Thyroid Disorder Treatment
What Is a Thyroid Disorder?
Thyroid disorders are conditions that affect the thyroid gland. Your thyroid gland is one of the endocrine glands that makes hormones to regulate physiological functions in your body, like metabolism (heart rate, sweating, energy consumed). Other endocrine glands include the pituitary, adrenal, and parathyroid glands and specialized cells within the pancreas.
Patients with a family history of thyroid cancer or who had radiation therapy to the head or neck as children for acne, adenoids, or other reasons are more prone to develop thyroid malignancy.
Common Thyroid Problems
Diseases of the thyroid gland are very common, affecting millions of Americans. The most common thyroid problems are:
- An overactive gland called hyperthyroidism (e.g., Graves’ disease, toxic adenoma or toxic nodular goiter)
- An underactive gland, called hypothyroidism (e.g., Hashimoto’s thyroiditis)
- Thyroid enlargement due to overactivity or from under-activity.
How is Thyroid Disorder diagnosed?
The diagnosis of a thyroid function abnormality or a thyroid mass is made by taking a medical history and a physical examination. In addition, blood tests and imaging studies or fine-needle aspiration may be required. As part of the exam, your doctor will examine your neck and ask you to lift up your chin to make your thyroid gland more prominent. Tests your doctor may order include:
- Evaluation of the larynx/vocal cords with a mirror or a fiberoptic telescope
- An ultrasound examination of your neck and thyroid
- Blood tests of thyroid function
- A radioactive thyroid scan
- A fine-needle aspiration biopsy
- A chest X-ray
- A CT scan or MRI scan
Thyroid Disorder Treatment
Depending on the nature of your condition, treatment may include the following:
If you experience this condition, your doctor will propose a treatment plan based on the examination and your test results. He may recommend:
An imaging study
to determine the size, location, and characteristics of any nodules within the gland. Types of imaging studies include CT or CAT scans, ultrasound, or MRIs.
A fine-needle aspiration biopsy – a safe, relatively painless procedure. With this procedure, a hypodermic needle is passed into the lump, and tissue fluid samples containing cells are taken. There is little pain afterward and very few complications from the procedure. This test gives the doctor more information on the nature of the lump in your thyroid gland and may help to differentiate a benign from a malignant or cancerous thyroid mass.
- Thyroid hormone replacement pills
- Medication to block the effects of excessive production of thyroid hormone
- Radioactive iodine to destroy the thyroid gland
- Surgical removal of the thyroid gland
Thyroid surgery is an operation to remove part or all of the thyroid gland. Typically, the operator removes the lobe of the thyroid gland containing the lump and possibly the isthmus. A frozen section (immediate microscopic reading) may be used to determine if the rest of the thyroid gland should be removed during the same surgery.
Sometimes, based on the result of the frozen section, the surgeon may decide not to remove any additional thyroid tissue, or proceed to remove the entire thyroid gland, and/or other tissue in the neck.
This decision is usually made in the operating room by the surgeon, based on findings at the time of surgery. Your surgeon will discuss these options with you preoperatively.
As an alternative, your surgeon may choose to remove only one lobe and await the final pathology report before deciding if the remaining lobe needs to be removed. If a malignancy is identified in this way, your surgeon may recommend that the remaining lobe of the thyroid be removed at a second procedure. If you have specific questions about thyroid surgery, ask your otolaryngologist to answer them in detail.
Thyroid Surgery Recovery
During the first 24 hours:
After surgery, you may have a drain (tiny piece of plastic tubing), which prevents fluid and blood from building up in the wound. This is removed after the fluid accumulation has stabilized, usually within 24 hours after surgery.
Complications are rare but may include:
- Bleeding under the skin that rarely can cause shortness of breath requiring immediate medical evaluation
- A hoarse voice
- Difficulty swallowing
- Numbness of the skin on the neck
- Vocal cord paralysis
- Low blood calcium
Following the procedure, if it is determined that you need to take any medication, your surgeon will discuss this with you prior to your discharge.
Medications may include:
- Thyroid hormone replacement
- Calcium and/or vitamin D replacement
Some symptoms may not become evident for two or three days after surgery. If you experience any of the following, call your surgeon or seek medical attention:
- Numbness and tingling around the lips and hands
- Increasing pain
- Wound discharge
- Shortness of breath
The parathyroid glands are four small glands in the neck that are part of the endocrine system. They produce parathyroid hormone (PTH), which maintains calcium and phosphorus levels in the blood. The primary disease associated with the parathyroids is an overproduction of PTH, known as hyperparathyroidism.
What Causes Parathyroid Disorder?
Several problems can occur when the parathyroid glands secrete a too much parathyroid hormone (PTH).
- The blood calcium level rises in a condition known as hypercalcemia. The bones lose calcium (osteoporosis) while the body absorbs too much calcium from food. Calcium levels may also increase in the urine, leading to kidney stones.
- A benign tumor called an adenoma usually forms on the overproducing parathyroid gland. It is important to note that benign tumors are not cancerous and that hyperparathyroidism is only very rarely associated with cancer.
- PTH also lowers blood phosphorus levels by increasing excretion of phosphorus in the urine.
twice as common in women as in men, and the risk increases with age. In most cases, the cause of hyperparathyroidism is not known. Symptoms are often subtle and may include:
- Weakness, fatigue, and depression
- Nausea, vomiting, loss of appetite, and constipation
- Impaired thinking and loss of memory
- Increased thirst and urination
- High blood pressure
Although medication is available to treat hyperparathyroidism, surgery is most often recommended and is the only cure. Surgery has a 95 percent success rate. Your doctor will make a small incision in your neck and remove the gland. Your particular problem will determine how many of the parathyroid glands need to be removed. Some parathyroid tissue must be left in place to help prevent hypoparathyroidism (decreased parathyroid activity).
If more than one parathyroid gland has to be removed, then the procedure will involve general anesthesia and may take up to three hours. However, in most cases of hyperparathyroidism, only one gland has to be removed and a less invasive procedure called minimally-invasive radio-guided parathyroid (MIRP) surgery can be performed. MIRP surgery only involves a local anesthetic, requires a much smaller incision, and has a very high success rate. The operation usually takes less than 30 minutes and you may return home within one to two hours. You will be able to return to your normal daily activities after just one day.
Risks and Complications
Complications of parathyroid surgery are more common in the traditional procedure than in the MIRP procedure, but both procedures are generally safe and successful. Less than 1 percent of patients undergoing surgery experience damage to the nerves controlling the vocal cords, which can affect speech. Patients requiring more extensive surgery could develop hypoparathyroidism, resulting in low calcium levels, which may require treatment with calcium or vitamin D.
Schedule a Consultation
If you believe you have a thyroid disorder, contact us today at 972.984.1050 to schedule a consultation. ENT & Allergy Centers of Texas serve McKinney, Allen, Plano and surrounding areas.