Thyroidectomy (Thyrotoxicosis) Treatment

What is thyroidectomy?

Thyroidectomy is the technique of removing all or part of the thyroid gland. The thyroid gland produces hormones that regulate every aspect of an individual’s metabolism, from the patient’s heart rate to how rapidly they burn their calories. It is used to treat thyroid disorders, like cancer, a noncancerous enlargement of the thyroid (goiter) and overactive thyroid (hyperthyroidism). How much of the patient’s thyroid gland will required to remove during thyroidectomy depends on the reason for surgery. If only a small portion is removed (partial thyroidectomy), the patient’s thyroid may be able to function normally like before, after surgery. If the patient’s entire thyroid is removed (total thyroidectomy), they will require daily treatment with thyroid hormone for replacing their thyroid's natural function.

What is Thyrotoxicosis?

An individual’s thyroid gland (a small butterfly-shaped organ in the lower front of an individual’s neck) makes the hormones that help the body use energy, stay warm, and thus keeping the organs working the way they should. Thyrotoxicosis is when the patients have way too much of those hormones in their blood.  This can happen most often because their thyroid gland makes too much of these hormones. That’s result in a condition known as hyperthyroidism.

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Causes of Thyrotoxicosis include the following:

Graves’ disease: Graves’ disease is the most common cause of hyperthyroidism and thyrotoxicosis. It leads the patient’s immune system to mistake the cells of an individual’s thyroid gland for invaders and attack those cells with antibodies (a type of protein). The reason so as to why this occurs is still unknown, but it makes the thyroid gland grow and make too much of the thyroid hormone. The condition tends to run in families (genetic), so the genes may play a vital part in whether the person will get it or not.

Nodules: Growths called nodules can be developed on the patient’s thyroid and affect how much hormone the thyroid gland makes. A single growth is called toxic nodular adenoma, while multinodular goiter or Plummer’s disease means the patients have a number of them.

Struma ovarii: This is a very rare type of ovarian tumor that is made mostly of thyroid tissue. In some cases, it can result in hyperthyroidism.

Thyroiditis: A bacteria or virus, certain medications (like lithium), or even the patient’s own immune system can inflame their thyroid gland and thus make the gland to release too much hormone into their bloodstream.

Thyroid supplement: Some people take thyroid hormone in the pill form for treating a medical condition, like hypothyroidism (when the patient’s thyroid doesn’t produce enough hormones). The patients can have too much in their blood if their prescription is off or they don’t take the medication as prescribed.

Symptoms

Normally, thyroid hormones help the patient’s burn energy at the correct speed. High levels can affect the patient’s body in lots of various ways. In general, the thyroid hormones speed up things like their heart, which generally beats faster. The patients might poop and sweat more, feel irritable and nervous, and have shaky hands and much weaker muscles. The patients may lose weight because they don’t eat adequate calories to match their faster metabolism. Graves’ disease can also cause watery eyes, red that bulge out with the swollen lids.

What is the thyroid gland?

The thyroid gland is a structure in an individual’s neck that produces a hormone known as thyroxine, this regulates the people’s body's metabolism. It is been observed that sometimes this gland can become overactive. This is called thyrotoxicosis and can result in symptoms such as sweatiness, eye problems, and losing weight.

What are the benefits of the Thyroidectomy for Thyrotoxicosis?

The patients will no longer have any distressing symptoms.

Are there any alternatives to the Thyroidectomy for Thyrotoxicosis?

Medication, such as propylthiouracil or carbimazole, can be used for controlling thyroid activity. Radioactive iodine can also be used for some of the patients. It is possible to remove only a part of the thyroid gland so that the patients can continue producing some thyroid hormones and there is no requirement for the patients to start taking thyroxine tablets. However, patients may require further treatment.

What does the thyroidectomy for thyrotoxicosis involve?

The surgery is done under a general anesthetic and generally takes 90 minutes to 2 hours. The patient’s surgeon will make an incision on the patient’s neck in the line of one of the patient’s skin creases and thus removing the thyroid gland.

What complications can occur?

General complications that can occur to the patients who are undergoing Thyroidectomy for Thyrotoxicosis

• Pain
• Infection of the surgical wound (site)
• Unsightly scarring
• Blood clotting

Specific complications that can occur to the patients who are undergoing Thyroidectomy for Thyrotoxicosis

• Bleeding
• Change in the patient’s voice
• Drop in calcium levels of the patients
• Drop in thyroid hormone levels of the patients
• Increase in thyroid hormone levels of the patients
• Difficulty in breathing

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How soon will the patients recover from the Thyroidectomy for Thyrotoxicosis?

The patients should be able to go home after 1 or 2 days. The patients should be able to return to their work and to their day to day activities after about 2 weeks. Regular exercise should help the patients to return to their day to day activities as quickly as possible. Before the patients start exercising, they ask the healthcare team or their GP for advice. The healthcare team will generally arrange for the patients to come back to the clinic. The surgeon will discuss any treatment or follow-up required by the patients.

Outlook

Thyrotoxicosis is a condition that is being caused by an overactive thyroid gland, the symptoms can be distressing. A thyroidectomy for removing the thyroid gland is one of the many ways thyrotoxicosis can be treated.