The most common thyroid problems include:
- An overactive gland, called hyperthyroidism (e.g., Graves’ disease, toxic adenoma, or toxic nodular goiter)
- An underactive gland, called hypothyroidism
- An enlarged thyroid (also called a goiter)
- A thyroid nodule
Patients with a family history of thyroid cancer, or who had radiation therapy to the head or neck are more prone to develop thyroid cancer. Significant swelling in the neck and difficulty breathing or swallowing, require evaluation by an otolaryngologist, or a visit to the emergency room when medical emergency is present.
In addition to thorough history and medical exam, your physician at Shea Clinic may order blood tests, perform an ultrasound or order additional imaging, and may or may not perform a perform a fine needle aspiration.
Other tests your doctor may order include:
- Evaluation of the larynx/vocal cords with a mirror or a fiberoptic telescope
- A radioactive thyroid scan
Many common thyroid problems are managed with medications and are not treated surgically. For example, Hashimoto’s thyroiditis, in which scarring and inflammation of the thyroid cause it to not make a sufficient amount of hormone, is treated with hormone pills.
However, other thyroid disorders do require surgery for optimal treatment. If thyroid surgery is recommended, your physician will determine whether to remove part, or all, of the thyroid gland. Instances when thyroid surgery may be required include:
- the fine needle aspiration is indeterminate, suspicious, or suggestive of cancer
- imaging shows that nodules have certain characteristics, or that nodules are getting bigger
- the windpipe or esophagus is compressed because one or both lobes are very large
The parathyroid glands are located just behind the thyroid gland which is in the lower neck in the midline. The parathyroid glands do not have any association with thyroid function. They only share a common location. Para- means beside or along side. The parathyroid glands are along side the thyroid gland. They are part of the endocrine system, and they produce parathyroid hormone (PTH) to regulate calcium levels in the blood.
It is very important to maintain appropriate calcium levels in the blood as muscles, including the heart require maintenance of strict calcium levels in order to function. PTH triggers cells within the bones called osteoclasts to remove calcium from the bone to raise calcium levels in the bloodstream.
When the parathyroids produce too much PTH, bones can become depleted of calcium and can become weakened. High blood levels of calcium can also produce kidney stones and problems with constipation. This overproduction of PTH can result from a tumor on one parathyroid gland or from certain chronic conditions that cause all the parathyroid glands to overproduce hormone. Tumors of the parathyroid glands are rarely cancerous.
Sometimes when hyperparathyroidism is mild, it can be observed; however, most moderate to severe cases require surgical intervention. Surgery removes the overactive gland in primary hyperparathyroidism, but when multiple glands are involved three to three and one half glands may be removed. Removal of the overactive parathyroid gland(s) allows calcium levels to return to normal. Often after surgery the suppressed glands require time to return to normal function. Calcium supplementation is required after surgery until normalization of calcium regulation returns. Usually calcium supplementation can be reduced in the weeks following surgery.
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