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The thyroid gland is an important endocrine gland found in your neck, responsible for secreting hormones into your body. The thyroid hormones mainly play a role in controlling your body’s metabolism, which is the process by which your body converts energy from food so that it can be used by the body.
As a result, the thyroid plays an important role. It continuously ensures that our energy supply is adequate to keep our bodily functions operating and that our body produces enough heat.
Thyroid hormone affects every organ system of the body. It controls growth, metabolism, and other key bodily functions.
First, the thyroid hormone affects the heart. Increased thyroid hormone increases heart rate, cardiac output, stroke volume, and heart contractility. It also affects breathing by allowing more oxygenated blood to reach the lungs and by stimulating your respiratory systems in the brain.
The thyroid hormone is also responsible for increasing your basal metabolic rate, stimulating the breakdown of carbohydrates, increasing your oxygen consumption, and increasing your body temperature.
In children, thyroid hormone works alongside growth hormone to aid growth, stimulate bone growth, and help with brain maturation.
When you have imbalances in thyroid hormones, a variety of symptoms arise.
In some cases, imbalances can be relatively small and not present symptoms. In more severe cases, you may be diagnosed with thyroid disease (either hypothyroidism or hyperthyroidism) and given a treatment plan.
Thyroid disease refers to any condition that prevents the thyroid from functioning correctly. Various factors, including iodine deficiency, autoimmune disorders, and inflammatory conditions, can cause it. Common thyroid conditions include Graves’ disease and Hashimoto’s thyroiditis, both of which are more common in women.
In hypothyroidism, your thyroid gland doesn’t produce enough thyroid hormone. This results in you feeling fatigued, having an intolerance to cold, gaining weight, experiencing changes in your voice, and having dry skin.
Some research has identified that the effects of hypothyroidism can extend to your mental health, too; however, these symptoms are reduced or resolved with treatment.¹ Neuropsychiatric changes include decreased attentiveness, apathy, slowing of thought and speech, reduced memory, and language difficulty.
Hypothyroidism is most commonly caused by autoimmunity, in which your body attacks its own healthy cells and destroys them. The exact cause of the autoimmunity itself is unknown and is likely to be a combination of both genetic and environmental factors.
Other cases of hypothyroidism can be caused by iodine deficiency, as iodine is necessary for thyroid hormone production.
In hyperthyroidism, your thyroid is overactive, resulting in excessive thyroid hormone production, and your body ends up using energy too quickly. This can present as an increased heart rate, fatigue, anxiousness, weight loss, and disturbed sleep. Hyperthyroidism is most commonly caused by Graves’ disease, an autoimmune condition.
Genetic factors are thought to play a role in developing this autoimmunity; however, the exact causal link is yet to be determined. It’s also most common in women, with data suggesting its lifetime risk in women is 3%.²
Many cases of thyroid problems are benign, some of which recover on their own without treatment. Some progress to more serious thyroid complications and require ongoing treatment programs.
Treatment differs depending on whether you’re dealing with hypothyroidism or hyperthyroidism, the origin of the condition, and whether it responds to drug therapy or requires further intervention.
Antithyroid medications, which can include propylthiouracil, thiamazole, and carbimazole, are prescribed for hyperthyroidism to reduce the level of circulating thyroid hormone to normal levels. They work by preventing the synthesis of thyroid hormones. Antithyroid medications have minor side effects, seen in only around 5% of patients.³
Permanent solutions may be required when treatment with drug therapy isn’t working for hyperthyroidism. Permanent solutions may also be required for thyroid cancer or suspected thyroid cancer to prevent its progression.
Surgery on your thyroid occurs in the hospital. Generally, you’ll be advised not to eat or drink anything after midnight on the day before your surgery.
Surgery generally takes two hours. Following the surgery, you’ll gradually regain consciousness. Hospital staff will provide pain medication if necessary and ensure you’re doing fine following the operation. Once you’re fully awake, you’ll be able to have something to eat and drink (although you may not regain your appetite instantly).
Thyroidectomy is the removal of all or part of your thyroid gland. It’s a relatively common procedure used to control thyroid enlargement, cancerous growths on the thyroid, and hormonal control in hyperthyroidism.
Hyperthyroidism that isn’t responding to treatment with drug therapy may require surgical intervention to remove all or part of the thyroid. Initially, this was the treatment of choice for hyperthyroidism, but advances in medicine have enabled most cases to be controlled with drug interventions instead.
Goiter often doesn’t require surgical intervention, but in some more severe cases, it may be necessary.
In thyroid cancer, removal of the thyroid may be necessary. Thyroid nodules, solid or fluid-filled lumps in your thyroid, may also be surgically removed if they’re suspected to be cancerous.
Surgical complications are relatively rare, reported as occurring in 1–3% of patients. The most common complication is hypocalcemia, in which the calcium levels in your blood are too low. This can be treated with a calcium infusion or by taking oral tablets of calcium in less severe cases.⁴
Laryngeal nerve injury is the other key injury occurring postoperatively. Your laryngeal nerve is connected to your voice box.
Other potential side effects of surgery include sore throat and voice changes; however, these pose less risk.
Following surgical thyroid treatment, you’ll likely be able to return home the following day or within the next few days. Expect to take a couple of weeks off work to allow your body to recover. Also, avoid any strenuous physical activity during this time. As with any surgical operation, you need time for the wound to heal and for your body to recover.
Following the surgical procedure, you’ll commence levothyroxine therapy. Levothyroxine is a synthetic form of the body’s natural thyroid hormone. It’s used to replace thyroid hormone following surgery as your body is no longer producing it itself.
Hormone replacement therapy is a lifelong treatment that requires ongoing monitoring to ensure you reach target hormone levels.
Ensuring you get the best treatment following your thyroid removal is important to prevent any comorbidities or other complications. First, your doctor needs to determine the appropriate dose of levothyroxine. This depends on a few factors, including your weight, age, and pregnancy status.
Follow-ups to ensure your thyroid hormone replacement therapy is working are also important. This is achieved by measuring your body’s level of thyroid-stimulating hormone (TSH).
If you have existing comorbidities, you’ll want to ensure that these have been taken into account by your doctor to prevent unwanted drug interactions.
To ensure that all these factors are met, as well as meeting your own individual needs, make sure to find a doctor you trust to ensure you’re getting the best possible treatment.
The thyroid is an important gland in your body.
Surgery may sometimes be required for an overactive thyroid, cancer, or other conditions. However, it’s possible for you to live a safe and healthy life without your thyroid.
Sufficient follow-up treatment and adequate hormone replacement therapy enable you to return to your normal life following thyroid surgery. If your thyroid is causing you problems and you suspect you may be in need of surgery, talk to your doctor about what’s best for you.
Following thyroid gland removal, your body can no longer produce thyroid hormones. This means you must take a thyroid hormone replacement drug to maintain normal thyroid hormone levels.
It’s possible to return to normal life after thyroid removal. As long as you’re sticking to your treatment plan and maintaining sufficient thyroid hormone levels, you should be able to resume your normal activities.
If you feel like you’re experiencing significant symptoms and having thyroid-related complications that are interfering with your daily life, talk to your doctor to see if changes can be made to your treatment plan.
Serious complications arising after having your thyroid removed are quite rare. Hypocalcemia can sometimes occur, leading to cardiac decompensation, in which your heart cannot deliver sufficient oxygenated blood to meet your body's needs. However, this can be addressed by treatment with calcium.
Graves disease (2022)
( As above)