Can Thyroid Levels Change After Thyroidectomy?

The thyroid gland is a butterfly-shaped hormone-producing gland located in the anterior base of the neck, slightly below the voice box. Although it is an essential gland for normal metabolism, certain medical conditions require a thyroidectomy.

Types

• Thyroidectomy is the medical term for the surgical removal of all or part of the thyroid gland. Existing classifications include:

  • Total thyroidectomy (removal of the entire gland)
  • Subtotal or partial thyroidectomy (disposal of part of the thyroid gland)
  • Hemithyroidectomy or unilateral lobectomy (removal of one lobe or half of the gland)
  • Isthmectomy (removal of the band of tissue connecting the two lobes of the thyroid)

Causes

• People may need a thyroidectomy for a variety of reasons, including a thyroid tumor (cancerous or benign), a nodule or cyst, an untreatable swelling of the thyroid gland (goiter), severe hyperthyroidism that resists other treatment methods, Graves' disease or aesthetic reasons.

Effects on Thyroid Levels

• Thyroid storm, which is a sharp increase in thyroid hormone levels, is a rare complication of thyroid surgery. Thyroid storms can be life threatening, and patients with an overactive thyroid are usually treated before undergoing surgery. Most people, however, can expect to become hypothyroid (thyroid insufficient) after a total thyroidectomy. In cases of partial thyroidectomy, the remaining part of the gland may retain enough activity to keep hormone blood levels normal.

Other Complications

• Other possible complications of thyroid surgery include:

  • Nerve injuries, particularly nerves of the vocal cords
  • Hypoparathyroidism (usually temporary), leading to low calcium levels in the blood
  • Airway obstruction
  • Tumor spillage
  • Bleeding
  • Infection
  • Wound complications
  • Surgical scars

Long-Term Outlook

• Although the prognosis of a thyroidectomy is usually good, most people who undergo the surgery will need oral thyroid hormone replacement therapy (synthetic thyroid hormone pills) for the rest of their lives. This is to help prevent adverse effects of the resultant hypothyroidism.

Considerations

• Note that a thyroidectomy is different from a thyroidotomy (also called thyrotomy). A thyroidotomy is an incision into the thyroid gland or cartilage, usually to gain access to other structures or to perform a biopsy.