Parathyroid adenoma is a small tumor of the parathyroid gland and is known to be the most common disorder of the gland. Parathyroid adenomas are benign therefore it is not malignant. The parathyroid gland increases in size and it tends to produce excess parathyroid hormones. This is also known as primary hyperparathyroidism. Patients are not aware of the tumors in most cases. Tumors are only found when patient’s routine blood test results show elevated blood calcium and parathyroid hormone levels. In serious cases, kidney stones can form as the bone density diminishes.
The parathyroid glands in the neck are responsible for controlling calcium use and removal in the body. The parathyroid glands do this by producing parathyroid hormones or PTH. PTH helps in controlling calcium, vitamin D and phosphorus levels within in the blood and bone. Parathyroid adenomas may also be due to genetic problems. If there is a family history of someone having a parathyroid adenoma, it is more likely for the present and upcoming generations to suffer from the same condition. Every effort must be made to treat these conditions prior to having a patient undergo a surgery.
Parathyroid Adenoma Symptoms
Most people who suffer from parathyroid adenoma have no symptoms. When blood tests are done for other medical reasons, parathyroid adenoma is discovered. However, there are reports that state parathyroid adenoma symptoms include bone fractures, kidney stones, muscle pain, confusion, constipation and nausea.
Interesting Questions about Thyroid:
How does radioactive iodine work?
The thyroid gland absorbs iodine from the blood. When radioactive iodine enters your thyroid, it slowly shrinks the gland over a period of weeks or months.
The treatment is safe, simple, convenient, and inexpensive. It is usually given only once, rarely causes any pain or swelling, and does not increase the risk of cancer. However, it must be avoided during pregnancy or nursing, and patients should not become pregnant for at least six months after treatment.
When is radioactive iodine used?
Radioactive iodine is the most common treatment for hyperthyroidism. It does not require hospitalization. About 90% of patients need only one treatment. They usually start getting better in three to six weeks, and most are cured within six months.
This treatment may also be used after surgery for certain thyroid cancers. Radioactive iodine dissolves any cancerous tissue that could not be removed by surgery. The dose of radioactive iodine is larger in this case, and patients usually stay in the hospital for a day or two.
What can be expected with radioactive iodine treatment for hyperthyroidism?
- It is usually given in liquid form or as a capsule. The dose can range from 4 to 29 millicuries.
- It is tasteless.
- There are almost never any side effects. In some rare cases, there can be an inflammation of the thyroid gland causing a sore throat and discomfort.
- Radioactive iodine not taken up by the thyroid gland is excreted in urine and saliva. There is no evidence that the small amount of I131 excreted in the urine and saliva is harmful. Nonetheless, prudent nuclear medicine experts have recommended a wide variety of precautions. While these recommendations are sometimes confusing and inconsistent, it may be appropriate to take a few simple measures to avoid unnecessary exposure of infants and children to I131. Treated patients should rinse out their glasses or cups and eating utensils immediately after drinking and eating. The toilet should be flushed immediately after use, and the rim of the bowl should be wiped dry, if necessary.
- It is advisable to drink two to three extra glasses of water a day during the four- to seven- day period following radioactive treatment so that radioactive material will not collect in the bladder for a long period of time.
- Because radioactive iodine passes into breast milk, breast feeding mothers are asked to wean their babies before treatment.
- It typically takes six weeks before thyroid hormone production is noticeably reduced. The average length of time for the thyroid hormone levels to become normal is about three to four months. If thyroid levels are not considerably reduced six months after treatment, the doctor might suggest repeating the treatment. Ninety percent of the time only one treatment is required; however, it might take as many as three attempts. The patient could be advised to take beta-blocking drugs and other medications the doctor believes are necessary until normal thyroid hormone production is restored.
- Many patients treated with radioactive iodine become hypothyroid. This may happen within weeks, months, or years of treatment. Therefore, patients should be aware of the signs and symptoms of hypothyroidism, and their physicians should monitor their thyroid hormone levels regularly. When the patient becomes hypothyroid, thyroid hormone replacement begins and continues for life-one pill a day.
What do antithyroid drugs do?
Antithyroid drugs block pathways leading to thyroid hormone production.
Antithyroid drugs used in this country are Propylthiouracil (PTU) and Tapazole®. Some physicians will recommend antithyroid medication as a first line of treatment to see if the patient is one of the lucky 30% of patients who go into a remission after taking antithyroid medication for one to two years. (Patients are said to be in remission if their hyperthyroidism does not recur after discontinuing the antithyroid drugs.) If antithyroid drugs do not work for the patient, then physicians usually recommend radioactive iodine.
Antithyroid drugs are also used to treat very young children, older patients with heart conditions, and pregnant women. For severe or complicated cases of hyperthyroidism, especially in older patients, PTU or Tapazole® can be given for four to six weeks to bring the hyperthyroidism under better control prior to administering radioactive iodine treatment.
In cases when women are diagnosed with Graves’ disease while they are pregnant, PTU is prescribed. The smallest dose possible is given because the medication does cross over to the fetus. The mother should be checked every three to four weeks during the pregnancy so that the lowest possible dose can be given. Too much PTU can cause fetal goiter, hypothyroidism, and mental retardation.
® Tapozole is a registered trademark of Jones Medical Industries.
Are there any side effects?
Antithyroid drugs cause side effects in about 10% of patients. Reactions can include:
- skin rash
- swollen, stiff, painful joints
- sore throat and fever
- low white blood count, which can lead to serious infections
- jaundice (yellow coloring of the skin) and, rarely, liver failure.
Most side effects clear up once the drugs are stopped. If you think you are having a reaction to anti-thyroid drugs, call your doctor immediately.
What can be expected with antithyroid drug treatment?
- Several pills are taken from one to four times a day, every day for six to 24 months.
- Some patients complain that the pills have an unpleasant smell and taste.
- There is usually some symptom relief within one to two weeks. In some cases, it can take several months to relieve symptoms.
- Antithyroid drugs have a relatively low success rate. While PTU or Tapazole® may correct the problem temporarily or for a few years, the chances of a permanent remission are about 30% once the drugs are stopped.
- The likelihood of achieving a permanent remission is increased if the patient takes the medication for one to two years.
- There are side effects in 10% of the people treated with Tapazole® or PTU. These are:
- skin rash over most of the body swollen, stiff, painful joints
- sore throat and fever — if this happens, the antithyroid drugs should be stopped immediately and the physician contacted
- liver damage, which is fatal in rare cases
- Because antithyroid drugs pass into breast milk, only PTU in a dosage less than 200 mg a day is advised if the baby is not weaned.
- Within 15 years, the thyroid gland may burn out, resulting in hypothyroidism, and the patient will need thyroid hormone replacement.
When are beta-blocking drugs used?
Beta-blocking drugs, also called beta blockers, treat the symptoms of hyperthyroidism. They do not significantly affect the gland or the levels of thyroid hormones in the blood. Instead, they “block” the effects of thyroid hormones.
Beta blockers are most useful for patients whose hyperthyroidism makes them uncomfortable. High hormone levels can cause a faster heart rate and trembling. Beta-blocking drugs help control these symptoms.
Beta-blocking drugs should not be used by patients with asthma.
Have more questions? Need more answers? Check our Full Thyroid FAQ
Parathyroid Adenoma Surgery
There are two main approaches to parathyroid adenoma surgery. Both can be accomplished using local anaesthesia and small incisions. Both also have the possibility of being discharged on the same day after a period of observation normally around 6 hours. The standard approach to parathyroid surgery has been used as treatment for parathyroid disorders. It involves a bilateral exploration for the removal of the diseased parathyroid glands. The focused or directed approach involves a lateral exploration to remove the diseased parathyroid glands. This may be performed through a small incision.
Parathyroid Adenoma Treatment
As far as parathyroid adenoma treatment is concerned, surgery is the most known and common treatment. For patients who have hyperparathyroidism, they need regular visits to their doctors for additional assessments. Estrogen replacement may also help relieve parathyroid adenoma symptoms and can even prevent bone loss in postmenopausal women. Most patients are observed for 4 hours before being discharged. Patient may have the option to stay overnight if they want to be sure that no complication will arise after the surgery. Patients may be able to resume to their daily activities after the surgery. It is also highly advised to avoid strenuous activities such as heavy lifting or sports for a minimum of 5 days. Patients may either opt to go back to work or take a few days off after the surgery.
Parathyroid Adenoma Diagnosis
Parathyroid adenoma diagnosis is done by taking blood tests. Blood tests are taken to check the levels of phosphorus, calcium, chloride and bicarbonate. A 24-urine test is also done to check if there are any signs of increased calcium in the urine. Other tests for parathyroid adenoma diagnosis include bone density exam, bone density exam, MRI (magnetic resonance imaging) or sestamibi neck scan, neck ultrasound and kidney ultrasound to check if there are kidney stones.
Thyroid FAQ & Links to Related Articles
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|Also called underactive thyroid, hypothyroidism is a disorder that is characterized by abnormal level of thyroid hormones in the body, which is too low.|
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|Parathyroid adenoma is a small tumor of the parathyroid gland and is known to be the most common disorder of the gland.|
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