Thyroid & Parathyroid

More About Thyroid


The thyroid gland sits just below your Adam’s apple in your neck. It makes the hormone thyroxine which controls your metabolic rate. If it is under or over active it can be corrected with a top up of thyroxine in tablet form or ‘anti-thyroid’ medicines.


This would be guided by your GP or endocrinology specialist.


 The thyroid may become enlarged, a goitre. This can be a generalised swelling or because it has nodules within it. The nodules may be numerous (multi-nodular goitre) or solitary nodules.


These nodules are common and often don’t cause any problems but may be a concern because:



–    Up to 20% of solitary nodules are a cancer.

–    Nodules may press on the neck causing discomfort on swallowing and difficulty breathing.

–    May become unsightly.



In order to assess the thyroid gland blood tests are performed to check if it is over or under-active and to see if you have antibodies against your thyroid gland. Lumps are assessed by Mr Chisholm. This would include assessment of your vocal cords as the nerve to the voice box (recurrent laryngeal) runs alongside the thyroid.


An ultrasound scan of your neck would be arranged if there are any lumps and, if they are suspicious, a needle test performed (FNAC).


This involves a fine needle being passed into the lump under ultrasound guidance and the cells examined under a microscope by a specialist pathologist.

From this it can usually be determined if the lumps are harmless, in which case they would usually be checked one more time to ensure they weren’t growing too quickly, or may represent a potentially serious problem.


 If necessary an operation can be performed to remove 1/2 or all the thyroid gland under general anaesthetic. Reasons for this are: ensure a nodule is not a cancer, remove a cancer, the thyroid is causing ‘pressure symptoms’ or the thyroid is overactive and hard to control (thyrotoxic). A thyroidectomy or hemithyroidectomy would involve a 1 night stay in hospital.

 Mr Chisholm is a highly trained thyroid surgeon. Operations are performed with a nerve monitor, a specialist piece of equipment to check the nerve to the voice box is working correctly throughout the operation.


All thyroid procedures he performs are anonymously added to the British Association of Endocrine and Thyroid Surgeons (BAETS) database to audit his outcomes and ensure they are in line with the best.


Further information (please click on link to open in new window)

British Thyroid Association

British Association of Endocrine and Thyroid Surgeons




 More About Parathyroids


The parathyroid glands control the levels of calcium in your body through the release of a substance called parathyroid hormone. If you have too much calcium in your body you may suffer from ‘stones, bones, groans and moans’ referring to kidney stones, bone thinning (osteoporosis) and fractures, abdominal discomfort (groans) and constipation and psychiatric ‘moans’ eg. lethargy and fatigue. This will have been identified by your GP or endocrinologist.


There are many reasons to have high calcium levels so these need to be looked into first. If it turns out the high calcium is due to ‘primary hyperparathyroidism’ the only cure is removal of the faulty gland(s).


Most people have 4 glands but some have up to 7. The are usually in the neck situated just behind the thyroid gland.


The most common occurrence in primary hyperparathyroidism is for 1 of the glands to grow and overproduce parathyroid hormone. Sometimes all 4 glands may be at fault. In order to find the faulty gland you will have an ultrasound scan of the neck as well as another type of scan called sestamibi. The sestamibi scan is performed at Musgrove Park Hospital.


By careful analysis of the scans a ‘minimal access’ procedure can usually be performed leaving a scar 2- 2.5cm in length hidden in a skin crease.



Further information (please click on link to open in new window) 


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