thyroid conditions

Thyroid and

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Common thyroid conditions are goitres and nodules, thyroid cancer and hyperparathyroidism

Thyroid conditions: goitre and nodules

Thyroid goitres and nodules

Thyroid goitres and nodules are abnormal enlargements or growths in the thyroid gland. The butterfly-shaped thyroid gland wraps around the windpipe (trachea) and produces hormones key to regulating metabolism and other important body functions. A “goitre” is an abnormal enlargement of the gland and does not necessarily mean the thyroid is malfunctioning.

What are the causes?

Iodine deficiency has been identified as a cause of both the thyroid goitre and nodules. The thyroid gland uses iodine to produce thyroid hormones and an iodine-deficient diet will signal to the gland to increase production causing it to grow in size.

Other conditions such as Hashimoto’s disease inflame the tissue and create enlarged nodules or a goitre. Large and hard nodules can be a sign of thyroid cancer, which is a fairly common malignancy. Thyroid cancer patients tend to do well after surgery to remove the thyroid and often have a normal survival. Sometimes the thyroid may have an overactive (toxic) nodule which causes hyperthyroidism and needs to be removed surgically.

Symptoms of thyroid goitres and nodules

Thyroid goitres and enlarged nodules may cause swelling at the base of the neck, make breathing or swallowing difficult, and can be felt.

Goitres may also cause coughing and hoarseness. Most thyroid nodules are small and do not have signs or symptoms. Additionally, symptoms of hyperthyroidism – sudden weight loss, pounding heart, trouble sleeping, muscle weakness and nervousness – can be a sign of thyroid nodules.

Nodules are 95% non-cancerous. Both women and men develop nodules (the rate is 3 times higher for women) and the likelihood of nodules forming increases with age. Nodules are detected during a routine neck exam.

Thyroid surgery figures

Total (thyroidectomy) or partial (lobectomy) removal of the thyroid gland is a treatment option for thyroid nodules. The procedure is very safe. Less than 1% of patients have damaged vocal cords after surgery.

Similarly, 1% of patients develop a condition called hypoparathyroidism whereby the body has trouble controlling calcium levels. Hypoparathyroidism can be treated with calcium supplements. After a thyroidectomy or totally removed thyroid, patients will need to take synthetic thyroid hormones for the rest of their life.

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Thyroid surgery

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thyroid conditions: thyroid cancer (symptoms & causes)

Thyroid cancer

Thyroid cancer is the malfunctioning of DNA in the thyroid gland, causing an overgrowth of cells. The thyroid gland is a butterfly-shaped gland that sits just below the Adam’s apple and covers the front of the windpipe. The thyroid gland produces thyroid gland hormone that regulates the body’s metabolism.

Thyroid cancer symptoms

Thyroid cancer often develops slowly and is not part of regular screening. A patient may exhibit one or more of the following symptoms:

  • A lump in the neck or throat that may get bigger over time
  • Difficulty breathing or swallowing
  • Swollen lymph glands in the neck
  • A hoarse voice

An ultrasound will detect if there are any nodules, and also their number and their condition (hard or fluid-filled). A fine-needle aspiration biopsy will remove cells from the nodules to test for cancerous cells. A blood test will detect high or low levels of thyroid gland hormone and electrolytes (calcium).

Individuals are considered at high risk if a family member has had thyroid cancer and there are some genetic tests available to see if a patient has a higher risk of developing this type of cancer in their lifetime.

Causes of thyroid cancer

Thyroid cancer is linked to certain genetic conditions but the exact cause is unknown. People predisposed to thyroid cancer have a family history of various subtypes of thyroid cancer. These types of cancer cases have increased where there has been exposure to radiation either from radiation therapy or nuclear radiation exposure.

Thyroid cancer figures

Australian women over 30-years old are at higher risk of developing thyroid cancer but survival rate is at 97%. Of all the cancers, this cancer has the highest five-year survival rate.

The four types of thyroid cancer:

  • Papillary and/or mixed papillary/follicular thyroid cancer accounts for 70- 80% of cases in Australia
  • Follicular and/or Hurthle cell thyroid cancer accounts for 20% of cases
  • Medullary thyroid cancer: ~ 3%
  • Anaplastic thyroid cancer: ~ 2%

Treatment for thyroid cancer

Thyroid conditions: hyperparathyroidism

Primary hyperparathyroidism

The parathyroid produces parathyroid hormone (PTH) which controls the level of calcium in the blood that affects your muscles, nerves, and bones. The condition hyperparathyroidism is caused when one of the parathyroid glands produces too much parathyroid hormone due to a tumour. The majority of hyperparathyroidism cases are primary hyperparathyroidism.

Primary hyperparathyroidism symptoms

High blood calcium can cause you to feel tired and irritable, and have aches and pains that are also indications of many other conditions. Typically hyperparathyroidism is detected during a blood test for another condition. The blood will have elevated levels of calcium.

However, 80% of hyperparathyroidism cases do not have any symptoms. An experienced endocrinologist will help to determine the best course of action after a diagnosis of hyperparathyroidism.

What is secondary and tertiary hyperparathyroidism?

Sometimes the parathyroid glands are enlarged and produce too much parathyroid hormone because they are responding to a low calcium environment in the blood.

Low calcium stimulates the parathyroids to produce parathyroid hormone to try and increase blood calcium. The parathyroid hormone (PTH) causes the bone to be reabsorbed to free up calcium. This situation can result in bone loss (osteopenia) and osteoporosis. The overproduction of PTH is typically triggered by one of three things:

  1. Low calcium blood levels (hypocalcemia)
  2. Vitamin D deficiency
  3. High blood phosphorus (hyperphosphatemia)

The most common cause of secondary hyperparathyroidism is kidney failure. Secondary hyperparathyroidism can be resolved by restoring kidney function.

Tertiary hyperparathyroidism is the continued overproduction of PTH even after resolving the causes of secondary hyperparathyroidism.

Parathyroid primary figures

The incidence of primary hyperparathyroidism is higher in women than in men. The chances of primary hyperparathyroid problems increase greatly for both men and women after their 40s. The incidence of hyperparathyroidism is highest in postmenopausal women and lowest in children.

Parathyroid problems can result in kidney problems, kidney stones and excessive urination. People may feel forgetful, depressed, tired, and lose their appetite. Some people feel nausea and pain in their torso, joints or bones.

Hyperparathyroidism treatment

Parathyroid surgery is highly successful (95%) for the majority of primary hyperparathyroidism cases. The surgery presents low risks to your health. Very occasionally there could be a vocal cord injury after surgery (1% or less). In 5 % of cases, the surgery is not successful as the small tumour (adenoma) cannot be found, or if there is more than one adenoma. Occasionally a further operation is needed.

At Advance Surgical, Mr Jon Armstrong and the team help people who want to lose weight through bariatric surgery, suffer from an endocrine disorder or need general surgery.

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