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How do I know if I will need thyroid or
parathyroid surgery?


Thyroid nodules (growths in the thyroid gland) are extremely common. The majority of these lesions are benign (not cancer). However, the thyroid gland can develop nodules or lesions that may require removal by a thyroid surgeon. Some of these nodules can be cancerous and need to be removed. To evaluate if a nodule could be cancerous, we often recommend an FNA (Fine Needle Aspiration) biopsy. If an FNA biopsy reveals benign tissue, patients can be followed conservatively (without thyroid surgery). At times, patients may experience symptoms from even benign nodules. These symptoms can include difficulty swallowing or breathing, a choking sensation, or the feeling that something is stuck in their throat. On occasion, patients can have voice hoarseness as a thyroid nodule or goiter enlarges and begins to push on the windpipe, vocal cords, or esophagus. We refer to these as compressive symptoms and these symptoms may become severe enough that we recommend surgery.


The parathyroid glands are not related to thyroid function at all. The name “para” thyroid simply comes from the fact that they are near the thyroid gland and share some of the same blood supply as the thyroid. They are primarily involved with regulating calcium levels in the body. Whereas the thyroid gland is important for metabolism and can affect the function of all organ systems in the body. At times, the parathyroid glands can grow and produce too much parathyroid hormone (PTH) in the body. This overproduction inappropriately pulls calcium out of the bone and puts it into the blood stream. This can cause patients to have a number of symptoms such as lethargy, problems with concentration, memory loss, depression, high blood pressure, heart problems, kidney stones, and osteoporosis. The presence of some of these symptoms combined with either an elevated PTH and/or calcium level means that a patient may require parathyroid surgery. At times, patients have a normal calcium level and an elevated parathyroid hormone level. Other times, patients can have an elevated calcium level and normal parathyroid hormone levels. Both of these groups of patients still have primary hyperparathyroidism and will require parathyroid surgery. In my experience, patients feel much better after parathyroid surgery to remove their abnormal gland or glands. Many patients have told me it was “life changing” for them, giving them an increased energy level and improved cognitive function.

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