Thyroid and Parathyroid Not the Same
With a history of osteoporosis and arthritis, Jewell Williams of Clinton, 75, discovered she had another contributing factor to her aches and pains. Parathyroid disease was diagnosed during a routine blood test at her physician's office last spring.
Williams had a severely elevated level of calcium in her blood. She also had an elevated level of parathyroid hormone (PTH), which meant that somewhere deep inside her neck, her parathyroid glands were producing too much PTH.
"I didn't feel well at all, I was just tired, and my bones ached, every one of them," said Williams.
Tests showed Williams' parathyroid glands, as well as her nearby thyroid gland, were not functioning properly. While the thyroid and parathyroid glands sound like the same thing, they are actually very different in function.
The thyroid regulates the body's metabolism, while the parathyroid regulates its calcium levels. Both are located in the neck.
"All my doctors told me I needed to have them removed," said Williams.
Williams had surgery June 14 at Fort Sanders Regional Medical Center. Dr. P. Kevin Zirkle, an endocrine surgeon, removed one of her four parathyroid glands, and all of her thyroid gland.
Since the surgery, Williams returns regularly to her endocrinologist or primary care physician to have her blood checked to regulate her thyroid and calcium levels. But she said the pain from the surgery was well managed, and the scar on her neck is healing.
Williams said surgery is never something anyone looks forward to, but she felt confident about her care from Dr. Zirkle and Fort Sanders.
"I've liked may care at Fort Sanders," said Williams. "I couldn't have asked for any better. All of them were very caring, and I was very pleased with them."
Physician Experience Matters
The best route to success with surgery on the parathyroid glands is to find a surgeon who has done hundreds of the procedures, according to endocrine surgeon Dr. P. Kevin Zirkle, who performs some 100 parathyroid surgeries each year at Fort Sanders Regional Medical Center.
The parathyroid glands are tiny - the size of baby peas - according to Zirkle, and finding all four of them in the neck can seem like a nearly impossible task.
"Since they're so small, they're hard to find, and an inexperienced surgeon might injure a small gland without knowing it," says Zirkle. "They can hide inside the thyroid, they can be in the chest, or behind the jaw."
A test called sestamibi (MIBI) scan is being used to help surgeons find these elusive glands. The scan uses low-dose radioactive materials to locate the parathyroid glands and can find about 75 to 90 percent of them. Other tests, like ultrasound or CT scans, are often used to help locate the glands before surgery as well.
But on the operating table, sometimes it's just experience that helps Dr. Zirkle find every parathyroid gland and decide which ones to remove. Ideally, the surgeon will leave at least 1/2 of one gland to regulate calcium in the body.
After each removal, while the patient is still under anesthesia, Zirkle tests the patient's blood to get a quick reading on PTH, the hormone secreted by the parathyroid. In just a few minutes, the Fort Sanders Laboratory can tell him whether PTH levels have returned to normal.
"Rarely are all four parathyroid glands diseased," said Zirkle. "In most cases, it's just one gland that needs to be removed. We just don't know until we get in there."
The surgery usually can be done in about an hour, including the blood tests.
Studies published in numerous medical journals tie the success of the operation directly to the number of procedures the surgeon has performed. Parathyroid surgery has a high cure rate, greater than 95 percent, according to medical studies, if the surgeon is experienced and all the diseased tissue is removed, but the healthy tissue is left.
For more information, call 865-673-3678.
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