One of the most common thyroid conditions is benign thyroid nodules. These non-cancerous lumps on the thyroid gland can cause pain and difficulty breathing or swallowing.
Thyroid radiofrequency ablation (RFA) eliminates or shrinks thyroid nodules using targeted heat. The treatment uses a small, radio wave-emitting needle that heats and destroys thyroid nodules.
While thyroid radiofrequency ablation is a safe and effective treatment for patients with thyroid nodules or hyperthyroidism, many patients have questions when deciding if the procedure is right for them. Here are some of the most commonly asked questions about thyroid RFA to help you make an informed decision about your health.
Why Do I Need Thyroid Ablation?
Thyroid ablation removes benign thyroid nodules to improve thyroid function and reduce symptoms associated with thyroid nodules. Symptoms of thyroid nodules include:
- Irregular menstrual cycles (including heavy or missed periods)
- Unexplained weight changes
- Digestive distress (including diarrhea or constipation)
- Sleep issues and daytime fatigue
- Depression or anxiety
- Nerve problems (including tremors or numbness in the extremities)
However, it can also reduce thyroid function in hyperthyroidism (overactive thyroid) patients. If left untreated, hyperthyroidism can cause severe, life-altering complications, including:
- Eye problems and vision loss
- Fertility and birth problems
- Atrial fibrillation
- Heart failure
- Thyroid storm
Does Thyroid Ablation Hurt?
Patients who undergo thyroid radiofrequency ablation (TRA) rarely report pain or discomfort due to the local anesthesia administered before the procedure. You may experience mild tenderness around the insertion site for several days following the procedure, which can be managed with OTC pain relievers.
Am I a Candidate for Thyroid Ablation?
Thyroid radiofrequency ablations, although highly effective, are not suitable for all patients or conditions. You may be a candidate for thyroid RFA if you have the following:
- Benign inactive (cold) thyroid nodules
- Benign overactive (toxic/hot) thyroid nodules that produce excess thyroid hormones
- A thyroid disorder associated with hyperthyroidism (including Graves Disease)
Several conditions may preclude you from getting thyroid radiofrequency ablation, and you may need an alternative treatment like thyroid surgery or radioactive iodine treatment. You may be an unsuitable candidate for thyroid RFA if you:
- Use blood thinners or anticoagulants that you cannot stop for several days before the procedure
- Have sonographic features in their thyroid nodules that have a high risk of cancer
- Have sustained damage to your vocal cords
- Have had previous surgery on your throat
- Have a pacemaker or implantable defibrillator
- Pregnant women may also need to wait until after birth to receive thyroid RFA
To determine if you are a candidate for thyroid RFA, your doctor performs several diagnostic tests to confirm the presence and type of thyroid nodules and rule out other conditions. Some of the diagnostic tests they use include:
Blood and Urine Testing
Your doctor will order blood and urine testing to check for undetected issues. They examine your thyroid hormone levels, including free T4 and TSH level tests.
Your doctor may order a thyroid scan before the procedure. Radioactive dye will be placed in an IV or administered orally during a thyroid scan. Any functional portion of the thyroid absorbs the radioactive dye, which will be visible during the scan.
An ultrasound allows the doctor to observe all parts inside the thyroid gland and the structures surrounding the gland, including the lymph nodes. This enables them to look for abnormalities indicating whether a nodule is benign or cancerous.
Fine Needle Aspiration Biopsy
If your doctor suspects cancer or if the results of the ultrasound were inconclusive, they may perform a biopsy on the thyroid nodule. This involves using a small hollow needle inserted into the gland to take a tissue sample.
How Do I Prepare for Thyroid Ablation?
If you and your doctor have determined that thyroid ablation is the best treatment for your thyroid nodules, there are a few things you will have to do to prepare.
If you are taking prescription medications, consult your doctor to determine if other medicines will interfere with the procedure. These medications may include blood thinners like warfarin and heparin.
On the day of the procedure, arrange to have someone else drive you home from your procedure. Ensure you shower and clean your neck, avoid wearing jewelry or makeup, and wear comfortable clothing. Do not eat or drink for at least six hours before the ablation procedure.
What Happens During Thyroid Ablation?
If you are undergoing thyroid radiofrequency ablation, you’ll lie on the exam table with your head on a small pillow to hyperextend your neck. Your doctor will then attach two grounding pads to your thighs before administering local anesthesia to the area of your neck above the thyroid. Your doctor may also offer IV anesthesia to keep you comfortable during the procedure.
With the help of an ultrasound guiding system, your doctor inserts a thin needle into the thyroid nodule and turns on the generator. This causes electricity to flow through the needle to generate heat at the tip. Your doctor moves the needle across the nodule, burning it from the inside. Any healthy thyroid tissue will remain unaffected, and the burned tissue will shrink over time.
How Often is Thyroid Ablation Successful?
Thyroid ablation procedures are highly successful and have few or no complication risks. Even if the nodule is not destroyed, most patients experience a 30-50% decrease in the nodule’s size in the first two months after treatment, with the nodule continuing to shrink over the next 12 months.
If the procedure is performed on a particularly large nodule, you may need multiple sessions to see a noticeable decrease in the nodule’s size. Only about 3-4% of patients experience complications with thyroid radiofrequency ablation, and most of them are mild.
How Long Until I See Noticeable Results?
The recovery timeline varies in patients who undergo thyroid radiofrequency ablation. Patients often see a 50% reduction in volume within six months. However, you may experience noticeable results, including a reduction in symptom frequency and intensity within the first two weeks following the procedure.
You’ll visit your endocrinologist for follow-up appointments at six weeks, six months, and twelve months to measure the volume reduction and determine whether you need additional treatment.
Are There Any Side Effects to Thyroid Ablation?
In patients undergoing thyroid radiofrequency ablation, minor burns are the most common side effect. This typically happens due to the heated needle tip; however, this is relatively rare. Other rare side effects include:
- A collection of blood (hematoma)
- Thyroid nodule rupture
- Nerve injury
- Voice changes
- Lidocaine toxicity
- Trachea or esophagus injury
Most side effects, like nerve damage and vocal changes, are temporary and resolve on their own. If you experience persistent side effects like fever or vomiting, it may indicate an infection, and you should visit your doctor immediately.
Does Thyroid Ablation Treat Cancer?
Typical thyroid ablation is not usually used as a thyroid cancer treatment. However, thyroid radiofrequency ablation has emerged as a treatment option in patients with low-risk thyroid cancer who are not eligible for thyroid surgery.
When is Surgery Preferable to Thyroid Ablation?
While thyroid ablation is often preferable to surgery due to its decreased recovery time, lower chance of complications, and less invasive nature, there are some circumstances where surgery is preferable.
If you have had previous throat surgery, scar tissue may prevent the electrode from accurately penetrating the thyroid. Another common reason for endocrinologists to opt for surgery instead of ablation is if your nodules are cancerous.
Treat Thyroid Issues at Associated Endocrinologists
If you have hyperthyroidism or any other thyroid disease, the doctors at Associated Endocrinologists can help relieve your symptoms. Our experienced, board-certified endocrinologists specialize in performing both nuclear medicine and thyroid radiofrequency ablation.
If you are experiencing thyroid issues, call Associated Endocrinologists at (248) 855-5620 today to schedule an initial consultation.