We have seen numerous selfies posted in the forum - some as described, inadvertently highlighting thyroid issues. (Others were purposely taken to for the purpose of checking thyroid/throat issues.)
While the paper doesn't add that much to our understanding of anything, it is good someone decided to write on the topic.
Ann Afr Med
. Oct-Dec 2021;20(4):293-296.
doi: 10.4103/aam.aam_64_20.
Selfie-driven thyroid disease leads: A study on a unique sign and its utility in clinical practice
Introduction: Taking a photograph of self alone or with a group called selfie, has become modern-day rage with spurt in smartphone technology. It has catapulted from a hobby into psychiatric ailment, especially among teens and young adults. Although it is considered a psychiatric ailment keeping them aloof from social interactions, we observed an inadvertent advantage in this process. In this context, we present some intriguing findings in this study.
Materials and methods: This retrospective study was based on compilation of 14 cases from endocrine surgery outpatient cum inpatient database collected over 2 years' period. The inclusion criteria are the chief complaint (CC) was noted only after watching the selfie picture and not otherwise; the CC leads them to consult physician; the picture was captured by oneself or other person who was also part of that image; and the CC leads to definitive diagnosis of thyroid disease requiring treatment. All other clinical, investigative, and treatment (medical and surgical) were studied.
Results: In all, we had 14/5820 (0.0024%) cases meeting the above criteria. CC and later confirmed in pictures were four cases of Grave's disease associated ophthalmopathic exophthalmos, eight cases of goiter, and two cases of facial puffiness (myxedema related). All these CC helped in investigating for the diagnosis of Graves' disease (4), nodular goiter (8), and hypothyroidism (2) confirmed by appropriate investigations. Ten cases underwent thyroidectomy (two of the nodular goiter cases were papillary thyroid cancer) and four cases took conservative medical treatment.
Conclusions: Although selfie is considered a modern-day lifestyle-induced psychiatric illness, it can inadvertently help in picking up thyroid diseases in earlier stages.
I have diagnosed a couple of friends on their appearance and correctly too. When I was under the care of the endocrinologist what hit me hard in the waiting area was how very ill everyone looked.
Puffy look to the skin which is dull and often dry, eyes abnormally large and staring, lank thin unhealthy looking hair, and just a general look of not being well, evidence of a goitre. Overactive is quite easy to spot.
"Although selfie is considered a modern-day lifestyle-induced psychiatric illness" That's really sad, although doesn't surprise me. But, maybe we should all start taking selfies as a record like we keep track of our blood results.
A few more patients might be found (and possibly treated) if only Doctors would pay a bit more attention to blood results of complete TFTs and not TSH. Thanks for posting this helvella , and I hope that a few more people would take note of how they look in photos.
I heard of a case where a news reporter was told by a very receptive viewer after watching the news caster reporting to have her thyroids checked out. You won't believe it the reporter listened and needed her thyroids removed.
My friend who I realised had Graves was really seriously advanced when I expressed my concern she did act on it and had to have immediate treatment she went for thyroidectomy in the end - her eyes have not properly recovered it must have been treated too late to reverse the damage - sometimes there can be denial so I was relieved she sought help. I can’t say she looks very well even now.
Wow!What a story. It will take time till your friend gets her old self back. Give it some time. The body has to acclimate to not having thyroids to now having thyroids from a bottle. The body needs time to heal and make new adjustments.
Your a very kind and very supportive friend.
Your friend is very lucky to have you ❤.
Best Wishes For Your Friends Speedy and Steady Recovery.
Friendships never rust. Friends can sometimes be just as important as family and more. Friends for ever by choice.
My thyroid cancer was huge and growing inwards. The thing that I’d noticed was wrong was that I couldn’t do up necklaces and polo neck sweaters felt as though they were strangling me.
It was first identified by an anaesthetist who was looking at me neck to see how whether it was in good enough shape for the anaesthetic for BC.
She asked me how long I’d had thyroid problems.
I haven’t.
Are you sure?
Of course.
I took my mobile from my locker and showed her a wonderful picture of my neck on my wedding day. My head was bent right back as my husband was kissing me 💗💗
She looked at it, raised her eyes and jabbed her finger at the image of my neck.
What’s that?
My neck. It’s just fat.
She tutted and shook her head, looking so annoyed that I feared she may put me to sleep for ever.
The tumour was finally picked up on a CT scan which was measuring up for radiation. I thought this was a coincidence - until I saw her smiling at me through the glass of the radiography office. 😳
even before the day's of selfie's , old photo's have provided me with interesting evidence when looked at with the benefit of hindsight ...
I have one from what i now think was a 'hyper' phase, (a couple of years before being diagnosed hypo). I knew i'd got thinner , but it was only seeing it years later on a photo taken by someone else that made me realise the truth of what others had been saying at the time .. to have so little body fat over any muscles just wasn't normal compared to how my body usually looked if i'd to lost a little weight naturally.
And i have one taken immediately before being diagnosed hypo .... an uncharacteristically 'puffy face' , particularly around my eyes and bridge of my nose, is plainly in evidence.
My face and neck have disappeared under all the bloating. I no longer have anywhere to put eyeshadow. My eyes are tiny compared to how they used to look. Necklaces don't fit, polo necks strangle me etc. But it's just soft puffy flab. I have noticed recently since reducing my Levo and increasing my T3 that my watch is doing up a hole tighter, as is my belt and my feet aren't so swollen. But they are still numb and painful sadly.
i no longer have anywhere decent to put the eyeshadow , since the narrow bit of upper eyelid is largely hiding under the droopy bit above ( i don't care cos i can't abide the feeling of stuff on my face anyway) But ironically ... if i'm unwell, due to over , and possibly, but not sure , undermedication , the narrow bit of my eyelids gets a browny/orange colouration like a sun tan all by itself ... weird, but true .
I've seen that eye staining in other people. It hasn't happened to me. I miss having eyes. I don't want to wear eyeshadow most of the time. But it would be nice to have eyelids I could see!
i've solved that problem, i don't look in mirrors .. or take selfie's.. in my head i still look 31 and i intend to keep it that way..... truth be damned !
My eyes used to puff up spontaneously a lot in my 30's. Didn't know what it was, maybe thyroid related, no idea but suspect I had problems going my symptoms, but I also have brown colouration on my eyes, and if I get my underbrows waxed then it looks strange as that is pale and the rest is brown. Again, don't know if thyroid related. Started self-treating 2020.
i think i remember some mention of brown round the eyes in Theodore Kocher's Nobel prize speech on the physical signs of thyroid disease. It's long, but well worth a read for everyone (especially Doctors !).. the original link in the post no longer works , but i put a new one at the bottom.
Thank you for this. I read through it, some places rather quickly. Is the brown staining only associated with hyperthyroidism which is what it seems to say.
This also .... The bloatedness, which has the character of an oedema in the early stages
and in severe cases as well, can later and in mild cases make room for simple
depositions of fat;
I have pads of fat under my knees and yet to one side slightly - to the middle rather than right under the knee, plus both calves are enlarged. No-one seems to take any notice of this. I am trying to get another appointment to get it looked at but hard to get one. The neuro did write in her letter to the practice to have my legs looked at but I never heard anything at all from the practice!
"Is the brown staining only associated with hyperthyroidism which is what it seems to say." I cant remember when i had it last,
I'm pretty sure it was there when i had some other overmedicated symptoms . so i'd agree with the 'hyper'....... but i'm also fairly sure it was there after my dose was lowered a bit too much.
I don't rightly remember, because i didn't associate it with thyroid hormone at those times .. just thought it was a more general 'poor health' sign.
It's not there at the moment but i don't know my current bloods. I feel ok, if anything a smidge undermedicated, but not much.
Do you mean the staining not there or the fat pads, or both ?! Glad you feel ok. I wish I could tell how I feel. I only felt better when first started levo in 2020 and then T3 in '21 , now , just tired and not sleeping - back to insomnia all the time.
well , now you come to mention it ... it seems obvious ... but i can see why you didn't notice at the time . i don't think i would have thought anything about it either unless it hurt. Well done that anaesthetist .
Before Docs only looked at screens for results and declared everything 'normal' - they had good observational skills. They also checked throats and palpated the neck and jaw line. So it would seem pictures/selfies are replacing these skills.
Since being diagnosed in 2005 I have become an observer of necks and can see so many Hypo features in people everywhere - especially TV audiences !
I have also told the story here many times of the two necklace type wrinkles on the neck that a Greek Doctor said was the way he could diagnose a potential problem. Even spotted them on Joanne Lumley recently !
Also spotted something on my daughters neck as she swallowed a sip of bubbly on arriving in Crete on holiday. Tests and scans followed locally revealing a lump and eventually back in the UK her thyroid cancer was diagnosed. Had her GP been able to observe her neck whilst swallowing he may have spotted something - or taken a picture ! But no - he refused to look at the Greek scans and results and declared everything fine with his own TSH test - not once but twice.
So sad that so many skills have been lost as we hurtle towards remote medicine. So let's keep taking those pics and carefully observing friends and family.
I once read somewhere that one of the self-help tests is to take a sip of water and swallow whilst looking in the mirror to check for irregularities of the neck - lumps and bumps - often one sided !
Interesting read.. 👍... When I was clearly showing symptoms of an overactive thyroid at the end of 2017 and 2018 my gp put those symptoms down to the menupause 🙄.. I was examined on a few occasions at that time but was never told what the doctor was checking for, upshot in later 2018 I collapsed was taken to my doctors where the lovely new gp I'd never seen diagnosed me there and then with overactive thyroid (thank goodness) unfortunately I went in to thyroid crisis and was in hospital the ward doctor asked what were my uptake scan results "what did my endocrinologist say" I told him I've never been offered an uptake scan!! And I've never seen an endocrinologist!! My T4 was 100 my T3 was 39.5 my TSH was undetectable, he got me the appointment with the endocrinologist who proceeded to examine my throat and then gleefully saying "you have no goiter" I asked does that make a difference to my diagnosis" he was very flippant and said I don't think we need to do anything other than keep you on anti thyroid medication, unfortunately I couldn't stomach both anti thyroid medications as I keep being sick, I asked for an uptake scan but he was very rude in saying "why do you want an uptake scan I've told you the process go back on anti thyroid medication, I firmly insisted on an uptake scan he was so rude to me but eventually gave in and agreed I could have one, I did, it came back as thyrotoxic uptake in both lobes, he rang me asking if I could come to his clinic that day, changed his tune pretty fast when he saw the results, he then processed to tell me there was no hope for saving my thyroid as it was so toxic and it needed to be removed ASAP.. So then I broached the subject of the goiter, I said "I have no goiter but still have graves thyrotoxic how do you explain that when you placed everything on the fact I can't be that bad as I have no goiter" total silence, then typing fast to get me to a surgeon 🙄... I later found out the exam my gp did on me was to detect a goiter, I got my medical records and it says, "checked her throat on several occasions no goiter visible" no further action 🙄... It beggers belief that in this day and age that some gps and endocrinologist still think you need a goiter to detect graves or any thyroid condition 🤦♀️
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Another study on Thyroid function and Heart Failure that relies on TSH only
