heart attack.

But there’s a reason for hope. You can lower your risk for atherosclerosis, or slow its progression, by making lifestyle changes and managing underlying conditions. Research shows some treatments can reduce the size of plaque in your arteries (plaque regression) or change its chemical makeup, so it’s less likely to rupture.

That’s why visiting a healthcare provider for yearly checkups is important. They’ll evaluate your risk for atherosclerosis and explain what you can do to lower it.

What are the complications of atherosclerosis?

Atherosclerosis interferes with the normal workings of your cardiovascular system. It can limit or block blood flow to various parts of your body, including your heart and brain. Possible complications of reduced blood flow include:

• Carotid artery disease.
• Coronary artery disease.
• Heart attack.
• Mesenteric ischemia.
• Peripheral artery disease.
• Renal artery stenosis.
• Stroke.
• Transient ischemic attack (TIA).

Atherosclerosis can also weaken your artery walls, leading to the formation of aneurysms.

Early diagnosis and treatment of atherosclerosis can help you avoid or delay complications.

How common is atherosclerosis?

Atherosclerosis is very common. The complications of plaque buildup (including heart attacks and strokes) are the leading cause of death worldwide.

About half of people age 45 to 84 have atherosclerosis but aren’t aware of it, according to the U.S. National Institutes of Health.

What are the symptoms of atherosclerosis?

Atherosclerosis often doesn’t cause symptoms until an artery is very narrow or blocked. Many people don’t know they have plaque buildup until a medical emergency, like a heart attack or stroke, occurs.

You may notice symptoms if your artery is more than 70% blocked. Such extensive plaque buildup can lead to complications, which in turn cause symptoms. The chart below lists some symptoms you may feel depending on the complication.

Complication of atherosclerosis	Possible symptoms
Coronary artery disease	·Stable angina. ·Shortness of breath (dyspnea) during light physical activity. · Sometimes, the first symptom is a heart attack.
Heart attack	· Chest pain or discomfort (angina). · Pain in your back, shoulders, neck, arms or belly. · Shortness of breath or trouble breathing. · Feeling dizzy or lightheaded. ·Heart palpitations. ·Fatigue. · Nausea or vomiting that may feel like indigestion.
Mesenteric ischemia	· Pain or cramping in your belly (abdomen) after eating. ·Bloating, nausea and vomiting. · Diarrhea. · Unintentional weight loss due to “food fear” (fear of pain after eating).
Peripheral artery disease (PAD)	·Intermittent claudication. This is leg pain or cramping you feel when you’re active. It goes away when you rest. It’s the first symptom of PAD. · Burning or aching pain in your feet and toes when you rest, especially when lying flat. · Changes in skin color (like redness). · Cool skin on your feet. · Frequent skin and soft tissue infections, often in your legs or feet. · Sores on your feet or toes that don’t heal.
Renal artery stenosis	· Markedly elevated blood pressure that’s resistant to multiple medications. · Changes in how often you pee. · Swelling (edema). · Feeling drowsy or tired. · Skin that feels dry, itchy or numb. · Headaches. · Unexplained weight loss. · Nausea, vomiting or loss of appetite.
Stroke or transient ischemic attack (TIA)	· Dizziness. · Drooping on one side of your face. · Loss of feeling, loss of muscle strength or weakness on one side of your body. · Severe headache. · Slurred speech or difficulty forming words. · Vision loss in one eye. You may notice a dark shade coming down over your field of sight.
Carotid artery disease	· Usually, the first symptoms are a TIA or stroke.

Call 911 or your local emergency number right away if you or someone near you has symptoms of a heart attack, stroke or TIA. These are medical emergencies that require immediate care.

What causes atherosclerosis?

Damage to your artery’s inner lining (endothelium) causes atherosclerosis to begin. The damage usually occurs slowly and over time.

Stages of atherosclerosis

The stages of atherosclerosis happen over many years and include:

• Endothelial damage and immune response. Atherosclerosis begins with endothelial damage. Your endothelium is a thin lining of cells that covers the inner layer of your artery wall (intima). Many factors can cause endothelial damage, including high LDL cholesterol levels and toxins from tobacco products. The damage triggers chemical processes that cause white blood cells to travel to the injury site. These cells gather and lead to inflammation within your artery.
• Fatty streak formation. A “fatty streak” is the first visible sign of atherosclerosis. It’s a yellow streak or patch formed out of dead foam cells at the site of endothelial damage. Foam cells are white blood cells that consume invaders to try to get rid of them. In this case, they consume cholesterol and thus appear foamy. Continued foam cell activity causes further damage to your endothelium.
• Plaque growth. Dead foam cells and other debris continue building up. So, the fatty streak turns into a larger piece of plaque. A fibrous cap (made of smooth muscle cells) forms over the plaque. This cap prevents bits of plaque from breaking off into your bloodstream. As the plaque grows, it gradually narrows your artery’s opening (lumen), so there’s less room for blood to flow through.
• Plaque rupture or erosion. In this stage, a blood clot forms in your artery due to plaque rupture or plaque erosion. Plaque rupture happens when the fibrous cap that covers the plaque breaks open. With plaque erosion, the fibrous cap stays intact, but endothelial cells around the plaque get worn away. Both events lead to the formation of a blood clot. The clot blocks blood flow and can lead to a heart attack or stroke.

What are the risk factors for atherosclerosis?

There are many risk factors for atherosclerosis. Non-modifiable risk factors are those you can’t change. You may be able to reduce modifiable risk factors, including some medical conditions and lifestyle factors, in some cases.

It’s important to note that some risk factors vary based on your sex assigned at birth. For example, people assigned male at birth (AMAB) face a higher risk of atherosclerosis at a younger age than people assigned female at birth (AFAB).

Non-modifiable risk factors	· Increasing age. People assigned male at birth face a higher risk after age 45. People assigned female at birth face a higher risk after age 55. · Family history of premature cardiovascular disease. This means a close biological family member who’s AMAB was diagnosed with cardiovascular disease before age 45. Or, one who’s AFAB was diagnosed before age 55.
Medical conditions	· Diabetes. · High blood pressure (hypertension). · High cholesterol (hyperlipidemia), especially high LDL cholesterol or high levels of a specific lipoprotein called lipoprotein (a). · Metabolic syndrome.
Lifestyle factors	· Smoking or tobacco use. · Lack of physical activity. · A diet high in saturated fat, trans fat, sodium and sugar.

Talk to your provider about your risks and what you can do to lower them.

How is atherosclerosis diagnosed?

To diagnose atherosclerosis or calculate your risk for developing it, a healthcare provider will:

• Perform a thorough physical exam. This includes using a stethoscope to listen to your heart and blood flow through your arteries. For example, your provider will check your carotid arteries (in your neck) for a whooshing sound called a “bruit.” This sound may indicate the presence of plaque.
• Ask about your medical history and family history. These details can help show your risk for atherosclerosis and its complications.
• Ask about your lifestyle. Your provider may ask about lifestyle factors like past or present use of tobacco products.
• Order blood tests. Cardiac blood tests show your cholesterol levels and many details about your heart function.

What tests will be done to diagnose this condition?

Your healthcare provider may order additional tests to diagnose atherosclerosis and plan treatment. These tests include:

• Angiography. This test uses special X-rays to locate and measure blockages. Your healthcare provider will inject a contrast dye into your arteries to help the blockages show up on the X-rays.
• Ankle/brachial index. This test compares the blood pressure in your ankle to the pressure in your arm to measure blood flow in your arms and legs.
• Chest X-ray. A chest X-ray takes pictures inside of your chest.
• CT scan. This scan takes pictures inside of your body and can show any hardening and narrowing of your large arteries.
• Echocardiogram (echo). An echo takes pictures of your heart’s valves and chambers and measures how well your heart is pumping.
• Electrocardiogram (EKG). An EKG measures your heart’s electrical activity, rate and rhythm.
• Exercise stress test. This test measures your heart function while you’re physically active.
• Carotid ultrasound. This test takes ultrasound pictures of the arteries in your neck (carotid arteries). It can detect hardening or narrowing of these arteries as blood flows to your brain.
• Abdominal ultrasound. This ultrasound takes pictures of your abdominal aorta. It checks for ballooning (abdominal aortic aneurysm) or plaque buildup in your aorta.

What specialists might I need to see for atherosclerosis?

If you have atherosclerosis, your healthcare provider may recommend you see a specialist, such as a:

• Cardiologist, who specializes in the heart.
• Nephrologist, who specializes in the kidneys.
• Neurologist, who specializes in the nervous system (brain and spine).
• Vascular surgeon, who specializes in blood vessels.

What is the treatment for atherosclerosis?

Atherosclerosis treatment includes one or more of the following:

• Lifestyle changes.
• Medications.
• Procedures or surgeries.

Your healthcare provider will develop a plan based on your needs. Common treatment goals include:

• Lowering your risk of blood clots.
• Preventing complications like a heart attack or stroke.
• Easing symptoms.
• Helping you develop patterns of eating that support your heart and blood vessels.
• Slowing or stopping plaque buildup in your arteries.
• Improving blood flow by widening your arteries or bypassing (avoiding) blockages.

Lifestyle changes

Lifestyle changes may lower your risk of complications. Your provider will create a plan specific to your needs. General tips include:

• Avoid all tobacco products (including smoking and vaping).
• Follow a heart-healthy eating plan like the Mediterranean Diet.
• Build exercise into your daily routine.

Medications

Medications target risk factors for plaque buildup and may help slow the progression of atherosclerosis. Your provider may prescribe medications to:

• Lower your blood pressure.
• Lower your cholesterol.
• Manage your blood sugar levels.
• Prevent blood clots.

It’s important to take all of your medications as prescribed. Always check with your provider before making any changes to your medication schedule.

Procedures or surgeries

Various minimally invasive procedures and complex surgeries can help people with severe blockages or a high risk of complications. Common treatment options include:

• Angioplasty.
• Atherectomy.
• Carotid endarterectomy.
• Coronary artery bypass grafting (CABG).
• Peripheral artery bypass.
• Stent placement.
• Vascular disease bypass.

How can I prevent atherosclerosis?

You may not be able to prevent atherosclerosis. But you can reduce your risk and lessen the effects of the disease. Here are some steps you can take:

• Eat foods low in saturated fat, trans fat, cholesterol, sodium (salt) and sugar.
• Exercise regularly. Start with short walks and build up to 30 minutes a day most days of the week.
• Keep a weight that’s healthy for you. Ask your provider what that should be.
• Manage any health conditions, especially diabetes, high blood pressure and high cholesterol.
• Don’t use tobacco products.
• Have a yearly checkup with a healthcare provider.

What is the outlook for people with atherosclerosis?

Early diagnosis and treatment can help people with atherosclerosis live healthy, active lives. But the disease can cause medical emergencies and even be fatal. That’s why knowing your risks and working with your healthcare provider to lower them is important.

How do I take care of myself?

It’s essential to work closely with your healthcare provider. They’ll keep a close eye on your condition and tell you how often you should come in for appointments. Go to all of your appointments and follow-ups, and be an active partner in your care. Tell your provider right away about any new or changing symptoms.

Also, take care of your mental health. It’s normal to feel anxious about what the future could bring. You may also feel overwhelmed by the need to make lifestyle changes. But those feelings shouldn’t prevent you from enjoying life. Some tips for managing your thoughts and worries include:

• Share your feelings with a counselor or support group.
• Connect with others who have cardiovascular disease. You can share your experiences and learn from each other.
• Talk to your family and friends about the lifestyle changes you’re making. Explain why these changes are important to you and ask them to help you stay on track.

A note from QBan Health Care Services

Atherosclerosis is a common condition. So, remember that if you have atherosclerosis, you’re not alone. Many other people are in your shoes. Your healthcare provider is ready to help you manage your condition so you can live a long and healthy life.

Erectile dysfunction, commonly referred to as ED, is the inability to achieve and sustain an erection suitable for sexual intercourse. It is estimated that about 1 in 10 adult males suffer from ED on a long-term basis.

What is erectile dysfunction (ED)?

Erectile dysfunction (ED) is the inability to get and keep an erection firm enough for sexual intercourse. Estimates suggest that one of every 10 men will suffer from ED at some point during his lifetime. It is important to understand that in most cases, ED is a symptom of another, underlying problem. ED is not considered normal at any age, and may be associated with other problems that interfere with sexual intercourse, such as lack of desire and problems with orgasm and ejaculation.

How common is erectile dysfunction?

Approximately one in 10 adult males will suffer from ED on a long-term basis.

Many men do experience occasional failure to achieve erection, which can occur for a variety of reasons, such as drinking too much alcohol, stress, relationship problems, or from being extremely tired.

The failure to get an erection less than 20% of the time is not unusual and typically does not require treatment. However, the failure to achieve an erection more than 50% of the time generally means that there is a problem and treatment is needed.

ED does not have to be a part of getting older. While it is true that some older men may need more stimulation, they should still be able to achieve an erection and enjoy intercourse.

What causes erectile dysfunction (ED)?

ED can be caused by a number of factors, including:

• Vascular disease: Blood supply to the penis can become blocked or narrowed as a result of vascular disease such as atherosclerosis (hardening of the arteries).
• Neurological disorders (such as multiple sclerosis): Nerves that send impulses to the penis can become damaged from stroke, diabetes, or other causes.
• Psychological states: These include stress, depression, lack of stimulus from the brain and performance anxiety.
• Trauma: An injury could contribute to symptoms of ED.

Chronic illness, certain medications, and a condition called Peyronie’s disease can also cause ED. Operations for the prostate, bladder, and colon cancer may also be contributing factors.

What medications could cause erectile dysfunction (ED)?

Erectile dysfunction (ED) is a common side effect of a number of prescription drugs. While these medications may treat a disease or condition, in doing so they can affect a man’s hormones, nerves or blood circulation, resulting in ED or increasing the risk of ED.

If you experience ED and think that it may be a result of the medication you are using, do not stop taking the medication. If the problem persists, contact your doctor and he or she may be able to prescribe a different medication. Common medications that may list ED as a potential side effect include:

• Diuretics (pills that cause increase urine flow).
• Antihypertensives (high blood pressure drugs).
• Antihistamines.
• Antidepressants.
• Parkinson’s disease drugs.
• Antiarrhythmics (drug for irregular heart action).
• Tranquilizers.
• Muscle relaxants.
• Nonsteroidal anti-inflammatory drugs.
• Histamine H2-receptor antagonists.
• Hormones.
• Chemotherapy medications.
• Prostate cancer drugs.
• Anti-seizure medications.

Other substances or drugs that can cause or lead to ED include these recreational and frequently abused drugs:

• Alcohol.
• Amphetamines.
• Barbiturates.
• Cocaine.
• Marijuana.
• Methadone.
• Nicotine.
• Opiates.

These drugs not only affect and often suppress the central nervous system, but can also cause serious damage to the blood vessels, leading to permanent ED.

How are depression and erectile dysfunction related?

For some men, depression can accompany the condition of erectile dysfunction (ED). It is common for men with ED to feel angry, frustrated, sad, unsure of themselves, or even less “manly.” Such feelings may lead to a lack of self-esteem and, in severe cases, to depression.

Depression that accompanies ED is treatable. The first step in addressing your concerns about ED-related depression is to be honest with yourself, your partner, and your doctor. After depression has been brought out into the open, coping with it will be easier and less stressful.

How is erectile dysfunction (ED) diagnosed?

Because there are a variety of causes for ED, there are several different tests your doctor may use to diagnose the condition and determine its cause. Only after the cause of ED is determined can it be effectively treated.

Before ordering any tests, your doctor will review your medical history and perform a thorough physical examination. The doctor will also “interview” you about your personal and sexual history. Some of these questions will be very personal and may feel intrusive. However, it is important that you answer these questions honestly. The questions asked may include:

• What medications or drugs are you currently using? This includes prescription drugs, over-the-counter drugs, herbals, dietary supplements and illegal drugs.
• Have you had any psychological problems such as stress, anxiety and depression?
• When did you first notice symptoms of ED?
• What are the frequency, quality and duration of any erections you have had?
• What are the specifics of the circumstances under which ED first occurred?
• Do/did you experience erections at night or during the morning?
• What sexual techniques do you use?
• Are there problems in your current relationship?

The doctor may also wish to interview your sexual partner since your partner may be able to offer in sight about the underlying causes.

After your physical examination and discussion, your doctor may then order any one of the following tests to further diagnose your condition:

• Complete blood count (CBC): This is a set of blood tests that, among other things, can detect the presence of anemia. Anemia is caused by a low red blood cell count and can cause fatigue, which in turn can cause ED.
• Liver and kidney function tests: These blood tests may indicate whether ED may be due to your kidneys or liver functioning improperly.
• Lipid profile: This blood test measures the level of lipids (fats), like cholesterol. High levels may indicate atherosclerosis (hardening of the arteries), which can affect blood circulation in the penis.
• Thyroid function test: One of the thyroid hormones’ functions is to regulate the production of sex hormones, and a deficiency in these hormones may contribute to or cause ED.
• Blood hormone studies: Testosterone and/or prolactin levels in the blood may be measured to see if abnormalities in either of these sex hormones are present.
• Urinalysis: Analysis of urine can provide a wealth of information, including information on protein, sugar and testosterone levels. Abnormal measurements of these substances can indicate diabetes, kidney disease or a testosterone deficiency, all which can cause ED.
• Duplex ultrasound: This is perhaps the best test for evaluating ED. An ultrasound uses high-frequency sound waves to take “pictures” of the body’s tissues. For people with ED, an ultrasound may be used to evaluate blood flow and check for signs of a venous leak, atherosclerosis (hardening of arteries) or tissue scarring. This test is performed both while the penis is erect (usually induced by an injection of a drug that stimulates erection) and also while it is soft.
• Bulbocavernosus reflex: This test evaluates nerve sensation in the penis. During the test, your doctor will squeeze the head of your penis, which should immediately cause your anus to contract. If nerve function is abnormal, there will be a delay in response time.
• Nocturnal penile tumescence (NPT): This test measures a man’s erectile function while he is sleeping. Normally, a man will have five or six erections while asleep. A lack of these erections may indicate there is a problem with nerve function or circulation to the penis. The test uses two methods, the snap gauge method and the strain gauge method. The snap gauge method is performed by wrapping three plastic bands of varying strength around the penis. Erectile function is then measured based on which of the three bands breaks. The strain gauge method works by placing elastic bands around the tip and base of the penis. If the penis becomes erect during the night, the bands stretch, measuring the changes in penile circumference.
• Penile biothesiometry: This test involves the use of electromagnetic vibration to determine sensitivity and nerve function. A decreased sensitivity to these vibrations may indicate nerve damage.
• Vasoactive injection: During this test, an erection is produced by injecting special solutions that cause the blood vessels to dilate (enlarge) allowing blood to enter the penis.
• Dynamic infusion cavernosometry: This test is used for men with ED who have a venous leak. During this test, fluid is pumped into the penis at a predetermined rate. By measuring the rate at which fluid must be pumped to attain a rigid erection, doctors can determine the severity of the venous leak.
• Cavernosography: Used in conjunction with the dynamic infusion cavernosometry, this test involves injecting a dye into the penis. The penis is then X-rayed so that the venous leak can be seen.
• Arteriography: This test is given to people who are candidates for vascular reconstructive surgery. A dye is injected into the artery believed to be damaged and X-rays will be taken.

Before you are given any of these tests, your doctor will explain what is involved. If you have any questions, do not hesitate to ask your doctor.

What doctors treat erectile dysfunction?

The type of medical specialist who treats ED will depend on the cause of the problem. Based on your family’s medical history, as well as your own medical history and current health, your doctor may treat you with oral medications (Viagra®, Levitra®, Cialis®).

If these options fail, you may be referred to a urologist who can assist with other non-surgical options such as vacuum device or injections or surgical treatment options. If needed, your doctor may also refer you to a psychologist specializing in sexual dysfunction.

How is erectile dysfunction treated?

ED can be treated in many ways, including:

• Oral medications.
• Sex therapy.
• Penile injections.
• Vacuum devices.
• Intraurethral medication.
• Surgery (penile implant).

Each type has its own pros and cons. Discuss your options with your doctor to determine the best treatment for you.

The first step to treating ED is to find the underlying cause. Then the appropriate treatment can begin. There are a number of non-surgical and surgical options that can help a man regain normal sexual function.

What non-surgical treatments are there for erectile dysfunction (ED)?

Education and communication

Education about sex, sexual behaviors, and sexual responses may help a man overcome his anxieties about sexual dysfunction.

Talking honestly with your partner about your needs and concerns may also help to overcome many barriers to a healthy sex life.

Medication

Medications such as sildenafil (Viagra®), vardenafil (Levitra®), or tadalafil (Cialis®) may help improve sexual function in men by increasing blood flow to the penis. Men who are on medicines that contain nitrates such as nitroglycerine should not take oral ED medications. The combination of nitrates and these specific medications can cause low blood pressure (hypotension).

The most common side effects of these medications are indigestion, nasal congestion, flushing, headaches and a temporary visual disturbance.

Mechanical aids

Aids such as vacuum devices and penile constriction rings serve as erectile aids for some men.

A vacuum constriction device (above) is a cylinder that is placed over the penis. The air is pumped out of the cylinder, which draws blood into the penis and causes an erection. The erection is maintained by slipping a band off of the base of the cylinder and onto the base of the penis. The band can stay in place for up to 30 minutes. The vacuum device can be safely used to treat most causes of erectile failure. Lack of spontaneity, discomfort, and cumbersomeness of the device seem to be the biggest concerns of patients.

Penile injection therapy (intracavernosal injection therapy)

Men are taught how to inject medications directly into the erection chambers of the penis to create an erection. Injection therapy is effective in treating a wide variety of erection issues caused by blood vessel, nerve and psychological conditions.

Using a tiny needle and syringe, the man injects a small amount of medicine into the side of his penis. The medicine relaxes the blood vessels, allowing blood to flow into the penis. This treatment has been widely used and accepted since the early 1980s. The three most common medicines are prostaglandin E1 (alprostadil), papaverine (Papacon®), and phentolamine (Regitine®).

The most common side effects are pain and penile scarring (fibrosis). In extremely rare cases, patients with cerebral and vascular disease or severe cardiovascular diseases might not be able to tolerate the dizziness and high blood pressure occasionally caused by injection therapy.

A painful erection that lasts longer than two to three hours is called priapism and may occur with injection therapy. This can be lessened with proper dosing and by following the treatment guidelines.

Psychology and sex therapies

Psychological causes may contribute to erectile failure even when there is a clear organic cause.

Therapy with a trained counselor can help a person address feelings of anxiety, fear or guilt that may have an impact on sexual dysfunction.

Sex therapy can be beneficial to most men when counseling is provided by a skilled sex therapist. Sex therapy also helps a man’s partner accept and cope with the problems.

A patient whose ED has a clear psychological cause should receive sex therapy counseling before any invasive treatments are pursued.

Hormone

Low hormone levels may play a role in ED. Hormone replacement in the form of topical gels, creams, patches, injections and pellets are only used after physician evaluation.

What are surgical treatment options for erectile dysfunction (ED)?

Penile prosthesis surgery

Inflatable penile prostheses are implanted during outpatient surgery. Once they are part of a man’s body, they enable him to have an erection whenever he desires. The use of a prosthesis preserves penile sensation, orgasm and ejaculation for most men.

The most commonly used penile implant consists of a pair of inflatable cylinders that are surgically implanted in the erection chambers of the penis. The cylinders are connected through tubing to a reservoir of fluid under the lower abdominal muscles, and to a pump inside the scrotal sac.

To inflate the penile prosthesis, the man compresses the pump a number of times to transfer fluid from the reservoir to the cylinders. This causes the penis to become erect. When inflated, the prosthesis makes the penis stiff and thick, which is very similar to a natural erection.

A penile prosthesis does not change the sensation on the skin of the penis or a man’s ability to achieve orgasm or ejaculate. Pressing on a deflation valve attached to the pump returns the fluid to the reservoir, which returns the penis to a flaccid state.

The surgical procedure is performed through one or two small incisions that are generally well hidden. Other people will be unable to tell that a man has an inflatable penile prosthesis. Complications following surgery are not common, but primarily include infection and mechanical device failure.

Approximately 95% of penile implant surgeries are successful in producing erections that enable men to have sexual intercourse. Moreover, patient satisfaction questionnaires show that up to 90% of men who have undergone penile implants say they would choose the surgery again, and overall satisfaction ratings are higher than those reported by men using oral medication or penile injection therapy.

Can erectile dysfunction (ED) be prevented?

For people who are at risk of developing ED due to personal behavior, steps may be taken to try to prevent its occurrence. However, other causes may not be preventable.

A number of studies now suggest a link between ED and obesity, high cholesterol, hypertension, diabetes and heart disease.

The following recommendations may help prevent ED or improve the problem if it is already present:

• Eat a healthy diet. A diet that limits saturated fat intake and includes several portions of fruits, vegetables and whole grains can benefit men with ED.
• Reduce cholesterol. High cholesterol can harden, narrow or block the arteries (atherosclerosis) leading to the penis. Men can lower cholesterol through diet, exercise and medication.
• Maintain a healthy weight.
• Exercise regularly. Regular exercise may reduce the risk of ED. Choose exercises that you enjoy and will make a regular part of your day. In addition to reducing the risk of ED, exercise also can help you manage stress. Check with your doctor before starting any exercise program.

A Note from QBan Health Care Services

If you suspect you have erectile dysfunction, please see your primary care physician or a urologist. He or she can perform tests to find out what is causing your problem and refer you to a specialist if needed. Once the cause is identified, there are several treatment options to choose from.

Arthritis is a common disorder that affects your joints. It can cause pain and inflammation, making it difficult to move or stay active. There are many types of arthritis. Each form causes different symptoms and may need different treatments. While arthritis usually affects older adults, it can develop in men, women and children of any age.

What is arthritis?

Arthritis is a disease that affects your joints (areas where your bones meet and move). Arthritis usually involves inflammation or degeneration (breakdown) of your joints. These changes can cause pain when you use the joint.

Arthritis is most common in the following areas of the body:

• Feet.
• Hands.
• Hips.
• Knees.
• Lower back.

What are the parts of a joint?

Joints get cushioned and supported by soft tissues that prevent your bones from rubbing against each other. A connective tissue called articular cartilage plays a key role. It helps your joints move smoothly without friction or pain.

Some joints have a synovial membrane, a padded pocket of fluid that lubricates the joints. Many joints, such as your knees, get supported by tendons and ligaments. Tendons connect muscles to your bones, while ligaments connect bones to other bones.

What are the different types of arthritis?

Arthritis is a broad term that describes more than 100 different joint conditions. The most common types of arthritis include:

• Osteoarthritis, or “wear and tear” arthritis, which develops when joint cartilage breaks down from repeated stress. It’s the most common form of arthritis.
• Ankylosing spondylitis, or arthritis of the spine (usually your lower back).
• Juvenile arthritis (JA), a disorder where the immune system attacks the tissue around joints. JA typically affects children 16 or younger.
• Gout, a disease that causes hard crystals of uric acid to form in your joints.
• Psoriatic arthritis, joint inflammation that develops in people with psoriasis (autoimmune disorder that causes skin irritation).
• Rheumatoid arthritis, a disease that causes the immune system to attack synovial membranes in your joints.

How common is arthritis?

Arthritis is the most common cause of disability in the U.S. About 50 million adults and 300,000 children manage some form of arthritis.

What causes arthritis?

Different types of arthritis have different causes. For instance, gout is the result of too much uric acid in your body. But for other types of arthritis, the exact cause is unknown. You may develop arthritis if you:

• Have a family history of arthritis.
• Have a job or play a sport that puts repeated stress on your joints.
• Have certain autoimmune diseases or viral infections.

What are the risk factors for arthritis?

Some factors make you more likely to develop arthritis, including:

• Age: The risk of arthritis increases as you get older.
• Lifestyle: Smoking or a lack of exercise can increase your risk of arthritis.
• Sex: Most types of arthritis are more common in women.
• Weight: Obesity puts extra strain on your joints, which can lead to arthritis.

What are the symptoms of arthritis?

Different types of arthritis have different symptoms. They can be mild in some people and severe in others. Joint discomfort might come and go, or it could stay constant. Common symptoms include:

• Pain.
• Redness.
• Stiffness.
• Swelling.
• Tenderness.
• Warmth.

How is arthritis diagnosed?

If you think you may have arthritis, see your healthcare provider. The provider will ask about your symptoms and learn how joint pain affects your life. Your provider will perform a physical exam, which may include:

• Assessing mobility and range of motion in your joints.
• Checking for areas of tenderness or swelling around your joints.
• Evaluating your overall health to determine if a different condition could be causing your symptoms.

Can imaging exams detect arthritis?

Imaging exams can help your healthcare provider get a clear picture of your bones, joints and soft tissues. An X-ray, MRI or ultrasound can reveal:

• Bone fractures or dislocations that may be causing you joint pain.
• Cartilage breakdown around your joints.
• Muscle, ligament or tendon injuries near your joints.
• Soft tissue inflammation.

Can a blood test detect arthritis?

There is no blood test that can directly detect arthritis. But if your healthcare provider suspects gout or rheumatoid arthritis, they may order blood work. It looks for uric acid or inflammatory proteins.

How is arthritis treated?

There’s no cure for arthritis, but there are treatments that can help you manage the condition. Your treatment plan will depend on the severity of the arthritis, its symptoms and your overall health.

Conservative (nonsurgical) treatments include:

• Medication: Anti-inflammatory and pain medications may help relieve your arthritis symptoms. Some medications, called biologics, target your immune system’s inflammatory response. A healthcare provider may recommend biologics for your rheumatoid or psoriatic arthritis.
• Physical therapy: Rehabilitation can help improve strength, range of motion and overall mobility. Therapists can teach you how to adjust your daily activities to lessen arthritic pain.
• Therapeutic injections: Cortisone shots may help temporarily relieve pain and inflammation in your joints. Arthritis in certain joints, such as your knee, may improve with a treatment called viscosupplementation. It injects lubricant to help joints move smoothly.

Will I need surgery for arthritis?

Healthcare providers usually only recommend surgery for certain severe cases of arthritis. These are cases that haven’t improved with conservative treatments. Surgical options include:

• Fusion: Two or more bones are permanently fused together. Fusion immobilizes a joint and reduces pain caused by movement.
• Joint replacement: A damaged, arthritic joint gets replaced with an artificial joint. Joint replacement preserves joint function and movement. Examples include ankle replacement, hip replacement, knee replacement and shoulder replacement.

How can arthritis be prevented?

You can lower your chances of developing arthritis by:

• Avoiding tobacco products.
• Doing low-impact, non-weight bearing exercise.
• Maintaining a healthy body weight.
• Reducing your risk of joint injuries.

What’s the outlook for someone living with arthritis?

Since there’s no cure for arthritis, most people need to manage arthritis for the rest of their lives. Your healthcare provider can help you find the right combination of treatments to reduce symptoms. One of the biggest health risks associated with arthritis is inactivity. If you become sedentary from joint pain, you may face a greater risk for cancer, heart disease, diabetes and other serious conditions.

What can I do to make living with arthritis easier?

Changing your routine can make living with arthritis easier. Adjust your activities to lessen joint pain. It may help to work with an occupational therapist (OT). An OT is a healthcare provider who specializes in managing physical challenges like arthritis.

An OT may recommend:

• Adaptive equipment, such as grips for opening jars.
• Techniques for doing hobbies, sports or other activities safely.
• Tips for reducing joint pain during arthritic flare-ups.

Do certain types of weather make arthritis worse?

Some people find that arthritis feels worse during certain types of weather. Humidity and cold are two common triggers of joint pain.

There are a variety of reasons why this might happen. People tend to be less active in rainy seasons and the wintertime. The cold and damp can also stiffen joints and aggravate arthritis. Other theories suggest that barometric pressure, or the pressure of the air around us, may have some effect on arthritis.

If you find that certain types of weather make your arthritis worse, talk to your healthcare provider about ways to manage your symptoms. Dressing warmly, exercising inside or using heat therapy may help relieve your pain.

A note from QBan Health Care Services

Arthritis is a disease that affects the joints. There are many types of arthritis, all of which can cause pain and reduce mobility. Some forms of arthritis result from natural wear and tear. Other types come from autoimmune diseases or inflammatory conditions. There are a variety of treatments for arthritis, ranging from physical or occupational therapy to joint surgery. Your healthcare provider will assess your symptoms and recommend the right treatment plan for your needs. Most people can successfully manage arthritis and still do the activities they care about.

The prostate is a gland below the bladder and in front of the rectum in men and people assigned male at birth (AMAB). It consists of connective tissues and glandular tissues. It adds fluid to semen, and its muscles help push semen through your urethra. Conditions that affect your prostate include cancer, prostatitis and benign prostatic hyperplasia.

What is a prostate?

The prostate is a small gland that’s part of the male reproductive system.

What does a prostate do for a man?

Your prostate contributes additional fluid to your semen (ejaculate). Ejaculate is a whitish-gray fluid that releases from your penis when you orgasm. The fluid contains enzymes, zinc and citric acid, which help nourish sperm cells and lubricate your urethra (pronounced “yer-ree-thruh”). The urethra is a tube through which ejaculate and pee flow out of your body.

Your prostate’s muscles also help push semen into and through your urethra when you orgasm.

Do women have a prostate?

No, women don’t have a prostate. Women and people assigned female at birth (AFAB) have Skene’s glands. However, some people refer to Skene’s glands as the female prostate gland.

The Skene’s glands are on either side of the urethra. Medical researchers believe these glands may secrete fluid that helps with urination (peeing) and cleanliness. They may also have a function for sexual intercourse, possibly providing the fluid for female ejaculation.

Where is the prostate located?

Your prostate is below your bladder and in front of your rectum. Your urethra runs through the center of your prostate.

What does the prostate look like?

Your prostate has five lobes: anterior (in the front) and posterior (in the back) lobes, two lateral lobes (on the sides) and one median (in the middle) lobe. Connective tissues and glandular tissues make up its structure. The prostatic fascia covers your prostate. Prostatic fascia is a sheet of stretchy connective tissue.

How big is the prostate?

Your prostate is about the size of a walnut.

The prostate usually gets larger after age 40 (benign prostatic hyperplasia). It can grow from the size of a walnut to the size of a lemon. Benign prostatic hyperplasia (BPH) isn’t cancerous, and it doesn’t increase your risk of developing prostate cancer.

How much does your prostate weigh?

Your prostate weighs about 1 ounce (30 grams), which is as heavy as five U.S. quarters.

What are the common conditions and disorders that affect the prostate?

Common conditions that affect your prostate include:

• Prostate cancer. Prostate cancer is the second most common type of cancer that affects men and people assigned male at birth (AMAB).
• Inflammation (prostatitis). Four different prostatitis conditions cause inflammation in your prostate gland: acute bacterial prostatitis, chronic bacterial prostatitis, chronic pelvic pain syndrome (CPPS) and asymptomatic inflammatory prostatitis. It’s the most common urinary tract issue in men and people AMAB younger than 50, and the third most common in men and people AMAB over 50.
• Benign prostatic hyperplasia. BPH causes your prostate to grow, which can cause blockages in your urethra. Almost all men and people AMAB will develop some prostate enlargement as they age.

What are the warning signs of prostate problems?

Common warning signs of prostate problems include:

• Pain in your penis, testicles or perineum (pronounced “pare-uh-nee-um”). The perineum is the area between your testicles and your rectum.
• Frequent urges to pee.
• Pain while peeing (dysuria) or ejaculating.
• Slowness or dribbling of your pee stream.
• Difficulty starting to pee.
• Frequent need to get up at night to pee.
• Erectile dysfunction (ED).
• Blood in urine or semen (hematospermia).
• Pain in your lower back, hip or chest.

What are common tests that check the health of the prostate?

Common tests to check your prostate health include:

• Digital rectal exam. Your healthcare provider inserts a gloved, lubricated finger into your rectum and feels your prostate gland. Bumps or hard areas may indicate cancer.
• Prostate-specific antigen blood test. Your prostate makes a protein called protein-specific antigen (PSA). Elevated PSA levels may indicate cancer. PSA levels may also rise if you have BPH or prostatitis.
• Biopsy. Your healthcare provider uses a needle to get a sample of your prostate tissue. A healthcare provider will examine the sample under a microscope in a lab.

What are common treatments for the prostate?

Prostate treatment depends on the type of condition you have.

Prostate cancer

• Active surveillance. You get screenings, scans and biopsies every one to three years to monitor cancer growth.
• Brachytherapy. Brachytherapy is a type of internal radiation therapy. Your healthcare provider places radioactive seeds in your prostate. The seeds help preserve the surrounding healthy tissue.
• Focal therapy. Focal therapy focuses on treating only the cancerous area of your prostate. Focal therapy options include high-intensity focused ultrasound (HIFU), cryotherapy, laser ablation and photodynamic therapy (PDT).
• Prostatectomy. Your healthcare provider surgically removes your prostate.

Prostatitis

Depending on the cause and type of your prostatitis, your healthcare provider may recommend:

• Medications. Some medications help relax the muscles around your prostate and bladder to help improve urine flow. Antibiotics help kill infection-causing bacteria.
• Stress management. Counseling for anxiety and depression can help relieve symptoms.
• Exercises. Pelvic floor exercises can help reduce or eliminate muscle spasms.

Benign prostatic hyperplasia

• Medications. Medications can help decrease the production of hormones that cause your prostate to grow.
• Surgery. Surgery can remove the obstructing prostate tissue that blocks the flow of pee.
• Water vapor therapy. A healthcare provider inserts an instrument through your urethra and into your prostate. The instrument emits steam vapor, which kills prostate cells and shrinks your prostate.

How do I keep my prostate healthy?

Help keep your prostate healthy by:

• Getting regular prostate screenings. Most people should start screenings at 50. If you have a family history of prostate cancer, it’s a good idea to start screenings at a younger age.
• Exercising regularly. People who are more physically active are less likely to have BPH.
• Eating a healthy diet. Eating the recommended amount of fruits, vegetables and healthy protein may help promote prostate health.
• Quitting tobacco products. Tobacco products may increase your risk of developing prostate cancer.

Can supplements improve my prostate health?

Dietary supplements don’t have to go through clinical trials or get approval from the United States Food and Drug Administration (FDA), so there isn’t much data on them. Supplements may show minor benefits, but most people won’t see an improvement in their prostate health from taking them.

Can you live without a prostate?

Yes, you can live without your prostate.

If you have prostate cancer, you and your healthcare provider may decide to remove your entire prostate gland. Common side effects of living without a prostate include ED and uncontrollable peeing.

How can I feel my prostate?

You can’t touch your prostate, but you can feel it from the outside of your body (externally) or through your rectum (internally).

The easiest way to feel your prostate is from the back half of your perineum, near your rectum. The area mainly contains nerves and veins, not tissue. Your prostate should feel soft or rubbery.

You can also feel your prostate more directly through your rectum. Your prostate is about two inches inside your rectum. It’s between your penis and your rectum, and it feels soft or rubbery.

When you touch your prostate externally or internally, you may feel a sudden urge to pee.

However, you can’t accurately check your prostate health through a self-examination. If you have any concerns about your prostate health, talk to a healthcare professional. They can answer any of your questions and accurately assess your prostate health.

A note from QBan Health Care Services

Your prostate is a small, walnut-shaped organ. It’s below your bladder and in front of your rectum. Its primary functions are to create fluids in your semen and force semen through your urethra when you ejaculate. Your prostate will likely get larger as you age, which is normal. Prostate cancer is the second most common cancer that affects men and people AMAB. It’s a good idea to get regular prostate screenings after you turn 50. If you notice any symptoms that indicate prostate conditions, talk to your healthcare provider.

Your thyroid creates and produces hormones that play a role in many different systems throughout your body. When your thyroid makes either too much or too little of these important hormones, it’s called a thyroid disease. There are several different types of thyroid disease, including hyperthyroidism, hypothyroidism, thyroiditis and Hashimoto’s thyroiditis.

What is the thyroid?

The thyroid gland is a small organ that’s located in the front of the neck, wrapped around the windpipe (trachea). It’s shaped like a butterfly, smaller in the middle with two wide wings that extend around the side of your throat. The thyroid is a gland. You have glands throughout your body, where they create and release substances that help your body do a specific thing. Your thyroid makes hormones that help control many vital functions of your body.

When your thyroid doesn’t work properly, it can impact your entire body. If your body makes too much thyroid hormone, you can develop a condition called hyperthyroidism. If your body makes too little thyroid hormone, it’s called hypothyroidism. Both conditions are serious and need to be treated by your healthcare provider.

What does the thyroid do?

Your thyroid has an important job to do within your body — releasing and controlling thyroid hormones that control metabolism. Metabolism is a process where the food you take into your body is transformed into energy. This energy is used throughout your entire body to keep many of your body’s systems working correctly. Think of your metabolism as a generator. It takes in raw energy and uses it to power something bigger.

The thyroid controls your metabolism with a few specific hormones — T4 (thyroxine, contains four iodide atoms) and T3 (triiodothyronine, contains three iodide atoms). These two hormones are created by the thyroid and they tell the body’s cells how much energy to use. When your thyroid works properly, it will maintain the right amount of hormones to keep your metabolism working at the right rate. As the hormones are used, the thyroid creates replacements.

This is all supervised by something called the pituitary gland. Located in the center of the skull, below your brain, the pituitary gland monitors and controls the amount of thyroid hormones in your bloodstream. When the pituitary gland senses a lack of thyroid hormones or a high level of hormones in your body, it will adjust the amounts with its own hormone. This hormone is called thyroid stimulating hormone (TSH). The TSH will be sent to the thyroid and it will tell the thyroid what needs to be done to get the body back to normal.

What is thyroid disease?

Thyroid disease is a general term for a medical condition that keeps your thyroid from making the right amount of hormones. Your thyroid typically makes hormones that keep your body functioning normally. When the thyroid makes too much thyroid hormone, your body uses energy too quickly. This is called hyperthyroidism. Using energy too quickly will do more than make you tired — it can make your heart beat faster, cause you to lose weight without trying and even make you feel nervous. On the flip-side of this, your thyroid can make too little thyroid hormone. This is called hypothyroidism. When you have too little thyroid hormone in your body, it can make you feel tired, you might gain weight and you may even be unable to tolerate cold temperatures.

These two main disorders can be caused by a variety of conditions. They can also be passed down through families (inherited).

Who is affected by thyroid disease?

Thyroid disease can affect anyone — men, women, infants, teenagers and the elderly. It can be present at birth (typically hypothyroidism) and it can develop as you age (often after menopause in women).

Thyroid disease is very common, with an estimated 20 million people in the Unites States having some type of thyroid disorder. A woman is about five to eight times more likely to be diagnosed with a thyroid condition than a man.

You may be at a higher risk of developing a thyroid condition if you:

• Have a family history of thyroid disease.
• Have a medical condition (these can include pernicious anemia, Type 1 diabetes, primary adrenal insufficiency, lupus, rheumatoid arthritis, Sjögren’s syndrome and Turner syndrome).
• Take a medication that’s high in iodine (amiodarone).
• Are older than 60, especially in women.
• Have had treatment for a past thyroid condition or cancer (thyroidectomy or radiation).

What causes thyroid disease?

The two main types of thyroid disease are hypothyroidism and hyperthyroidism. Both conditions can be caused by other diseases that impact the way the thyroid gland works.

Conditions that can cause hypothyroidism include:

• Thyroiditis: This condition is an inflammation (swelling) of the thyroid gland. Thyroiditis can lower the amount of hormones your thyroid produces.
• Hashimoto’s thyroiditis: A painless disease, Hashimoto’s thyroiditis is an autoimmune condition where the body’s cells attack and damage the thyroid. This is an inherited condition.
• Postpartum thyroiditis: This condition occurs in 5% to 9% of women after childbirth. It’s usually a temporary condition.
• Iodine deficiency: Iodine is used by the thyroid to produce hormones. An iodine deficiency is an issue that affects several million people around the world..
• A non-functioning thyroid gland: Sometimes, the thyroid gland doesn’t work correctly from birth. This affects about 1 in 4,000 newborns. If left untreated, the child could have both physical and mental issues in the future. All newborns are given a screening blood test in the hospital to check their thyroid function.

Conditions that can cause hyperthyroidism include:

• Graves’ disease: In this condition the entire thyroid gland might be overactive and produce too much hormone. This problem is also called diffuse toxic goiter (enlarged thyroid gland).
• Nodules: Hyperthyroidism can be caused by nodules that are overactive within the thyroid. A single nodule is called toxic autonomously functioning thyroid nodule, while a gland with several nodules is called a toxic multi-nodular goiter.
• Thyroiditis: This disorder can be either painful or not felt at all. In thyroiditis, the thyroid releases hormones that were stored there. This can last for a few weeks or months.
• Excessive iodine: When you have too much iodine (the mineral that is used to make thyroid hormones) in your body, the thyroid makes more thyroid hormones than it needs. Excessive iodine can be found in some medications (amiodarone, a heart medication) and cough syrups.

Is there a higher risk of developing thyroid disease if I have diabetes?

If you have diabetes, you’re at a higher risk of developing a thyroid disease than people without diabetes. Type 1 diabetes is an autoimmune disorder. If you already have one autoimmune disorder, you are more likely to develop another one.

For people with Type 2 diabetes, the risk is lower, but still there. If you have Type 2 diabetes, you’re more likely to develop a thyroid disease later in life.

Regular testing is recommended to check for thyroid issues. Those with Type 1 diabetes may be tested more often — immediately after diagnosis and then every year or so — than people with Type 2 diabetes. There isn’t a regular schedule for testing if you have Type 2 diabetes, vut your healthcare provider may suggest a schedule for testing over time.

If you have diabetes and get a positive thyroid test, there are a few things to you can do to help feel the best possible. These tips include:

• Getting enough sleep.
• Exercising regularly.
• Watching your diet.
• Taking all of your medications as directed.
• Getting tested regularly as directed by your healthcare provider.

What common symptoms can happen with thyroid disease?

There are a variety of symptoms you could experience if you have a thyroid disease. Unfortunately, symptoms of a thyroid condition are often very similar to the signs of other medical conditions and stages of life. This can make it difficult to know if your symptoms are related to a thyroid issue or something else entirely.

For the most part, the symptoms of thyroid disease can be divided into two groups — those related to having too much thyroid hormone (hyperthyroidism) and those related to having too little thyroid hormone (hypothyroidism).

Symptoms of an overactive thyroid (hyperthyroidism) can include:

• Experiencing anxiety, irritability and nervousness.
• Having trouble sleeping.
• Losing weight.
• Having an enlarged thyroid gland or a goiter.
• Having muscle weakness and tremors.
• Experiencing irregular menstrual periods or having your menstrual cycle stop.
• Feeling sensitive to heat.
• Having vision problems or eye irritation.

Symptoms of an underactive thyroid (hypothyroidism) can include:

• Feeling tired (fatigue).
• Gaining weight.
• Experiencing forgetfulness.
• Having frequent and heavy menstrual periods.
• Having dry and coarse hair.
• Having a hoarse voice.
• Experiencing an intolerance to cold temperatures.

Can thyroid issues make me lose my hair?

Hair loss is a symptom of thyroid disease, particularly hypothyroidism. If you start to experience hair loss and are concerned about it, talk to your healthcare provider.

Can thyroid issues cause seizures?

In most cases, thyroid issues don’t cause seizures. However, if you have a very severe cases of hypothyroidism that hasn’t been diagnosed or treated, your risk of developing low serum sodium goes up. This could lead to seizures.

How is thyroid disease diagnosed?

Sometimes, thyroid disease can be difficult to diagnose because the symptoms are easily confused with those of other conditions. You may experience similar symptoms when you are pregnant or aging and you would when developing a thyroid disease. Fortunately, there are tests that can help determine if your symptoms are being caused by a thyroid issue. These tests include:

• Blood tests.
• Imaging tests.
• Physical exams.

Blood tests

One of the most definitive ways to diagnose a thyroid problem is through blood tests. Thyroid blood tests are used to tell if your thyroid gland is functioning properly by measuring the amount of thyroid hormones in your blood. These tests are done by taking blood from a vein in your arm. Thyroid blood tests are used to see if you have:

• Hyperthyroidism.
• Hypothyroidism.

Thyroid blood tests are used to diagnose thyroid disorders associated with hyper- or hypothyroidism. These include:

• Thyroiditis.
• Graves’ disease.
• Hashimoto’s disease.
• Goiter.
• Thyroid nodule.
• Thyroid cancer.

The specific blood tests that will be done to test your thyroid can include:

• Thyroid-stimulating hormone (TSH) is produced in the pituitary gland and regulates the balance of thyroid hormones — including T4 and T3 — in the bloodstream. This is usually the first test your provider will do to check for thyroid hormone imbalance. Most of the time, thyroid hormone deficiency (hypothyroidism) is associated with an elevated TSH level, while thyroid hormone excess (hyperthyroidism) is associated with a low TSH level. If TSH is abnormal, measurement of thyroid hormones directly, including thyroxine (T4) and triiodothyronine (T3) may be done to further evaluate the problem. Normal TSH range for an adult: 0.40 – 4.50 mIU/mL (milli-international units per liter of blood).
• T4: Thyroxine tests for hypothyroidism and hyperthyroidism, and used to monitor treatment of thyroid disorders. Low T4 is seen with hypothyroidism, whereas high T4 levels may indicate hyperthyroidism. Normal T4 range for an adult: 5.0 – 11.0 ug/dL (micrograms per deciliter of blood).
• FT4: Free T4 or free thyroxine is a method of measuring T4 that eliminates the effect of proteins that naturally bind T4 and may prevent accurate measurement. Normal FT4 range for an adult: 0.9 – 1.7 ng/dL (nanograms per deciliter of blood)
• T3: Triiodothyronine tests help diagnose hyperthyroidism or to show the severity of hyperthyroidism. Low T3 levels can be observed in hypothyroidism, but more often this test is useful in the diagnosis and management of hyperthyroidism, where T3 levels are elevated. Normal T3 range: 100 – 200 ng/dL (nanograms per deciliter of blood).
• FT3: Free T3 or free triiodothyronine is a method of measuring T3 that eliminates the effect of proteins that naturally bind T3 and may prevent accurate measurement. Normal FT3 range: 2.3 – 4.1 pg/mL (picograms per milliliter of blood)

These tests alone aren’t meant to diagnose any illness but may prompt your healthcare provider to do additional testing to evaluate for a possible thyroid disorder.

Additional blood tests might include:

• Thyroid antibodies: These tests help identify different types of autoimmune thyroid conditions. Common thyroid antibody tests include microsomal antibodies (also known as thyroid peroxidase antibodies or TPO antibodies), thyroglobulin antibodies (also known as TG antibodies), and thyroid receptor antibodies (includes thyroid stimulating immunoglobulins [TSI] and thyroid blocking immunoglobulins [TBI]).
• Calcitonin: This test is used to diagnose C-cell hyperplasia and medullary thyroid cancer, both of which are rare thyroid disorders.
• Thyroglobulin: This test is used to diagnose thyroiditis (thyroid inflammation) and to monitor treatment of thyroid cancer.

Talk to your healthcare provider about the ranges for these thyroid blood tests. Your ranges might not be the same as someone else’s. That’s often alright. If you have any concerns or worries about your blood test results, talk to your provider.

Imaging tests

In many cases, taking a look at the thyroid itself can answer a lot of questions. Your healthcare provider might do an imaging test called a thyroid scan. This allows your provider to look at your thyroid to check for an increased size, shape or growths (nodules).

Your provider could also use an imaging test called an ultrasound. This is a diagnostic procedure that transmits high-frequency sound waves, inaudible to the human ear, through body tissues. The echoes are recorded and transformed into video or photographic images. You may think of ultrasounds related to pregnancy, but they are used to diagnose many different issues within your body. Unlike X-rays, ultrasounds do not use radiation.

There’s typically little or no preparation before your ultrasound. You don’t need to change your diet beforehand or fast. During the test, you’ll lie flat on a padded examining table with your head positioned on a pillow so that your head is tilted back. A warm, water-soluble gel is applied to the skin over the area that’s being examined. This gel won’t hurt your skin or stain your clothes. Your healthcare provider will then apply a probe to your neck and gently move it around to see all parts of the thyroid.

An ultrasound typically takes about 20 to 30 minutes.

Physical exam

Another way to quickly check the thyroid is with a physical exam in your healthcare provider’s office. This is a very simple and painless test where your provider feels your neck for any growths or enlargement of the thyroid.

How is thyroid disease treated?

Your healthcare provider’s goal is to return your thyroid hormone levels to normal. This can be done in a variety of ways and each specific treatment will depend on the cause of your thyroid condition.

If you have high levels of thyroid hormones (hyperthyroidism), treatment options can include:

• Anti-thyroid drugs (methimazole and propylthioracil): These are medications that stop your thyroid from making hormones.
• Radioactive iodine: This treatment damages the cells of your thyroid, preventing it from making high levels of thyroid hormones.
• Beta blockers: These medications don’t change the amount of hormones in your body, but they help manage your symptoms.
• Surgery: A more permanent form of treatment, your healthcare provider may surgically remove your thyroid (thyroidectomy). This will stop it from creating hormones. However, you will need to take thyroid replacement hormones for the rest of your life.

If you have low levels of thyroid hormones (hypothyroidism), the main treatment option is:

• Thyroid replacement medication: This drug is a synthetic (man-made) way to add thyroid hormones back into your body. One drug that’s commonly used is called levothyroxine. By using a medication, you can manage thyroid disease and live a normal life.

Are there different types of thyroid removal surgery?

If your healthcare provider determines that your thyroid needs to be removed, there are a couple of ways that can be done. Your thyroid may need to be completely removed or just partially. This will depend on the severity of your condition. Also, if your thyroid is very big (enlarged) or has a lot of growths on it, that could prevent you from being eligible for some types of surgery.

The surgery to remove your thyroid is called a thyroidectomy. There are two main ways this surgery can be done:

• With an incision on the front of your neck.
• With an incision in your armpit.

The incision on the front of your neck is more of the traditional version of a thyroidectomy. It allows your surgeon to go straight in and remove the thyroid. In many cases, this might be your best option. You may need this approach if your thyroid is particularly big or has a lot of larger nodules.

Alternatively, there is a version of the thyroid removal surgery where your surgeon makes an incision in your armpit and then creates a tunnel to your thyroid. This tunnel is made with a special tool called an elevated retractor. It creates an opening that connects the incision in your armpit with your neck. The surgeon will use a robotic arm that will move through the tunnel to get to the thyroid. Once there, it can remove the thyroid back through the tunnel and out of the incision in your armpit.

This procedure is often called scarless because the incision is under your armpit and out of sight. However, it’s more complicated for the surgeon and the tunnel is more invasive for you. You may not be a candidate for this type of thyroid removal if you:

• Are not at a healthy body weight.
• Have large thyroid nodules.
• Have a condition like thyroiditis or Graves’s disease.

Talk to your about all of your treatment options and the best type of surgery for you.

How long does it take to recover from thyroid surgery (thyroidectomy)?

It will take your body a few weeks to recover after your thyroid is surgically removed (thyroidectomy). During this time you should avoid a few things, including:

• Submerging your incision under water.
• Lifting an object that’s heavier than 15 pounds.
• Doing more than light exercise.

This generally lasts for about two weeks. After that, you can return to your normal activities.

How long after my thyroid is removed will my tiredness go away?

Typically, you will be given medication to help with your symptoms right after surgery. Your body actually has thyroid hormone still circulating throughout it, even after the thyroid has been removed. The hormones can still be in your body for two to three weeks. Medication will reintroduce new hormones into your body after the thyroid has been removed. If you are still feeling tired after surgery, remember that this can be a normal part of recovering from any type of surgery. It takes time for your body to heal. Talk to your healthcare provider if you are still experiencing fatigue and other symptoms of thyroid disease after surgery.

If part of my thyroid is surgically removed, will the other part be able to make enough thyroid hormones to keep me off of medication?

Sometimes, your surgeon may be able to remove part of your thyroid and leave the other part so that it can continue to create and release thyroid hormones. This is most likely in situations where you have a nodule that’s causing your thyroid problem. About 75% of people who have only one side of the thyroid removed are able to make enough thyroid hormone after surgery without hormone replacement therapy.

Can I check my thyroid at home?

You can do a quick and easy self-exam of your thyroid at home. The only tools you need to do this self-exam are a mirror and a glass of water.

To do the thyroid self-exam, follow these steps:

• Start by identifying where your thyroid is located. Generally, you’ll find the thyroid on the front of your neck, between your collar bone and Adam’s apple. In men, the Adam’s apple is much easier to see. For women, it’s usually easiest to look from the collar bone up.
• Tip your head back while looking in a mirror. Look at your neck and try to hone in on the space you will be looking once you start the exam.
• Once you’re ready, take a drink of water while your head is tilted back. Watch your thyroid as you swallow. During this test, you’re looking for lumps or bumps. You may be able to see them when you swallow the water.

Repeat this test a few times to get a good look at your thyroid. If you see any lumps or bumps, reach out to your healthcare provider.

Should I exercise if I have a thyroid disease?

Regular exercise is an important part of a healthy lifestyle. You do not need to change your exercise routine if you have a thyroid disease. Exercise does not drain your body’s thyroid hormones and it shouldn’t hurt you to exercise. It is important to talk to your healthcare provider before you start a new exercise routine to make sure that it’s a good fit for you.

Can I live a normal life with a thyroid disease?

A thyroid disease is often a life-long medical condition that you will need to manage constantly. This often involves a daily medication. Your healthcare provider will monitor your treatments and make adjustments over time. However, you can usually live a normal life with a thyroid disease. It may take some time to find the right treatment option for you and manage your hormone levels, but then people with these types of conditions can usually live life without many restrictions.

A note from QBan Health Care Services

Your thyroid is an important gland in your endocrine system that affects many aspects of your body. Thyroid disease is very common and treatable. If you experience any thyroid disease-related symptoms or want to know if you have any risk factors for developing thyroid disease, don’t be afraid to talk to your healthcare provider. They’re there to help you.

Your thyroid is an important endocrine gland that makes and releases certain hormones. Your thyroid’s main job is to control your metabolism — how your body uses energy. Sometimes, your thyroid doesn’t work properly. These conditions are common and treatable.

What is the thyroid?

Your thyroid is a small, butterfly-shaped gland located at the front of your neck under your skin. It’s a part of your endocrine system and controls many of your body’s important functions by producing and releasing (secreting) certain hormones. Your thyroid’s main job is to control the speed of your metabolism (metabolic rate), which is the process of how your body transforms the food you consume into energy. All of the cells in your body need energy to function.

When your thyroid isn’t working properly, it can impact your entire body.

What is the endocrine system?

Your endocrine system is a network of several glands that create and secrete (release) hormones.

A gland is an organ that makes one or more substances, such as hormones, digestive juices, sweat or tears. Endocrine glands release hormones directly into the bloodstream.

Hormones are chemicals that coordinate different functions in your body by carrying messages through your blood to your organs, skin, muscles and other tissues. These signals tell your body what to do and when to do it.

The following organs and glands make up your endocrine system:

• Hypothalamus.
• Pituitary gland.
• Thyroid.
• Parathyroid glands.
• Adrenal glands.
• Pineal gland.
• Pancreas.
• Ovaries.
• Testes.

What does my thyroid do?

As an endocrine gland, your thyroid makes and secretes hormones. Your thyroid produces and releases the following hormones:

• Thyroxine (T4): This is the primary hormone your thyroid makes and releases. Although your thyroid makes the most of this hormone, it doesn’t have much of an effect on your metabolism. Once your thyroid releases T4 into your bloodstream, it can convert to T3 through a process called deiodination.
• Triiodothyronine (T3): Your thyroid produces lesser amounts of T3 than T4, but it has a much greater effect on your metabolism than T4.
• Reverse triiodothyronine (RT3): Your thyroid makes very small amounts of RT3, which reverses the effects of T3.
• Calcitonin: This hormone helps regulate the amount of calcium in your blood.

In order to make thyroid hormones, your thyroid gland needs iodine, an element found in food (most commonly, iodized table salt) and water. Your thyroid gland traps iodine and transforms it into thyroid hormones. If you have too little or too much iodine in your body, it can affect the level of hormones your thyroid makes and releases.

Your thyroid hormones affect the following bodily functions:

• How your body uses energy (metabolism).
• Heart rate.
• Breathing.
• Digestion.
• Body temperature.
• Brain development.
• Mental activity.
• Skin and bone maintenance.
• Fertility.

What other organs and glands interact with the thyroid?

Your endocrine system is an elaborate network of glands and hormones. Many glands and hormones rely on other glands and hormones to send them signals to start working. In addition, certain hormones can suppress other hormones.

Your body has a complex system for controlling the level of thyroid hormones in your body. First, your hypothalamus (a part of your brain located on the undersurface of it) secretes thyroid-releasing hormone (TRH), which stimulates a part of your pituitary gland to secrete thyroid-stimulating hormone (TSH). TSH then stimulates your thyroid follicular cells to release thyroxine (T4) and triiodothyronine (T3) if there are adequate levels of iodine in your body.

Your thyroid gland and its hormones affect almost every organ system of your body, including:

• Your cardiovascular system: Your thyroid helps regulate the amount of blood your heart pumps through your circulatory system (cardiac output), heart rate and strength and vigor of your heart’s contraction (contractility of the heart).
• Your nervous system: When your thyroid isn’t working properly, it can cause symptoms that affect your nervous system, including numbness, tingling, pain or a sense of burning in the affected parts of your body. In addition, hypothyroidism can cause depression and hyperthyroidism can cause anxiety.
• Your digestive system: Your thyroid is involved with how food moves through your digestive system (gastrointestinal motility).
• Your reproductive system: If your thyroid isn’t working properly, it can cause irregular menstrual periods and issues with fertility.

Can a person live without a thyroid?

Yes, you can live without your thyroid. However, you’ll need to take hormone replacement medication for the rest of your life in order to stay healthy and prevent certain side effects and symptoms. Thyroid removal surgery, known as a thyroidectomy, is a common surgery that can treat certain thyroid conditions.

Where is the thyroid located?

Your thyroid gland is located in the front of your neck, straddling your windpipe (trachea). It’s shaped like a butterfly — smaller in the middle with two wide wings that extend around the side of your throat. A healthy thyroid gland is not usually visible from the outside (there’s no appearance of a lump on your neck), and you can’t feel it when you press your finger to the front of your neck.

What are the parts of the thyroid?

There are two main parts of your thyroid: the two halves (lobes) and the middle of the thyroid that connects the two lobes (thyroid isthmus).

Your thyroid is made of thyroid follicle cells (thyrocytes), which create and store thyroid hormone (mainly T3 and T4), and C-cells, which secrete the hormone calcitonin.

How big is the thyroid?

Your thyroid is about 2 inches long. A healthy thyroid usually does not stick out from your throat and you can’t see it by looking at your neck.

However, certain conditions can cause your thyroid to become enlarged. This is known as goiter. If you have a goiter, you may experience the following symptoms:

• Swelling in the front of your neck, just below the Adam’s apple.
• A feeling of tightness in your throat area.
• A change in your voice, such as hoarseness (scratchy voice).

What conditions and disorders affect the thyroid?

There are several different types of thyroid disease. Thyroid disease is very common, with an estimated 20 million people in the United States having some type of thyroid disorder. Women and people assigned female at birth (AFAB) are about five to eight times more likely to be diagnosed with a thyroid condition than men and people assigned male at birth (AMAB).

Thyroid diseases are split into two types: primary and secondary.

In primary thyroid disease, the disease originates in your thyroid gland. In secondary thyroid disease, the disease originates in your pituitary gland. As an example, if you have a nodule on your thyroid that’s releasing excess amounts of thyroid hormones, it would be called primary hyperthyroidism. If a tumor in your pituitary gland is releasing excess amounts of thyroid-stimulating hormone (TSH), which then stimulates your thyroid to produce excess thyroid hormones, it would be called secondary hyperthyroidism.

The four main conditions that affect your thyroid include:

• Hypothyroidism (underactive thyroid).
• Hyperthyroidism (overactive thyroid).
• Goiter (enlarged thyroid).
• Thyroid cancer.

Hypothyroidism

Hypothyroidism (underactive thyroid) happens when your thyroid doesn’t produce and release enough thyroid hormones. This causes aspects of your metabolism to slow down. It’s a fairly common condition that affects approximately 10 million people in the United States. It is treatable.

Causes of hypothyroidism include:

• Hashimoto’s disease, an autoimmune disease.
• Thyroiditis (inflammation of the thyroid).
• Iodine deficiency.
• A nonfunctioning thyroid gland (when the thyroid doesn’t work correctly from birth).
• Over-treatment of hyperthyroidism through medication.
• Thyroid gland removal.

Hyperthyroidism

Hyperthyroidism (overactive thyroid) happens when your thyroid produces and releases more thyroid hormones than your body needs. This causes aspects of your metabolism to speed up. Approximately 1 out of 100 people over the age of 12 have hyperthyroidism in the United States. It is treatable.

Causes of hyperthyroidism include:

• Graves’ disease, an autoimmune condition.
• Thyroid nodules.
• Thyroiditis (inflammation of the thyroid).
• Postpartum thyroiditis (inflammation of the thyroid that happens after giving birth).
• Excess iodine in your blood from diet and/or medication.
• Over-treatment of hypothyroidism through medication.
• A benign (noncancerous) tumor in your pituitary gland.

Goiter

Goiter is an enlargement of your thyroid gland. Goiters are relatively common; they affect approximately 5% of people in the United States

Goiters have different causes, depending on their type.

• Simple goiters: These goiters develop when your thyroid gland doesn’t make enough hormones to meet your body’s needs. Your thyroid gland tries to make up for the shortage by growing larger.
• Endemic goiters: These goiters occur in people who don’t get enough iodine in their diet (iodine is necessary to make thyroid hormone). Iodine is added to table salt in the United States and several other countries, so people who live in those countries usually don’t get endemic goiters.
• Sporadic goiters: These goiters have no known cause in most cases. In some cases, certain medications, such as lithium, can cause sporadic goiters.

Thyroid cancer

Thyroid cancer is cancer that begins in your thyroid tissues. Approximately 53,000 people in the United States receive a diagnosis of thyroid cancer every year. Treatments for most thyroid cancers are very successful.

Thyroid cancer is classified based on the type of cells from which cancer grows. Thyroid cancer types include:

• Papillary: Up to 80% of all thyroid cancer cases are papillary.
• Follicular: Follicular thyroid cancer accounts for up to 15% of thyroid cancer diagnoses.
• Medullary: About 2% of thyroid cancer cases are medullary. It’s often caused by a gene mutation.
• Anaplastic: About 2% of thyroid cancer cases are anaplastic.

What are the early warning signs and symptoms of thyroid problems?

Different thyroid conditions have different symptoms. However, since your thyroid has a large role in certain body systems and processes, such as heart rate, metabolism and temperature control, there are certain symptoms to look out for that could be a sign of a thyroid condition, including:

• Slow or rapid heart rate.
• Unexplained weight loss or weight gain.
• Difficulty tolerating cold or heat.
• Depression or anxiety.
• Irregular menstrual periods.

If you’re experiencing any of these symptoms, talk to your healthcare provider about getting a blood test to check your thyroid function.

What are common tests to check the health of the thyroid?

The first-line test for checking the health of your thyroid is a blood test that measures your levels of thyroid-stimulating hormone (TSH). It’s a screening test for both hypothyroidism and hyperthyroidism.

In general, the normal range for a TSH blood test is 0.5 to 5.0 mIU/L (milli-international units per liter). However, this can vary from lab to lab and depending on certain factors, such as pregnancy and your age.

Your provider can also check the levels of T4 and T3 (thyroid hormones) in your blood.

If your test results come back abnormal your provider may suggest having an imaging test such as a thyroid scan, which uses small amounts of a safe, radioactive material to create images of your thyroid, or a thyroid ultrasound.

How are thyroid conditions treated?

There are several treatment options for thyroid conditions depending on what the conditions are and how severe they are. The three main options for treatment include:

• Medication.
• Surgery.
• Radiation therapy and chemotherapy.

Medication

Medications for thyroid conditions include:

• Antithyroid medications: These medications block the ability of your thyroid to make hormones. Healthcare providers may prescribe this for hyperthyroidism.
• Beta-blockers: These medications help treat symptoms of hyperthyroidism, such as rapid heartbeat, but they do not treat the thyroid condition itself.
• Radioactive iodine: This medication damages thyroid cells, eventually leading to the destruction of your thyroid gland. This is a treatment option for hyperthyroidism and thyroid cancer.
• Thyroid hormone medications: These medications are a synthetic form of thyroid hormones for the treatment of hypothyroidism. People who have a thyroidectomy or a nonfunctioning thyroid from radioactive iodine usually need to take these medications for the rest of their life.

Surgery

The most common type of surgery associated with thyroid conditions is a thyroidectomy. A thyroidectomy is the surgical removal of your entire thyroid gland. Thyroidectomy is one of the treatment options for thyroid disease and is the first-line treatment for thyroid cancer.

Another surgery option is a lobectomy, which involves removing only a part of your thyroid.

Radiation therapy and chemotherapy

Radiation therapy and/or chemotherapy are treatment options for thyroid cancer. Both therapies kill cancer cells and prevent them from growing. Most cases of thyroid cancer do not require radiation or chemotherapy.

What are the risk factors for developing a thyroid condition?

Thyroid conditions are common and can affect anyone at any age. However, some factors put you at a higher risk of developing a thyroid condition, including:

• Having a family history of thyroid disease.
• Having an autoimmune condition, such as Type 1 diabetes, rheumatoid arthritis or lupus.
• Taking a medication that’s high in iodine.

Being older than 60, especially if you’re a woman or a person who was assigned female at birth (AFAB).

How can I keep my thyroid healthy?

The main way to keep your thyroid healthy is to make sure you’re getting enough iodine in your diet. Your thyroid needs iodine to make thyroid hormones. The good news is that the majority of people get adequate amounts of iodine through iodized table salt and foods that are fortified with iodine.

Other food sources that contain iodine include:

• Cheese.
• Cow’s milk.
• Eggs.
• Yogurt.
• Saltwater fish.
• Shellfish.
• Seaweed.
• Soy milk.
• Soy sauce.

However, it’s important not to consume too much iodine because it can cause problems. If you have any questions or concerns about your thyroid health, don’t be afraid to talk to your healthcare provider.

When should I call my doctor about my thyroid?

If you’re experiencing symptoms of thyroid disease, such as changes in your weight, heart rate and temperature sensitivity, contact your healthcare provider. They can run a simple blood test to see if your thyroid is the cause of your symptoms.

A note from QBan Health Care Services

Your thyroid is an important gland in your endocrine system that affects many aspects of your body. Thyroid disease is very common and treatable. If you experience any thyroid disease-related symptoms or want to know if you have any risk factors for developing thyroid disease, don’t be afraid to talk to your healthcare provider. They’re there to help you.