Thyroid Gland Removal

Question:

I am a 44-year-old single female. I have lumps on my thyroid area. One on the left side is 2.4cm and another on the right side is pea sized. I have had an ultra-sound and blood test which showed normal results and at the doctor’s suggestion, a biopsy was done. The results of the biopsy were not so good so the doctor advised surgery and total removal of the thyroid gland after which thyroid hormone pills have to be taken for life.

I would like to know what complications can arise after surgery and what aftercare is necessary? Does the thyroid hormone pill have any side effects and can the body function as per normal without the thyroid gland but only with the pill? Do I have any option other than surgery? And is the surgery done under local or general anaesthesia?

Answer:

You mentioned that the results of the thyroid biopsy were “not so good”. It is unclear whether you have benign (non-cancerous) thyroid nodules or thyroid cancer. Sometimes, it is not possible to have diagnostic results from a fine-needle aspiration biopsy of the thyroid.

Since you have been advised to have total removal of your thyroid gland, it may suggest that you have thyroid cancer. In this case, you should proceed with the surgery to remove your thyroid gland. After the surgery, you will require radioiodine treatment to totally ablate any remnant of thyroid gland and to take thyroid hormone for life after these treatments.

Thyroid hormone or thyroxine is a natural hormone used as a thyroid replacement therapy for people with hypothyroidism (under-active thyroid), which means that their thyroid gland does not secrete an adequate amount of thyroid hormones. In your case, it is compulsory to take thyroxine, as there is no thyroid gland left after the surgery and radioiodine treatments.

The potential side effects of thyroxine are anxiety, restlessness, palpitation and insomnia, and they can occur when the dosage is excessive. These side effects would disappear once the dosage is adjusted appropriately. Your body can function as per normal on thyroxine replacement without the thyroid gland.

If the thyroid nodules were benign nodules, then a partial surgical removal of the affected thyroid gland would suffice. Alternatively, if you have benign thyroid nodules, you can choose not to have surgery and opt for monitoring and follow up by your doctor.