Thyroid and Parathyroid Disorders Treatment | Nacogdoches Medical Partners

Thyroid and parathyroid disorders can affect many aspects of your health, from energy levels and weight to heart function and mood. Understanding conditions like hyperthyroidism, hypothyroidism and other thyroid-related issues can help you recognize symptoms early and seek appropriate care. If you or a loved one are experiencing symptoms, Nacogdoches Medical Partners is here to guide you through the journey toward better thyroid health.

What Is Hyperthyroidism?

Hyperthyroidism, also known as overactive thyroid, happens when the thyroid gland produces more thyroid hormones than the body needs. The thyroid is a small, butterfly-shaped gland located in the front of your neck. It makes two primary hormones—thyroxine (T4) and triiodothyronine (T3)—which regulate how your body uses energy (metabolism). When these hormones are produced in excess, the body's vital functions speed up, affecting various systems, including the heart, muscles, digestive tract and brain.

Several factors and medical conditions may trigger hyperthyroidism, such as:

Graves’ disease: An autoimmune disorder where the immune system mistakenly stimulates the thyroid to produce too much hormone.
Thyroid nodules: Lumps within the thyroid gland that become overactive and produce excess hormones.
Thyroiditis: Inflammation of the thyroid, which can release stored hormones into the bloodstream.
Excessive iodine intake: Too much iodine from supplements, medications or diet can prompt the thyroid to overproduce hormones.
Medication overuse: Taking too much thyroid hormone medication for hypothyroidism may lead to hyperthyroidism.

How Is Hyperthyroidism Diagnosed?

To confirm hyperthyroidism, healthcare providers typically perform a combination of the following tests:

Blood tests for TSH, T3 and T4 Levels: These aim to measure thyroid hormone levels. A low TSH level with high T3 and T4 levels usually indicates hyperthyroidism.
Thyroid antibody tests: Used to detect autoimmune causes, such as Graves' disease.
Thyroid ultrasound or scan: These imaging tests assess the size, shape and activity of the thyroid. If nodules are present, further evaluation may be necessary.
Radioactive iodine uptake test: This test checks how much iodine the thyroid absorbs to identify causes like Graves’ disease or toxic nodules.

Reach out to a healthcare provider if you experience any of the following signs that may indicate hyperthyroidism, such as:

Persistent rapid heartbeat or heart palpitations.
Unexplained weight loss despite an increased appetite.
Nervousness, anxiety or irritability without an obvious cause.
Difficulty sleeping or insomnia.
Frequent bowel movements or diarrhea.

What is Hypothyroidism?

Hypothyroidism, also called underactive thyroid, occurs when the thyroid gland does not produce enough thyroid hormones to meet the body’s needs. Since the thyroid hormones help regulate how the body uses energy, a lack of these hormones slows down many vital processes, affecting the heart, digestion, brain function and metabolism. This slowdown can lead to a range of physical and emotional symptoms, though the condition often develops gradually.

Several conditions may lead to hypothyroidism, which may include:

Hashimoto’s disease: An autoimmune disorder where the immune system attacks the thyroid, impairing hormone production over time.
Thyroiditis: Inflammation of the thyroid gland, sometimes following pregnancy or a viral infection.
Surgical removal of the thyroid: Partial or complete thyroid removal may result in hypothyroidism.
Radiation treatment: External radiation for cancer or radioactive iodine treatment can damage the thyroid and reduce its function.
Medications: Certain drugs, such as lithium or amiodarone, can interfere with thyroid hormone production.

Doctors use a combination of medical history, physical exams and blood tests to diagnose hypothyroidism:

TSH test: A high TSH level suggests the thyroid is underactive.
T4 test: A low T4 level supports the diagnosis of hypothyroidism. Measuring free T4 (the active form) helps confirm the condition.
Thyroid antibody test: Used to detect autoimmune causes, such as Hashimoto’s disease.
Imaging tests: Ultrasound or thyroid scans may be used in some cases, especially if there is a concern about nodules or gland enlargement.

Contact your healthcare provider if you experience any symptoms that could suggest hypothyroidism, such as:

Persistent fatigue or lack of energy, even after resting.
Unexplained weight gain despite no changes in diet or activity.
Cold intolerance or feeling cold when others are comfortable.
Constipation, dry skin or hair thinning.
Depression or low mood that doesn’t seem to improve.

Since hypothyroidism may affect fertility, women who are trying to conceive or who are pregnant should also seek medical advice if they have symptoms or a history of thyroid problems. Early diagnosis is especially important during pregnancy to ensure healthy development of the baby.

How Are Thyroid and Parathyroid Disorders Treated?

Treatment for thyroid and parathyroid disorders depends on the specific condition, its severity and how it affects your daily life. Both noninvasive and surgical options are available and the right approach will vary from each patient. Many parathyroid and thyroid disorders may be managed with medication or other non-surgical interventions. These options aim to restore balance to hormone levels and manage symptoms effectively.

Medications

For hypothyroidism:

Levothyroxine: A synthetic form of T4 that replaces the hormones your thyroid cannot produce. It is typically taken daily in pill form and adjusted over time based on regular blood tests.
Monitoring: Regular blood tests ensure the correct dose, preventing symptoms caused by under- or over-treatment.

For hyperthyroidism:

Antithyroid medications: Drugs like methimazole and propylthiouracil (PTU) reduce the production of thyroid hormones.
Beta-blockers: These do not address hormone levels directly but help manage symptoms like rapid heart rate, tremors or anxiety.

Radioactive Iodine Therapy

Radioactive iodine therapy aims to treat hyperthyroidism by gradually shrinking the thyroid gland and reducing its hormone production. This non-surgical treatment involves swallowing a small dose of radioactive iodine, which the thyroid absorbs.

Calcium and Vitamin D Supplements (Parathyroid Disorders)

For hypoparathyroidism: When the parathyroid glands don’t produce enough parathyroid hormone (PTH), calcium and vitamin D supplements may help maintain healthy calcium levels.
For hyperparathyroidism: In mild cases, medications and lifestyle changes (like hydration and moderate calcium intake) may be recommended to manage symptoms without surgery.

Observation and Monitoring

In cases of subclinical hypothyroidism or mild thyroid nodules, doctors may recommend periodic monitoring with blood tests or ultrasound to track hormone levels and gland size over time.

Surgical Treatment Options

In some cases, surgery may be necessary to help manage thyroid or parathyroid conditions. The goal of surgery is to remove abnormal tissues or glands that are causing symptoms or disrupting normal hormone function.

Thyroid Surgery (Thyroidectomy)

Thyroid surgery can be total or partial. Total thyroidectomy involves removing the entire thyroid gland. This may be recommended for cases of thyroid cancers, large goiters that affect breathing or swallowing or hyperthyroidism is unresponsive to medication or radioiodine therapy.

On the other hand, partial thyroidectomy (lobectomy) involves removing one lobe of the thyroid. This may be considered if only part of the gland is affected, such as a benign nodule or mild goiter. After surgery, patients will often need lifelong levothyroxine therapy after a total thyroidectomy, as the body can no longer produce thyroid hormones on its own.

Parathyroid Surgery (Parathyroidectomy)

Surgery may be recommended when:

Blood calcium levels are dangerously high.
There is bone loss or kidney stones due to excess calcium.
Symptoms like fatigue, depression or muscle weakness interfere with daily life.

When Is Surgery Considered?

Surgery may be recommended when noninvasive treatments are not enough to manage symptoms or when the condition poses serious health risks. Below are some scenarios where surgery may be necessary:

Thyroid cancer: Immediate surgery is often required to remove cancerous tissue.
Large goiters: If a goiter compresses the airway or makes swallowing difficult, surgery may be the best option.
Nodules with suspicious characteristics: Nodules with abnormal features in imaging may require biopsy or removal to rule out cancer.
Persistent hyperparathyroidism: Surgery is often needed if high calcium levels are causing bone or kidney damage.
Uncontrolled hyperthyroidism: When medications or radioactive iodine therapy are ineffective or not tolerated, surgery may be the next step.

Recommendations

Thyroid and parathyroid disorders may be managed effectively with the right treatment plan, whether through medication, lifestyle changes or surgery. If you experience persistent symptoms or if your condition becomes more severe, your healthcare provider will guide you in choosing the best course of action.