Thyroid/Parathyroid

The thyroid and parathyroid are separate glands located in the neck. Each serves an important function: the thyroid generates a hormone that regulates the body’s metabolism, while the parathyroid controls the level of calcium in the blood. Together, they are responsible for many of the body’s daily functions.

Thyroid Conditions

The thyroid gland produces thyroid hormone (TH) that controls your body’s energy production and consumption.

This hormone helps regulate a variety of body processes including heart rate, body temperature and how quickly you burn calories. When too much or too little hormone is generated, your health is negatively affected.

Hyperthyroidism is the name given to a disorder that is the result of too much TH hormone. This causes the metabolism to speed up, leading to rapid or irregular heartbeat, anxiety, irritability, nervousness, fatigue, heat intolerance, excessive sweating, tremors, weight loss and increased bowel movements. Hyperthyroidism can be caused by an autoimmune disorder known as Grave’s disease, nodules, goiter, inflammation of the thyroid gland and too much iodine. The condition is usually treated with drugs such as beta-blockers, antithyroid medications like methimazole, radioactive iodine or surgery.

When the opposite occurs and too little TH hormone is produced, the metabolism slows down and results in a condition known as hypothyroidism. Symptoms include depression, fatigue, sore muscles, dry skin, puffy face, swollen legs, weight gain, constipation and sensitivity to cold. An autoimmune disorder called Hasihomoto’s thyroiditis is the most common cause of hypothyroidism. Others include an inflammation of the thyroid gland called lymphocytic thyroiditis, thyroid destruction following radioactive iodine treatment or surgery, pituitary gland injury and iodine deficiency. Treatment for this disorder involves life-long therapy with synthetic thyroid hormone.

Parathyroid Disorders

The parathyroid is a group of glands that produce a hormone (PTH) to regulate calcium and phosphorous levels in the body.

Bone and tooth development and strength are dependent on calcium. As with the thyroid gland, too much or too little PTH causes a variety of medical problems.

Hyperparathyroidism occurs when too much PTH is secreted into the bloodstream. This creates an imbalance of high calcium levels and low phosphorous levels. Symptoms include osteoporosis, kidney stones, bone and joint pain, weakness, lethargy, loss of concentration, depression, loss of appetite, constipation, nausea and vomiting. The cause may be linked to a benign tumor or enlarged parathyroid gland. Surgery is the preferred treatment for hyperparathyroidism.

When too little PTH is produced, calcium levels in the blood drop while phosphorous levels rise. This condition is known as hypoparathyroidism and causes weakness, anxiety, fatigue, muscle aches and cramps, headaches, muscle spasms, cataracts, depression, mood swings, memory loss and tingling sensations in the fingers, toes and lips. Injury to the parathyroid glands, endocrine disorders and genetic conditions are the most common causes of hypoparathyroidism. Calcium carbonate and vitamin D supplements are given to restore the proper balance of calcium and phosphorous in the body.

Thyroid Nodules

Thyroid nodules are lumps in the thyroid gland that may be solid or filled with fluid. They are usually noncancerous and rarely cause problems. In some cases, they may enlarge to the point of causing breathing and swallowing difficulties or stimulating overproduction of thyroid hormone.

Thyroid Nodule Indications

Many times, you may be completely unaware that you have nodules growing on your thyroid gland. They may be discovered inadvertently during a routine examination by your physician. If they grow large enough, they may be visible to the naked eye and, in some cases, can be felt. When thyroid nodules press against your windpipe or esophagus, they can cause you to have trouble breathing or swallowing.

Nodules sometimes produce additional thyroid hormone, which causes an imbalance that leads to hyperthyroidism. Symptoms include rapid heartbeat, weight loss, anxiety, tremors, irritability, excessive perspiration and intolerance to heat. These are the result of a sped-up metabolism. In rare cases, thyroid nodules turn out to be cancerous.

Treatment for Thyroid Nodules

Thyroid nodules may develop due to a variety of conditions such as iodine deficiency, excess tissue growth, thyroid cysts, goiter (enlarged thyroid), Hashimoto’s disease (a thyroid disorder resulting in inflammation and reduced hormone production) and cancer. Heredity is also a factor; if thyroid nodules run in your family, you are more likely to have them.

Treatment depends on the size of the thyroid nodule and whether or not it’s cancerous. If a biopsy proves it’s benign and it isn’t causing any outward trouble, your doctor may suggest taking a wait-and-see approach. Unless it grows larger, treatment can be avoided. Other times, it may be beneficial to remove benign nodules. This is usually accomplished through surgery or thyroid hormone suppression therapy. If nodules are causing hyperthyroidism, you’ll likely receive radioactive iodine or anti-thyroid medication. Surgery is the option of choice for malignant (cancerous) thyroid nodules.

Thyroid Cancer

Though relatively rare, thyroid cancer occurs when abnormal cells multiply in the thyroid gland.
Fortunately, patients with thyroid cancer frequently do well because it is usually detected early and responds well to treatment. It is important to seek medical attention as soon as possible if you experience any symptoms of the disease.

Signs and Symptoms of Thyroid Cancer

There are several signs that might indicate thyroid cancer. These include a lump or swelling in the neck; neck, throat or ear pain; difficulty swallowing and/or breathing; hoarseness; chronic cough; swollen lymph nodes and wheezing. These don’t necessarily indicate the presence of thyroid cancer, which is fairly uncommon, but a physician should investigate to be on the safe side. Your doctor may perform a biopsy in order to diagnose or rule out cancer.

There are different types of thyroid cancer. Papillary, the most common, forms in the follicular cells that produce thyroid hormone. It usually strikes people aged 30 to 50. Follicular thyroid cancer originates in the same region, but typically affects those over 50. Medullary thyroid cancer forms in the C cells that produce calcitonin. Anaplastic thyroid cancer is rare, but grows rapidly and is difficult to treat. It usually occurs in people over the age of 60.

Risk factors for thyroid cancer include being female, exposure to high levels of radiation and genetics – especially having family members who have experienced thyroid disease or cancer.

Thyroid Cancer Treatments
Treatment for thyroid cancer depends on the type and stage of your cancer, your age and your overall health. Surgery to remove all or part of the thyroid gland or the lymph nodes in the neck is the most common form of treatment. When this is done, you’ll have to take synthetic thyroid medication for the rest of your life. You may also receive radioactive iodine treatment to destroy remaining cancerous tissue. Thyroid-stimulating hormone suppression therapy is used to reduce the levels of thyroid-stimulating hormone in your body, which can prevent future growth of cancerous cells. More advanced thyroid cancers may be treated with chemotherapy or radiation therapy.

Thyroid Surgery

Too much or too little hormone produced by the thyroid can cause serious medical complications; this can occur as the result of diseases, nodules on the thyroid or cancer. In cases such as these, thyroid surgery may be an option for treatment.

Thyroid Gland Removal

When certain conditions interfere with normal thyroid production, surgical removal of the thyroid gland is performed. This is usually done when thyroid cancer has been detected, an otherwise benign thyroid nodule grows so large it causes problems or hyperthyroidism (a disorder in which excess thyroid hormone is produced) does not respond to treatment with medications or radioactive iodine, though this is rare.

Thyroid surgery is known as a thyroidectomy. Two types of procedures are performed: a total thyroidectomy to remove the entire gland or a subtotal thyroidectomy, which removes part of the gland.

In a total thyroidectomy, the entire gland and surrounding lymph nodes are removed. The patient is given drugs to suppress thyroid hormone production, in addition to radioactive iodine. A subtotal thyroidectomy involves removal of one complete gland and part of the other, which is usually reserved for treating hyperthyroidism caused by Grave’s disease.

Effectiveness of Thyroid Surgery

The effectiveness of any surgical thyroid procedure depends on the type of cancer present and how much it has spread. Overall, the surgery is considered safe, but may lead to complications that include injury to the vocal cords and larynx (which could cause hoarseness, changes in the voice and problems speaking or swallowing), injury to the parathyroid glands (which could cause hypoparathyroidism, a separate condition in which too little parathyroid hormone is produced), difficulty breathing and the usual risks associated with most surgical procedures (bleeding and infection).

Call (913) 663-5100 for more information or to schedule an appointment.