Total Thyroidectomy (TT)

Helpful information to help prepare for before and after surgery.  I personally had a total thyroidectomy and it was the best option for me.  In 2007, I had a visibly large thyroid and I could feel it pressing against my throat.  I had so many nodules that my doctor simply stopped counting.  Recovery was tough as my body had to learn how to function with normal levels after suffering so long with hyper levels.

Thyroid Surgery Patient Information at Johns Hopkins

Thyroid surgery is performed for several reasons and can include symptomatic thyroid nodules, recurrent thyroid cysts, goiter, Graves’ disease, and to rule out or treat thyroid cancer. The purpose of thyroid surgery is to remove part or all of the thyroid gland. You will be in the hospital usually one night.

 

Thyroidectomy Patient Information at the Mayo Clinic

After thyroidectomy, a few people may experience neck pain and a hoarse or weak voice. This doesn't necessarily mean there's permanent damage to the nerve that controls the vocal cords. These symptoms are often short-term and may be due to irritation from the breathing tube that's inserted into the windpipe during surgery, or be a result of nerve irritation caused by the surgery.

Who should consider thyroidectomy for management of Graves' disease?

Thyroidectomy should be considered for anyone with Graves’ disease (GD) and moderate-to-severe eye disease, or smokers with GD due to increased risk of exacerbation of eye disease after radioactive iodine. Women with GD who are pregnant, nursing, or who have young children at home would benefit from a surgical consultation in an effort to avoid radiation exposure to the home... 

 

Considerations for Thyroidectomy as Treatment for Graves Disease

The treatment of Graves disease should be tailored to the specific needs of each patient with the benefits and risks of each therapy explained in full. Surgery is preferred in the treatment of Graves disease in the cases discussed above: large obstructing goiter, pregnancy, breastfeeding, moderate to severe ophthalmopathy, persistent hyperthyroidism after radioablation and ATD therapy, inability to tolerate RAI or ATDs, or a nodule with abnormal cytology on FNA. Total thyroidectomy is, in most cases, a definitive treatment of hyperthyroidism due to Graves disease with the added benefits of rapid treatment, avoidance of RAI and ATD side effects, and an equally low risk of disease recurrence. Successful surgical treatment involves much more than pure surgical skill; it necessitates the appropriate preoperative and postoperative medical management of each aspect of the patient’s disease.

 

Thyroid Hormone Replacement in Patients Following Thyroidectomy for Thyroid Cancer
Most often the problems are related to the dose and preparation of thyroid hormone (TH) to use. Some patients feel less well following thyroidectomy and/or radioiodine ablation than they did before their diagnosis. We present evidence that levothyroxine (L-T4) is the preparation of choice, and keeping the thyroid-stimulating hormone (TSH) between detectable and 0.1 mU/L should be the standard of care in most cases. In unusual circumstances, when the patient remains clinically hypothyroid despite a suppressed TSH, we acknowledge there may be as yet unidentified factors influencing the body’s response to TH, and individualized therapy may be necessary in such patients.

Thyroid Surgery's Impact on Hormone Production

With the total removal of the thyroid gland, your body can no longer naturally produce thyroid hormones. Thyroid hormones are essential because they control your body's metabolism. In other words, they dictate how your body uses energy—from how you process food to how fast you think.