Thyroid disease The thyroid gland produces the hormone thyroxine which controls metabolism. Surgery is undertaken for overactive thyroid glands resistant to treatment with drugs, goitres (enlarged thyroid glands) that are conspicuous or causes symptoms, and cancers. Thyroid disease is diagnosed by blood tests, ultrasound scans, needle biopsy and occasionally surgery. It is not always necessary to remove the whole thyroid gland so not everyone needs to take thyroxine. Surgery (thyroidectomy) involves a cut in the neck which usually heals quickly and recovery is swift. Hospital stay may only be 24-48 hours. Patients with thyroid cancer usually have an excellent outlook but may require treatment with radioiodine and thyroxine. Parathyroid surgery The four parathyroid glands are situated behind the thyroid gland in the neck. They produce the hormone parathormone which controls blood calcium levels. Enlargement of one (adenoma) or all four glands (hyperplasia) causes raised calcium. In severe cases this causes kidney stones, stomach ulcers, inflammation of the pancreas and bone disease. Nowadays effects are often more subtle and may include depression and neuromuscular problems. Parathyroid cancer is exceptionally rare. Diagnosis is often made incidentally on a blood test. Confirmation is often possible with scans. Surgery (parathyroidectomy) involves a cut in the neck which heals well. Usually only one gland is enlarged and removing it is curative. Less often all four glands are enlarged in which case three and a half are removed. Calcium and vitamen D supplements may then be necessary. In most cases recovery is swift. Hospital stay may be from one to two days, sometimes more if calcium levels drop.
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