Medication or surgery: How to treat endocrine conditions

A properly functioning endocrine system is essential to good health. Made up of glands that secrete the hormones used to regulate organ function, the endocrine system acts as a sort of chemical messenger system for the body. Three key components of the endocrine system include the thyroid, parathyroid and adrenal glands. When one or more isn’t functioning correctly, medical intervention may be needed. Surgery, often minimally invasive surgery, may be the best or only effective treatment option.

Susan Wcislak, MD, an endocrine surgeon and an independent member of the HonorHealth medical staff, explains the thyroid, parathyroid and adrenal glands. She also addresses common indicators for surgical intervention, with minimally invasive techniques being among the most recommended.  

Thyroid disease 

The thyroid is a gland located at the front of the neck that controls various functions within the body, including metabolism. The two primary types of thyroid disease are hyperthyroidism (when too much thyroid hormone is produced) and hypothyroidism (when too little thyroid hormone is produced). “Disruptions in thyroid function can sometimes result from the formation of thyroid nodules or hormone changes, such as those experienced during pregnancy or menopause,” says Dr. Wcislak. “While thyroid disease affects both men and women, it’s estimated to be five times more common among women.” 

Hyperthyroidism, which essentially puts the body in overdrive, often presents with symptoms such as heart palpitations, inability to tolerate heat, anxiety, weight loss and bulging eyes. In contrast, hypothyroidism slows the body’s overall performance and may result in general sluggishness, fatigue, depression, hair loss, constipation and weight gain. “In either instance, you would typically begin taking a thyroid medication,” explains Dr. Wcislak. “However, if symptoms or if medication doesn’t work, thyroid removal is an option.”

In the case of a thyroid nodule, a doctor will likely perform a biopsy to determine whether cancer is present. “About 95% of thyroid nodules are benign, but that other 5% can be worrisome,” Dr. Wcislak notes. When a nodule is confirmed to be benign and is not causing symptoms, it can be monitored via neck ultrasounds for a few years to watch for signs of growth. If there are symptoms or if it is cancer, a thyroidectomy is performed. Thyroid surgery typically requires a one-night hospital stay. 

Parathyroid disease 

The parathyroid glands, each about the size of a small drop of water, are located in the neck near the thyroid. The vast majority of people have four parathyroid glands, though it is possible for a person to have three to five. The role of the parathyroid is to maintain proper calcium levels in the blood and tissues. Some of the most common indicators of parathyroid disease are fatigue, brain fog, kidney stones, increased urination, acid reflux, osteoporosis and kidney issues. “High calcium is by far the most prevalent sign of parathyroid disease,” says Dr. Wcislak.   

The most effective cure for parathyroid disease is surgical removal of the affected gland(s). “The surgery is performed using minimally invasive surgery techniques that require only one small incision, surgery to treat parathyroid disease is typically done on an outpatient basis,” Dr. Wcislak explains. “Patients usually return home the same day.” 

Adrenal glands

Most people have two adrenal glands that are located above the kidneys on each side of the body. These glands produce hormones that are essential to maintaining blood pressure, creating a response to stress, and regulating metabolism. While symptoms vary depending on where the mass is located, common symptoms include inability to control blood pressure, issues with potassium blood levels, weight issues, easy bruising, weakness, high blood sugar, excessive hair growth, depression and muscle cramps.

“When a mass is the cause of adrenal disfunction, the affected gland is usually removed,” explains Dr. Wcislak. “In most cases, the body will compensate for the loss with the remaining adrenal gland increasing its performance. The majority of patients do not need medication to supplement adrenal function after surgery, but it is a possibility.” Surgical removal of an adrenal gland usually requires a one-night hospital stay.

Consult your primary care physician or endocrinologist if you suspect that an endocrine disorder may be the cause of your symptoms and, if so, what treatment approach is best for you. If you don’t have a physician, call 623-580-5800 to find an HonorHealth doctor near you.