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Having a better understanding of what a thyroidectomy is, what conditions may require a thyroidectomy, and what to expect during and after the procedure can help improve thyroid awareness and limit surgery-related trepidation.
A thyroidectomy is a surgical procedure done to remove all or part of the thyroid gland depending on the needs of the patient.
There are three different types of thyroidectomy: a total thyroidectomy, a subtotal or partial thyroidectomy, and a thyroid lobectomy. Each are used to treat specific conditions.
The most common procedure is a total thyroidectomy, which as the name implies, is the complete removal of the gland. Alternatively, a patient may be able to retain some of their thyroid by undergoing a partial thyroidectomy or lobectomy. Both procedures involve removing only a portion of the thyroid.
In preparation for the surgery, it is important to discuss what medications, activities, and foods should be avoided. It is common practice for doctors to request patients avoid eating or drinking after midnight the night before the procedure.
Generally, a thyroidectomy takes less than two hours to complete; less if it is a partial thyroidectomy. Recovery is usually done in the hospital and requires one or two nights' stay on the premises. Alternatively, you may choose outpatient thyroid surgery, which allows for the majority of recovery to take place off-site.
A thyroidectomy may be recommended for a variety of reasons. The most common of which is thyroid cancer. Depending on the development and spread of the cancer within the thyroid, a partial or total thyroidectomy may be recommended. If cancer has spread to much of the thyroid, it’s likely that a total thyroidectomy will be conducted. However, in the case of less aggressive forms of thyroid cancer, such as follicular and papillary, the possibility of a partial thyroidectomy may be available. If the cancerous cells are contained in a portion of the thyroid, it may be possible to remove just the infected areas rather than the entire thyroid. The benefit of this method is that the thyroid will remain partially functional.
Other major reasons to have a thyroidectomy involve hyperthyroidism (overactive thyroid function) and pregnancy. Thyroid nodules or goiter, also known as an enlarged thyroid, can cause hyperthyroidism and may require surgical intervention. Thyroid expansion can make it difficult to breath and inhibit swallowing. Removing some or all of the thyroid can lower thyroid hormone production to a healthier level.
Hyperthyroidism can contribute significantly to challenging pregnancies and births. Therefore, pregnant mothers may need to have all or part of their thyroid removed prior to pregnancy. Antithyroid drugs can resolve thyroid-related pregnancy difficulties but only if treatment has been previously established and maintained. Expecting mothers who do not have their hyperthyroidism managed may require a thyroidectomy for a quicker resolution.
The surgery generally has fewer pregnancy inhibiting factors when compared to other hyperthyroid treatments such as radioactive iodine treatments. Therefore, many doctors recommend that pregnant hyperthyroid women undergo a thyroidectomy.
Recovery from a thyroidectomy is minimal. Generally, patients must remain under observation for six hours. If it was an outpatient procedure, you may be allowed to leave shortly after this period.
In most cases, patients can return to work within one to two weeks after the procedure. Everyday activities can usually be recommenced after the patient is able to turn their head without pain. However, it is best to confirm with a surgeon prior to engaging in any strenuous, technical, or physical activity after any surgical procedure. Some may have to remain on an intravenous drip because swallowing and eating can be challenging within 24 hours of the surgery. The most common issues for patients after a thyroidectomy involves pain when swallowing and neck stiffness.
Thyroid surgeries are considered to be exceptionally safe with low risk of complications. Although rare, patients may develop hypoparathyroidism or hypocalcemia. These may be identified through symptoms including:
Generally, if one of these conditions arises, symptoms develop within one to two days after surgery. Treatment involves a temporary calcium supplement that helps relieve the associated symptoms. Hypocalcemia usually only remains for about a week. If symptoms remain after 10 days, speak with a physician about permanent hypoparathyroidism and commencing permanent supplementation of vitamin D and calcium.
A certainty of total thyroidectomy is the development of hypothyroidism. This condition involves a variety of symptoms caused by a slowing of numerous bodily functions.
Generally, hypothyroid patients must acquire treatment through thyroid hormone replacement therapy. In the case of a thyroidectomy, treatment for hypothyroidism should include a combination of thyroid hormone medication. This may require different forms of thyroid hormone ranging from T3 medication, a compounded T4 and T3 drug, natural desiccated thyroid medications, or a uniquely formulated combination. The patient’s needs should dictate the specifics of the treatment and allow for appropriate optimization.
Even if the patient undergoes a partial thyroidectomy, it is likely that they will need more than just T4 medication. This is because the thyroid is a large component of the conversion process of T4 (the storage from of thyroid hormone) into T3 (the active form of thyroid hormone). Without adequate T3 in your system, your body can suffer severe thyroid dysfunction and result in an array of symptoms throughout the body.
Learn more about with without a thyroid here
The more knowledge you have regarding the thyroid and important procedures like thyroidectomies, the more responsibility you can take for your personal thyroid health. Visit the thyroid health section of our blog to learn more.
Braverman, MD, Lewis E., and Robert D. Utiger, MD. ” Werner and Ingbar’s The Thyroid: A Fundamental and Clinical Text.” 9th ed., Philadelphia: Lippincott Williams & Wilkins (LWW), 2005.
Moreno, Pablo, et. al. “Subtotal Thyroidectomy: A Reliable Method to Achieve Euthyroidism in Graves’ Disease. Prognostic Factors.” World Journal of Surgery, Volume 30, Number 11, November 2006, pp. 1950-1956(7).
Rosato, L, et. al. “Complications of total thyroidectomy: incidence, prevention, and treatment.” Chir Ital. 2002 Sep-Oct;54(5):635-42.
Shomon, Mary J. “Living Well With Hypothyroidism: What Your Doctor Doesn’t Tell You That You Need to Know.” 2nd Edition, HarperCollins, 2005, Online.
Benkhadoura M. “Recurrent laryngeal nerve injury and hypoparathyroidism rates in reoperative thyroid surgery.” Turk J Surg. 2017 Mar 1;33(1):14-17.
Holtorf Medical GroupThe Holtorf Medical Group specializes in optimizing quality of life and being medical detectives to uncover the underlying cause of symptoms, rather than just prescribing medications to cover-up the symptoms. We are experts in natural, prescription bioidentical hormone replacement and optimization, complex endocrine dysfunction, fibromyalgia, chronic fatigue syndrome and Lyme disease. We’ve dedicated our practice to providing you the best in evidenced-based, integrative medicine that’s not only safe and effective, but provides measurable results.
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