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February 20, 2023 9 min read

Thyroid surgery is a procedure where the thyroid gland is partially or completely removed to treat certain conditions affecting the gland. The decision to have thyroid surgery is not always an easy one. The thyroid might be small, but it's an important gland that produces hormones that regulate many bodily functions, such as heart rate, body temperature, and metabolism. Therefore, it's important to know all the details before going under the knife. Here are some key questions to ask your doctor before deciding on getting thyroid surgery.

What is the reason for recommending thyroid surgery?

There are a few reasons why your doctor might recommend thyroid surgery. Your doctor may recommend surgery if you have thyroid nodules suspicious for cancer or if you have thyroid cancer.

Thyroid surgery is most commonly recommended if you have an enlarged thyroid (goiter), lymph nodes that grew large or suspicious for cancer, or thyroid cancer. In these cases, removing part or all of the thyroid is usually necessary in order to get rid of the problem and reduce symptoms related to them.

Additionally, you might need to undergo thyroid surgery if you have a thyroid disease called hyperthyroidism (overactive thyroid) and you don't do well with antithyroid drugs or you don't want radioactive iodine therapy. In that case, the doctor may do a thyroid surgery by removing part or the entire gland to help regulate your hormone levels and restore your thyroid function.

What type of thyroid surgery is being recommended, and how much of my thyroid will be removed?

The type of thyroid surgery recommended and how much of your thyroid will be removed depend on several factors, including the underlying cause and the patient's overall health. Here are the types of thyroid surgery.

Partial thyroid lobectomy

Partial thyroid lobectomy is a surgical procedure that involves removing only one of the lobes of your thyroid while the other parts are left intact. This surgery is very uncommon and is usually recommended for people who have a small goiter or benign thyroid nodules.

Thyroid lobectomy

This surgery involves removing either the entire right or left lobe of your thyroid.

Total thyroidectomy

Total thyroidectomy is a surgical procedure in which the whole thyroid gland is removed. This is recommended for thyroid cancer, severe hyperthyroidism, medullary thyroid cancer, or a substernal goiter.

Partial thyroidectomy

Partial is a procedure that removes only part of your thyroid gland in order to preserve thyroid function. The remaining portion of your thyroid gland may function normally, taking over the function of the entire thyroid gland.

What happens during the surgery?

During the surgery, you will be placed under general anesthetic. This means that you won't be awake or feel anything during the surgery. The surgeon then makes an incision in the neck area and removes all or part of the thyroid gland.

The surgeon may also remove any lymph nodes located near the thyroid gland to test for cancer cells. After removal, the tissue is sent to a lab for further testing if needed. Depending on the extent of the surgery, some patients may require additional procedures or treatments after their initial surgery. The entire operation should take between 2 to 3 hours.

How experienced is the surgeon performing the surgery in this particular procedure?

It's important that your surgery is performed by an experienced surgeon. Not only will it ensure a higher success rate, but it will also give you peace of mind. Here are some factors to consider when evaluating a surgeon's experience:

  • The number of procedures performed: A surgeon with many thyroid surgeries will likely have more experience and expertise.

  • Training and education: Find out about the surgeon's training and education. Have they received specialized training in endocrine or thyroid surgery? Where were they trained? Have they received any certificates or accreditation?

  • Outcome data: Data on the surgeon's outcomes, such as the number of successful procedures, complication rate, and patient satisfaction, can provide valuable information on their experience.

  • Patient reviews and testimonials: Hearing directly from other patients who have undergone thyroid surgery with a particular surgeon can provide valuable insight into their experience and the quality of care they received.

How long is the recovery period after surgery?

The recovery period after thyroid surgery varies depending on the individual and the type of surgery performed. However, you can expect to take several weeks to recover fully.

Here are some general guidelines for recovery after thyroid surgery:

  • Hospital stays: You can go home the same day or within 24 hours of the surgery, although a hospital stay may sometimes be required.

  • Activity restrictions: Most people will need to limit their physical activity for several weeks after the surgery, including avoiding heavy lifting and strenuous exercise.

Will the surgery affect my ability to speak or swallow?

Thyroid surgery can impact your ability to speak and swallow. In rare cases, permanent damage to the recurrent laryngeal nerve can occur, leading to permanent voice changes or difficulty swallowing.

What are the potential risks and complications of the surgery?

Undergoing surgery to remove your thyroid may seem scary, but the good news is that most people who undergo the procedure do so with little to no complications. But although thyroid surgery is generally safe and has a high success rate, there are potential risks and complications you need to be aware of. These include:

  • Pain: You'll likely experience pain for the first few days following the surgery. Your doctor will likely prescribe you pain relievers, or you can take over-the-counter pain medications.

  • Voice change or permanent hoarseness: In some cases, the surgery may impair your vocal cord nerves, which could cause hoarseness. This can be temporary or permanent.

  • Bleeding and difficulty swallowing: There is a risk of bleeding during or after the surgery and leaving you to have difficulty swallowing. However, according to a study, more than 21.3% of patients' swallowing process was better or more trouble-free than before.

  • Infection: There is a small risk of infection after the surgery.

  • Hypoparathyroidism: This occurs when the parathyroid glands, which produce parathyroid hormone, are accidentally removed or damaged during surgery.

  • Low calcium: Since the parathyroid glands control your calcium levels, you might experience low calcium levels if the surgery affects your glands.

  • Scarring: A scar will result from the incision made during the surgery.

  • Life-threatening risks: Though this is uncommon, occurring in 0.3% of cases, it can be dangerous if it progresses.

  • Hypothyroidism (underactive thyroid): After the surgery, especially if most of your thyroid is removed, your body will no longer be able to produce thyroid hormones. Thus, you'll have hypothyroidism.

Questions to ask before thyroid surgery

What kind of monitoring or follow-up care will be needed after the surgery?

Here are some general guidelines for follow-up care after thyroid surgery:

  • Regular checkup and follow-up appointments: Regular follow-up appointments with the surgeon are required to monitor the healing process and check for complications.

  • Imaging tests: Imaging tests, such as ultrasound or CT scans, may be performed to monitor the size and shape of the thyroid gland and any residual nodules or tumors.

  • Tests to monitor your thyroid function: Following the surgery, you'll need regular thyroid blood tests to check your thyroid function. If you undergo partial thyroidectomy and your thyroid is not functioning properly, or if you undergo total thyroidectomy, you'll likely need medications to replace your thyroid function.

How likely is it that the surgery will lead to hypothyroidism?

The likelihood of developing hypothyroidism depends on the type of thyroid surgery you undergo. If you undergo total thyroidectomy, you'll develop hypothyroidism since your body can't produce thyroid hormone without the thyroid gland. This means that it's permanent, and you'll need lifelong treatment for hypothyroidism.

On the other hand, if you undergo partial or subtotal thyroidectomy, your remaining thyroid tissue may be able to maintain normal hormone levels. However, your doctor might still monitor your thyroid function. If the remaining thyroid tissues don't function as well as they should, you'll still need thyroid hormone replacement therapy.

Hypothyroidism is a condition that occurs when the body doesn't have enough thyroid hormone to maintain normal metabolism – the way your body turns food into energy. Hypothyroidism can lead to a wide range of symptoms that may affect your quality of life.

What are the symptoms of hypothyroidism after thyroid surgery?

If you develop hypothyroidism, you may experience the following symptoms:

  • Fatigue: You'll often feel tired and have low energy levels.

  • Weight gain: Since hypothyroidism causes your metabolism to slow down, it can lead to weight gain.

  • Cold intolerance: You may feel cold more quickly than others and have a lower tolerance for cold temperatures.

  • Dry skin and hair: Hypothyroidism can cause your skin and hair to become thin and brittle.

  • Constipation: Hypothyroidism can slow down your digestive system, leading to constipation.

  • Depression: Hypothyroidism has been linked to depression, mood changes, and decreased mental clarity.

  • Joint and muscle pain: People with hypothyroidism may experience joint and muscle pain, stiffness, and weakness.

How will my thyroid hormone levels be monitored after the surgery?

After thyroid surgery, your healthcare provider will order blood tests to measure the levels of thyroid-stimulating hormone (TSH). TSH is a hormone produced by your pituitary gland. Its job is to regulate the release and production of your thyroid hormone. If your thyroid hormone is low, your pituitary gland will release more TSH to trigger your thyroid to release more hormones. In contrast, when your thyroid hormone is high, you'll have little to no TSH.

Other tests that may be performed are free thyroxine (FT4) and free triiodothyronine (FT3)

How will hypothyroidism be treated after the surgery?

You'll need thyroid hormone therapy if you have hypothyroidism or underactive thyroid. This therapy involves taking medication that'll supplement your body with the missing thyroid hormones. The most common medications include levothyroxine and natural desiccated thyroid (NDT).

Levothyroxine is the synthetic version of thyroxine thyroid hormone (T4). NDT, on the other hand, consists of the natural form of the hormone T4 and T3, which are two of the main thyroid hormones. Since NDT contains both hormones, many hypothyroid patients consider it to be the more effective option. You can buy desiccated thyroid online, such as VitaliThy.

Will I need to take thyroid hormone replacement medication for the rest of my life?

The need for thyroid hormone replacement medication after surgery depends on the extent of the surgery and the remaining function of your thyroid gland. If your entire thyroid gland is removed or the remaining tissue cannot produce enough hormones, hormone replacement therapy will be necessary for the rest of your life.

Will I need to make any lifestyle changes to manage hypothyroidism?

Besides taking thyroid hormone replacement medication, there are also certain lifestyle changes you can make to help improve your overall health and well-being. Some common recommendations include the following:

  • Eating a well-balanced diet.

  • Getting regular exercise.

  • Managing stress levels.

  • Avoiding alcohol and caffeine

How will my medical team monitor my progress and adjust my treatment plan if needed?

Your medical team will monitor your progress and adjust your treatment plan following your thyroid surgery. They may also refer you to a specialist, such as an endocrinologist, to help manage your condition.

If you have hypothyroidism and need to take medication, you'll likely need regular monitoring to ensure that you're taking the optimal dose of thyroid medication.

Are there any alternatives to thyroid surgery for my condition?

This depends. Your age, medical history, and the type of condition that you have will all factor into the decision-making process. If your doctor recommends thyroid surgery, be sure to ask about potential alternatives and weigh your options carefully. In most cases, thyroid surgery is only recommended as a last resort. Your doctor may recommend the following before resorting to thyroid surgery:


A goiter or thyroid nodule may be monitored with regular blood tests and ultrasound scans to monitor its size and growth.

Thyroid medication

Thyroid medication such as levothyroxine, liothyronine, and natural desiccated thyroid (NDT) may be used to increase hormone production if your goiter causes hypothyroidism. On the other hand, for goiters that cause hyperthyroidism, you may be prescribed medications to reduce hormone production, like methimazole (Tapazloe), and medications called beta blockers to manage your symptoms.

Iodine supplementation

If an iodine deficiency causes your goiter, supplementing your body with iodine may help shrink the goiter.

Radioactive iodine

Radioactive iodine can be used to treat hyperthyroidism, goiter, and thyroid cancer. It's administered orally in the form of a pill or a liquid. When you swallow the radioactive iodine, the thyroid gland absorbs it, and the radiation destroys the cells that make up the gland.

By destroying these cells, radioactive iodine treatment reduces or eliminates the production of thyroid hormones. The decrease in hormone production can help to alleviate the symptoms of hyperthyroidism, such as a rapid heartbeat, nervousness, weight loss, and goiter, which is a swelling in the neck caused by an enlarged thyroid gland.

External radiation therapy

External beam radiation therapy may be used with surgery or as a standalone treatment for small, low-risk tumors.


Chemotherapy for thyroid cancer is a treatment that uses drugs to destroy cancer cells. This treatment may be used in combination with surgery and radioactive iodine treatment.

Targeted drug therapy

Targeted drug therapy is a type of cancer treatment that zeroes in on specific chemicals found in cancer cells. By targeting these chemicals, these therapies can cause cancer cells to die. These treatments are available in various forms, such as pills or intravenous injections.

In the case of thyroid cancer, there are several different targeted therapy drugs available. Some of them work by targeting the blood vessels that the cancer cells rely on to get the nutrients they need to survive. Other drugs are designed to target specific gene mutations in cancer cells. To determine which targeted therapy may be most effective for your thyroid cancer, your healthcare provider may conduct tests on your cancer cells.

The takeaway: Asking the right questions can help with your decision

Thyroid surgery can be a difficult and scary process to go through. Preparation is key in order to ensure that it all goes as smoothly as possible. Before having thyroid surgery, it's important to ask your doctor specific questions so you can feel more comfortable and confident leading up to the operation. It'll also help you prepare for your life following your surgery.

Wojciech Majda
Wojciech Majda

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