Many thyroid diseases are life-long conditions that require routine monitoring and treatment to maintain your health. Thyroid conditions are common, with an estimated 20 million Americans living with a form of the disease.

If you have thyroid disease, your physician may recommend thyroid surgery as part of your treatment. Learn the most common reasons thyroid surgery is needed and what you can expect before, during, and after surgery.

You Have Thyroid Nodules

Thyroid nodules are growths in your thyroid gland. They can be fluid-filled or solid and feel like a lump on your thyroid. Most thyroid nodules are benign and don’t require surgery unless they are causing symptoms. A benign nodule is also referred to as an adenoma.

Physical symptoms like having a hoarse voice, trouble swallowing or breathing, and pain in your neck are indications of surgery. You may also opt for thyroid surgery if your nodule is noticeably large and you feel self-conscious about your appearance.

A small portion of thyroid nodules are cancerous and require surgical removal. If your doctor finds nodules during a physical exam, they may have you undergo testing to determine if your nodule is cancerous or benign.

This can include blood tests to check your thyroid hormone levels, a thyroid ultrasound, or a fine needle aspiration (FNA) biopsy. This minimally invasive biopsy inserts a thin needle into your thyroid gland to collect a sample for testing. It quickly determines if a nodule is benign or malignant.

You Are Diagnosed with Thyroid Cancer

Malignant thyroid nodules and other forms of thyroid cancer require thyroid surgery for treatment. Thyroid cancer may present as a lump on your neck, and you may feel pain in your neck, ear, or jaw. Thyroid cancer can’t be detected through blood tests or thyroid panels and is usually found through physical examination or an ultrasound of the neck.

Types of thyroid cancer that require surgery include:

  • Papillary thyroid cancer: a slow-growing cancer that spreads to nearby lymph nodes and is the most common type of thyroid cancer.
  • Medullary thyroid cancer: this type is associated with other endocrine tumors and can run in families.
  • Follicular thyroid cancer: can spread into the lungs and organs through the bloodstream if not treated.
  • Anaplastic thyroid cancer: the rarest type of thyroid cancer and the most aggressive.

Surgery to remove the cancerous tissue and the affected thyroid tissue is necessary to cure thyroid cancer. The amount of your thyroid gland that is removed depends on the location of your cancer. You may also need the lymph nodes around or behind your thyroid removed if it spreads.

You Have an Enlarged Thyroid

Having an enlarged thyroid, also called a goiter, is another common reason for surgery. Substernal goiters and multinodular goiters require thyroid tissue removal for treatment. With a substernal goiter, your thyroid gradually enlarges over the years and grows towards your collarbone and chest. This type of goiter doesn’t always grow outward, so you may not have a visible lump in your neck. Instead, it may enlarge towards the back of your neck.

You will receive a diagnosis of a multinodular goiter if you have an enlarged thyroid and more than one thyroid nodule. Multinodular goiters produce large lumps in the front of the neck and cause symptoms due to their size. Larger multinodular goiters may cause difficulty swallowing or breathing and voice changes.

Enlarged thyroids often require surgical treatment, where part or all of the thyroid is removed. The indications for thyroid surgery in these cases include the size of the goiter, the symptoms it’s causing, and if the goiter is toxic. A toxic goiter also called a hot goiter, produces excess thyroid hormones with adverse health effects.


You Have an Autoimmune Thyroid Disease

In autoimmune thyroid conditions like Hashimoto’s Disease or Graves’ Disease, your immune system attacks your thyroid, leading to an underactive or overactive thyroid. Surgical removal of the thyroid is more common for treating Graves’ Disease, where the immune system attacks the thyroid receptors.

If you have Graves’ Disease, your body creates antibodies for your thyroid stimulating hormone (TSH) receptors. This encourages your body to produce more thyroid hormones than you need, resulting in hyperthyroidism.

Symptoms of Graves’ Disease include weight loss, trouble sleeping, racing heart rate, tremors, and muscle weakness. If left untreated, it can also lead to neuropsychiatric symptoms, such as anxiety, depression, and dysphoria. Thyroid surgery is required if other medical interventions fail to control your condition.

People with Hashimoto’s Disease also benefit from surgical removal if their condition is difficult to treat. The chronic inflammation caused by this condition leads to a decrease in the production of thyroid hormones, called hypothyroidism, and can also cause these hormones to fluctuate unexpectedly.

Hashimoto’s symptoms include dry skin and hair, increased fatigue, hair loss, constipation, muscle weakness, and depression. If thyroid medications fail to treat the symptoms it causes adequately; surgery may be necessary.

What to Expect if You Need Thyroid Surgery

Thyroid surgery is an inpatient procedure requiring general anesthesia. You’ll undergo your operation in a hospital or surgery center. Once your surgery is scheduled, you’ll need a preoperative evaluation. This may include blood tests, imaging tests, and an electrocardiogram (EKG) to ensure you’re healthy enough for surgery.

Your surgeon will instruct you on how to prepare for your surgery. When you arrive for your procedure, you’ll change into a hospital gown and be given an IV for medications before being sedated for the surgery.

The surgeon begins your operation by making an incision in the front of your neck. Special attention is paid to your vocal cords, nerves, and your parathyroid glands to avoid damaging them during surgery. Then your surgeon removes tissue before suturing the wound closed.

The type of thyroid operation you need depends on your specific diagnosis and treatment plan. Your doctor may recommend one of the following options:

  • Total thyroidectomy: this surgery removes your entire thyroid gland.
  • Near-total removal: removes the majority of your thyroid gland, leaving some tissue on one side.
  • Hemithyroidectomy: removes one of your thyroid lobes, leaving the other intact.
  • Isthmusectomy: removes the central part of your thyroid that connects the two lobes.

After your thyroid surgery, you may feel some discomfort in your neck or throat and suffer from temporary hoarseness. Most people will be able to return home within a day after their surgery but will need time off from work and other activities to recover. You’ll also need to refrain from activities that can strain your neck for several weeks, like lifting heavy objects.

Since thyroid surgery can disturb the parathyroid glands in the neck, your physician will monitor you for signs of a problem. Parathyroid glands regulate calcium in the body, and damage to the glands can cause your calcium levels to drop.

If this happens, you’ll experience tingling or numbness in your hands or around your mouth. Blood tests are run after your surgery to check your calcium levels. If they’re low, you’ll need to take a calcium replacement.

Manage Your Thyroid Health

If you’ve been diagnosed with thyroid disease, consider managing your health with Associated Endocrinologists. Our board certified physicians welcome patients with thyroid, parathyroid, and other endocrine disorders.

We offer comprehensive thyroid care with our services, including thyroid ultrasound, fine needle biopsy, thyroid radiofrequency ablation, and radioactive iodine therapy. Call us at (248) 487-8335 to schedule an appointment.

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