Thyroid & Parathyroid


The thyroid is an organ in the endocrine system that must be monitored if it becomes swollen. A swollen or dysfunctional thyroid may reveal a "lump" within the tissue that generally cannot be determined upon examination as benign or malignant.

Thyroid surgery is used to treat several different thyroid conditions such as nodules, cancer and hyperthyroidism. Surgery is often considered a last resort for thyroid conditions and may be used if more conservative treatments have failed, a condition is recurring or cancer is present. Thyroid surgery removes part or all of the thyroid gland, depending on the type and severity of the condition.

The different types of thyroid surgery include:

  • Thyroid lobectomy - only the lobe of the thyroid is removed if a thyroid nodule is confined to just that area. This may also be performed with an isthmusectomy to remove the isthmus, the structure that connects the two lobes.
  • Subtotal thyroidectomy - one complete lobe, the isthmus and part of the other lobe is removed. This is typically used for hyperthyroidism caused by Graves' disease and small cancers.
  • Total thyroidectomy - the entire thyroid gland and surrounding lymph nodes are removed. This is the most common procedure for thyroid cancer to completely remove the disease.

If the entire thyroid is removed, you will need to take thyroid hormone replacement drugs, usually for the rest of your life. The lack of a thyroid will often bring about signs of hypothyroidism, or an underactive thyroid. Symptoms of hypothyroidism may include fatigue, exhaustion, depression, and difficulty concentrating.

Thyroid surgeries are performed through an incision in the middle of the neck. The procedure usually takes about two hours and is done under general anesthesia. An overnight hospital stay is required, but most patients are able to resume normal activities the day after surgery. Strenuous activities should be avoided for at least 10 days after surgery. Thyroid surgeries are considered safe procedures with few complications. Some people may experience hoarseness or a sore throat because of the breathing tube used during surgery.


The parathyroid glands are four small glands located behind the thyroid that regulate the calcium level in the body. By controlling the amount of calcium in the body, the parathyroid glands also control the strength and density of the bones. This also helps regulate the function of the nervous and muscular systems.

Although similar in name and location to the thyroid gland, the two are not related in function. The parathyroid glands can, however, be affected by conditions similar to the thyroid gland and other endocrine system structures by producing too much or too little parathyroid hormones.

The most common condition of the parathyroid glands is hyperparathyroidism, or overactivity of the parathyroid gland. This involves an overproduction of parathyroid hormone (PTH) regardless of the amount of calcium in the blood. Although not a cancerous condition, hyperparathyroidism is often caused by a tumor on the parathyroid gland, known as an adenoma, which enlarges the specific gland and forces it to continuously secrete PTH. Most people with hyperparathyroidism have only one enlarged gland, but others can have all four affected by the condition.

Hyperparathyroidism is known as a condition of "moans, groans, stones, and bones." Many people do not realize they had any symptoms until undergoing treatment and feeling much better as a result, while others really may not experience any symptoms. Common symptoms of hyperparathyroidism can include:

  • Increased thirst and urination
  • Kidney stones
  • Abdominal pain
  • Nausea
  • Vomiting
  • Osteoporosis

Treatment for this hyperparathyroidism depends on the symptoms and severity of the condition. Dr. Cohen may recommend just waiting and monitoring the condition for mild cases, while those with symptoms may benefit from medication or hormone replacement therapy. Surgery is considered the most effective treatment for hyperparathyroidism and removes one or more parathyroid glands. While this procedure once required a long incision and general anesthesia, it can now be performed through minimally invasive techniques to reduce the risk of infection and shorten recovery time.

Although hyperparathyroidism is not a serious condition, it can lead to complications such as osteoporosis, peptic ulcers and high blood pressure. Dr. Cohen can help you decide which treatment option is best for you in order to relieve symptoms and reduce the risk of future damage.

For more information about Thyroid & Parathyroid, contact our office at 818-609-0600 to schedule an appointment.

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