Could Your Symptoms Point to a Thyroid or Parathyroid Condition?

A lump in your neck, unexplained fatigue, or a kidney stone may not seem related, but these symptoms can sometimes point to a thyroid or parathyroid problem. Although the glands have similar names, they play different roles in keeping your body healthy.

Some thyroid and parathyroid conditions need little more than monitoring, while others may require surgery. Knowing the signs can help you get the right care.

The thyroid is a small, butterfly-shaped gland at the front of your neck. It produces hormones that help regulate your metabolism, which affects how your body uses energy.

Some thyroid conditions require surgery, including suspicious thyroid nodules, enlarged thyroid glands called goiters, thyroid cancer and certain cases of an overactive thyroid.

Some thyroid nodules cause no symptoms. Doctors may discover them during an imaging test, such as a chest X-ray or CT scan, performed for an unrelated reason.

Normal thyroid blood test results do not rule out a thyroid nodule or thyroid cancer. A nodule may need further evaluation even when hormone levels are normal.

Treatment depends on the nodule's size and appearance, whether it causes symptoms, and whether there is concern about cancer.

Your care may include monitoring the nodule over time, an ultrasound or a needle biopsy to help determine whether it is cancerous. When surgery is needed, a surgeon may remove part or all of the thyroid gland. Medication or other treatments may also be appropriate for certain conditions.

Despite their similar names, the parathyroid glands have a different job from the thyroid. These four tiny glands, located behind the thyroid, help regulate blood calcium levels. Calcium is essential for healthy bones, muscle function and nerve signaling.

One common parathyroid problem is primary hyperparathyroidism, which can occur when one or more glands become overactive. Often, a noncancerous growth called a parathyroid adenoma is the cause.

Some people with an overactive parathyroid gland have no obvious symptoms. The first clue may be an elevated calcium level found during routine bloodwork.

Others may experience:

Treatment depends on calcium levels, bone health, kidney function and overall health. Some people may be monitored or treated with medication, while others benefit from surgery to remove the overactive gland or glands.

"For many patients with primary hyperparathyroidism, surgery can correct the problem by removing the gland responsible for producing too much parathyroid hormone. Some patients are candidates for a focused procedure through a small neck incision,” notes Dr. Battiata.

Don't ignore a new lump or swelling in your neck, persistent hoarseness or difficulty swallowing. Also discuss unexplained fatigue, kidney stones, or elevated calcium levels with your doctor.

Your primary care physician can help determine whether you need further testing or a referral to a specialist. Depending on your symptoms and test results, evaluation may include bloodwork, imaging or a biopsy.

“Normal thyroid blood tests do not rule out a thyroid nodule or cancer,” says Dr. Battiata. “A nodule may need further evaluation even when hormone levels are normal.”

The good news is that many thyroid nodules are benign, and several thyroid and parathyroid conditions can be managed effectively with monitoring, medication or surgery when appropriate. Getting an accurate diagnosis is the first step toward finding the right treatment for you.

Andrew P. Battiata, MD, Lexington ENT & Allergy