The Thyroid Gland
The thyroid gland is a complex gland shaped like a shield or butterfly that wraps around the front of the trachea (windpipe) below the larynx (Adam’s apple/ voice box) in the neck. Its main function is to continuously release regulatory proteins called hormones, into the blood stream, that primarily control the rate of the body’s metabolism, temperature, level of energy, body weight and health of other organs. The amount of hormone produced is tightly regulated by another hormone (thyroid stimulating hormone, TSH) released by the master gland (pituitary gland) at the base of the brain. Diseased states of the thyroid gland may result in either too much thyroid hormone (hyperthyroidism) or too little thyroid hormone (hypothyroidism) causing generalized symptoms, weight loss or gain and rarely can be life-threatening if untreated.
What We Treat
The following list is by no means complete, but identifies a few of the more common thyroid and parathyroid gland disorders:
- Hyperthyroidism (overactive gland)
- Graves’ disease (overactive gland, weight loss, prominent eyes, rapid heart rate)
- Hypothyroidism (underactive gland, weight gain, excessive tiredness)
- Thyroiditis (inflammation of the gland causing pain and hormone irregularities)
- Benign (non-cancerous) thyroid tumors/nodules, cysts and massive enlargement of the gland that can cause trouble breathing or swallowing (Goiters)
- Malignant (cancerous) tumors/nodules of the thyroid gland
- Parathyroid gland tumors causing excess parathyroid hormone and blood calcium, osteoporosis, weakness, fatigue, memory loss, bone pain, kidney stones
- Lymph nodes in the neck that could have originated from a thyroid gland cancer
- Persistent hoarseness due to a thyroid tumor invading the vocal fold muscles or the directly or pressing on or invading a nerve controlling the vocal fold muscles
Patients concerned that they may have a thyroid or parathyroid disorder are urged to contact their personal physician or the Center for Thyroid & Parathyroid Surgery.
Hyperthyroidism (Overactive Thyroid Gland)
The thyroid, for reasons that are not completely understood, may go into overdrive—secreting way too much hormone and speeding up metabolism. A patient with Graves' disease, which is considered a disorder of the immune system (autoimmune disease), will develop a very high heart rate and protruding/prominent eyes, may become mentally ill and (if untreated) die from heart failure.
Hypothyroidism (Underactive Thyroid Gland)
Hypothyroidism, or not enough thyroid hormone in the blood, causes the body’s cells to slow down their rate of metabolism causing exhaustion, weight gain, depression, and in severe cases severe fluid retention in the body’s tissues, a condition called myxedema that may result in a coma or death.
Thyroid cancer is a rare but highly curable cancer representing approximately 1% of all human malignancies. Thyroid cancer is a malignant tumor or nodule arising from abnormal growth of thyroid cells that may invade surrounding tissues and/or metastasize (spread to areas beyond the thyroid gland) to lymph nodes near the thyroid gland in the neck or upper chest or beyond the neck, rarely resulting in death. Several different types of cancer arise from the thyroid gland with varying degrees of aggressiveness. The most common type, called papillary thyroid carcinoma (PTC), is typically slow growing and highly curable. However, a rare and rapidly fatal form is called anaplastic carcinoma.
Follicular, Hürthle cell and Medullary carcinomas are less common than the papillary type and may not have as good a prognosis.
Parathyroid Glands and Hyperparathyroidism
The parathyroid glands produce and release parathyroid hormone (PTH) into the bloodstream, which controls the bone stores of calcium, intestinal absorption from food sources, and excretion by the kidneys to maintain normal blood calcium levels. Normal blood levels of calcium are needed for proper functioning of the muscles, nervous system and bone health. Most people have four parathyroid glands, although rarely it is possible to have more than four. At least one normally functioning gland is needed for proper calcium regulation. These tiny glands are usually only several millimeters in their longest dimension (the size of a raisin) and are located close to the back of the thyroid gland and to the side or in front of the trachea. They may be very difficult to find during surgery and located in an unexpected area of the neck or upper chest.
Hyperparathyroidism is a disease in which one or more of the parathyroid glands enlarge forming a benign (non-cancerous) tumor that produces excess amounts of hormone. This results in above normal calcium levels in the blood and possibly in the urine as well. A single tumor is called an adenoma and enlargement of multiple glands is referred to as hyperplasia. High calcium levels can lead to: extreme fatigue, muscle weakness, memory loss and confusion, depression, mood swings, stomach ulcers, abdominal pain, hard stools, excess urination, kidney stones, brittle bones (osteoporosis) that fracture easily, high blood pressure and ultimately a shorter life span.
Primary hyperparathyroidism is a disease characterized by elevated levels of blood calcium potentially causing a variety of long-term consequences such as: extreme fatigue, muscle weakness, memory loss, confusion, difficulty concentrating, depression, mood swings, stomach ulcers, abdominal pain, hard stools, excess urination, kidney stones, thin, brittle bones (osteoporosis) that fracture easily, joint pain, cardiovascular disease (hypertension) and other subtle symptoms. The disease is generally caused by an over-production of parathyroid hormone from a benign tumor (adenoma) in one or more parathyroid glands situated in the neck, behind or adjacent to the thyroid gland. Once considered a rare disease, and often presenting only in the most advanced stages, primary hyperparathyroidism is now a commonly treated problem. In the United States, 28 out of every 100,000 people are expected to develop primary hyperparathyroidism. Women outnumber men 3:1 in frequency. The incidence increases with age.
The majority of patients (90%) with parathyroid disease have only one of the four glands enlarged (called a parathyroid adenoma, a benign hormone-secreting tumor). Rarely (in less than 1%) a fifth gland is present. The other 10% have all four glands enlarged (parathyroid gland hyperplasia) each contributing to the overall elevation of parathyroid hormone production. This condition is more often associated with chronic kidney failure. The incidence of double adenomas is also rare and more often seen in the elderly.