Introduction
Thyroid removal, also called thyroidectomy, is a surgical procedure that involves removing all or part of the thyroid gland. This operation may be necessary for a variety of medical reasons, including cancer, toxic nodules, goiter, persistent hyperthyroidism, and treatment-resistant Graves’ disease. In this article, we will look at the different reasons that can lead to thyroid removal as well as the post-operative implications and replacement treatment options available.
Medical reasons leading to thyroid removal
- Cancer : Cancer is one of the main reasons why total or partial thyroid removal may be necessary. There are different types of cancers affecting this gland (papillary, follicular or anaplastic cancers). Surgery is often performed with the aim of completely removing the cancer or reducing its size to improve the effectiveness of other treatments such as radiotherapy.
- Toxic nodules: Nodules are solid masses that form on the thyroid gland. Some nodules can produce too much thyroid hormone, causing hyperthyroidism. When these nodules are too large or cause breathing problems, they may require surgical removal.
- Goiter: Goiter is an enlargement of the thyroid gland that can be due to a variety of causes, including iodine deficiency and autoimmune disorders. In some cases, goiter can cause difficulty breathing or swallowing, which then warrants surgery to reduce its size.
- Persistent hyperthyroidism: Hyperthyroidism is a disorder in which the thyroid gland produces too much hormone. If drug treatments fail to control this hormonal overproduction and symptoms persist, partial or total thyroid ablation may be considered.
- Treatment-resistant Graves’ disease: Graves’ disease is an autoimmune disorder that causes hyperthyroidism. If drug treatments do not sufficiently improve the patient’s condition, a thyroidectomy may be recommended.
Post-operative implications
Total or partial removal of the thyroid usually results in significant improvement in symptoms associated with the previously mentioned medical conditions. However, patients will need to undergo post-operative replacement therapy to compensate for the loss of thyroid function.
It is important to note that some concerns have been raised regarding the number of potentially unwarranted surgical procedures. It is therefore crucial for patients to obtain a second medical opinion before undergoing thyroid ablation.
Impact on life expectancy
Overall, thyroid ablation does not have a major impact on the life expectancy of patients when it is performed for non-cancerous reasons and post-operative replacement therapy is well followed. However, in the case of cancer, the prognosis will depend on the type and stage of the cancer as well as the associated treatments (radiotherapy, chemotherapy).
Post-operative replacement therapy
After total or partial thyroid removal, patients usually must take synthetic thyroid hormones to compensate for the loss of function of their gland. Common options include:
- Levothyroxine: Levothyroxine (LT4) is a synthetic hormone that replaces the natural hormone T4 produced by the thyroid gland. It is generally prescribed as first intention and must be taken daily.
- Liothyronine: Liothyronine (LT3) is a synthetic hormone that replaces the natural hormone T3 produced by the thyroid gland. It can be prescribed alone or in combination with levothyroxine, depending on the patient’s needs.
The dosage of replacement hormones will be adjusted regularly based on the results of blood tests to ensure optimal hormonal levels for the patient.
Conclusion
Thyroid removal is a surgical procedure performed for a variety of medical reasons, some of which can be potentially serious. Although this operation can significantly improve the patient’s health, it requires post-operative replacement therapy to compensate for the loss of thyroid function. It is important for patients to be well informed about the implications of this procedure and to obtain a second medical opinion before undergoing thyroid removal.
