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Thyroid & Parathyroid Issues

Our physicians collectively embody decades of surgical experience. As a group, they have performed thousands of successful thyroid and parathyroid operations, which is important because experience matters. Studies have shown that surgical volume and experience are directly tied to higher cure rates, lower postoperative complications, and significantly lower risk of reoperations.
Experts in their field, our doctors diagnose thyroid and parathyroid disorders in collaboration with other specialists and through comprehensive testing that starts with a complete history and physical exam. It is important to confirm and address any issues quickly to avoid worsening conditions.

The Thyroid Gland


The thyroid is a butterfly-shaped gland located at the base of the front of neck just below the voice box.


The function of the thyroid is to process iodine and convert it into thyroid hormones. These hormones play a vital role in regulating body metabolism, temperature, weight, and musculoskeletal health.


Hyperthyroidism (overactive thyroid)

Hyperthyroidism is a condition in which the thyroid makes excessive levels of thyroid hormones. Your body’s metabolism increases, triggering symptoms that may include:

  • Being nervous or irritable
  • Mood swings
  • Fatigue or muscle weakness
  • Heat intolerance
  • Trouble sleeping
  • Hand tremors
  • Rapid and irregular heartbeat
  • Frequent bowel movements or diarrhea
  • Weight loss
  • Goiter, which is an enlarged thyroid that may cause the neck to look swollen

Graves’ Disease is one of the most common causes of hyperthyroidism. It is an autoimmune disease, more common in women than men, and can be associated with a special type of eye abnormality (Graves’ eye disease). Additionally, hyperthyroidism can be caused by a benign thyroid nodule that becomes overactive, or “hot.” If untreated, hyperthyroidism can lead to serious heart, bone, and other problems.
Hyperthyroidism can often be treated with medicine. However, surgery for hyperthyroidism is occasionally necessary if treatment with medication or radioactive iodine alone is not effective or contraindicated.

Hypothyroidism (underactive thyroid)

Hypothyroidism is a condition in which your thyroid gland does not produce enough thyroid hormones. Symptoms may include:

  • Fatigue
  • Weight gain
  • A puffy face
  • Cold intolerance
  • Joint and muscle pain
  • Constipation
  • Dry skin
  • Dry, thinning hair
  • Decreased sweating
  • Heavy or irregular menstrual periods and fertility problems
  • Depression
  • Slowed heart rate

Hashimoto’s Thyroiditis, also known as Hashimoto’s Disease, is an autoimmune disease that causes the body’s immune system to produce antibodies that attack thyroid tissue and damage the gland, leading to an under-productive thyroid. Other potential causes of hypothyroidism include thyroid nodules, congenital hypothyroidism, or radiation treatment of the thyroid.
Hypothyroidism can usually be easily and safely treated with thyroid hormone replacement.

Thyroid Nodules

A thyroid nodule is a growth or lump of the thyroid gland. These nodules are very common, and their frequency increases with age. Usually, thyroid nodules are discovered during a routine exam or on imaging performed for another reason.
Most often, thyroid nodules are asymptomatic; however, a small minority can grow enough to cause symptoms, such as trouble swallowing or sensation of a lump in your throat. Although a thyroid nodule can represent a thyroid cancer, the vast majority of nodules are not cancerous. In fact, it’s estimated that close to 90 percent of all thyroid nodules are benign (non-cancerous) growths.

To evaluate a thyroid nodule, your doctor may use blood tests or ultrasound imaging Some thyroid nodules don’t require any treatment. Depending on the size and appearance, some nodules may require biopsy or treatment with medical therapy or surgery.

Cancerous or suspicious thyroid nodules are typically treated with surgery.

Goiter (Enlarged Thyroid)

An enlarged thyroid gland, also known as a goiter, can be caused by iodine deficiency in the diet, autoimmune thyroid disease, or multiple thyroid nodules.

Symptoms may include:

  • Swelling at the base of your neck that may be particularly obvious when you shave or put on makeup.
  • A tight feeling in your throat.
  • Coughing.
  • Trouble breathing
  • Difficulty swallowing.

A physician can typically detect a goiter during a physical exam of your neck. To confirm the diagnosis, you may need blood tests, a thyroid ultrasound, or a CT scan.

Depending on the cause, goiters can occasionally be treated with medical therapy. Surgery may be recommended if the goiter continues to grow, especially if it begins to compress other structures in the neck such as the trachea and esophagus. Although the incidence for cancer is small, surgery would be recommended if this is suspected.

Cancer of the Thyroid

Thyroid cancer typically does not cause symptoms early in the disease. As cancer grows, it may cause:

  • A lump that can be felt through the skin on your neck.
  • Changes to your voice, including increasing hoarseness.
  • Difficulty swallowing.
  • Pain in your neck and throat.
  • Swollen lymph nodes in your neck.

There are several types of thyroid cancer including:

  • Papillary: This is the most common form of thyroid cancer. This type of cancer, which tends to grow slowly, typically has a good prognosis. It often spreads to neck lymph nodes.
  • Follicular: This is the second most common type of thyroid cancer. When diagnosed at a small size, these tumors also typically have a good overall prognosis.
  • Medullary: This form of thyroid cancer develops from cells in the thyroid gland that are different from papillary and follicular thyroid cancers. These cancers can occur sporadically (without a family history) or as part of multiple endocrine neoplasia (MEN) syndromes.
  • Anaplastic: This is the least common type of thyroid cancer, but it is typically the most aggressive. It most commonly presents as a rapidly enlarging neck mass.

Although an ultrasound examination and a needle biopsy are required for diagnosis, the primary treatment for thyroid cancer is surgery. It is determined on a case-by-case basis with deference to the patient’s biopsy and imaging, as well as other factors.


  • Lobectomy: Removal of one lobe and the isthmus which connects the lobes.
  • Total Thyroidectomy: Removal of the entire thyroid gland


The Parathyroid Glands


Most people have four parathyroid glands, two on each side of the thyroid gland. Normal parathyroid glands are 3-6mm in size, roughly the size of a grain of rice. Although they are most commonly found behind or next to the thyroid gland, the exact location of the parathyroid glands can vary considerably. Occasionally, parathyroid glands can be found behind the esophagus, next to the carotid artery, or even in the chest cavity.


Parathyroid glands’ primary function is to regulate the level of calcium in the blood. They do this by secreting parathyroid hormone (PTH) which controls how much calcium is released from bones into the bloodstream, how much calcium is absorbed by the intestines, and how much calcium is excreted in the kidneys. By controlling the amount of calcium in the body, the parathyroid glands control the strength and density of the bones. Furthermore, calcium is essential for numerous bodily functions, including muscle contraction, nerve function, and heart function.


Hyperparathyroidism (overactive parathyroid)

Hyperparathyroidism is a disorder in which the parathyroid glands produce too much hormone. Overactive parathyroid glands cause your blood calcium level to rise, which may lead to bone thinning (osteoporosis) and kidney stones. The most common cause is the development of a benign (noncancerous) tumor in one of the parathyroid glands. Less commonly, hyperparathyroidism can be caused by overgrowth of multiple parathyroid glands or, rarely, parathyroid cancer.

Symptoms of hyperparathyroidism include:

  • Muscle weakness.
  • Fatigue.
  • Aches and pains in bones and joints.
  • Depression.
  • Loss of appetite.
  • Nausea.
  • Uncontrolled acid reflux
  • Increased thirst and urination.
  • Confusion.

Hyperparathyroidism is a surgical disease and typically requires removal of overactive tissue for a cure while preserving normal parathyroid glands. The goal of surgery is to normalize calcium levels and relieve the negative effects of hyperparathyroidism.

Hypoparathyroidism (underactive parathyroid)

Hypoparathyroidism is a rare disorder in which the parathyroid glands do not produce enough parathyroid hormone. Underactive parathyroid glands lower the calcium level in your blood.


  • Parathyroidectomy: An outpatient procedure that typically involves a incision made in the lower central neck to remove the affected parathyroid tissue. This is typically performed in a minimally invasive fashion with a small incision (1-2 inch). Depending on the patient’s pathology, either one or multiple parathyroid glands may need to be removed. Normal parathyroid glands are preserved. Surgical cure is confirmed with rapid, intraoperative PTH blood testing.


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ENT Associates Main Office

1330 South Fort Harrison
Clearwater, FL 33756

Phone: 727-441-3588
Fax: 727-461-1038

Hours of Business: 8:00AM - 5:00PM

Extended Hours:
Countryside until 6:30PM (Thu Only)
Port Richey until 6:30PM (Alt Wed Only)

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