Total thyroidectomy

What is the thyroid gland?

The thyroid gland is an endocrine gland; this means that it manufactures hormones that are released into the bloodstream, which then act as messengers to affect cells and tissues in other parts of the body.

Where is the thyroid gland?

The thyroid gland is made up of two lobes (each about the size of half a plum) that are joined together by a ridge of thyroid tissue (called the isthmus). The two lobes lie on either side of your windpipe, with the gland as a whole lying just below your Adam’s Apple.

What do the thyroid hormones do?

Thyroid hormones regulate the speed at which your body cells work. If too much of the thyroid hormones are secreted, the body cells work faster than normal, and you have thyroid overactivity or ‘hyperthyroidism’ (also sometimes referred to as "thyrotoxicosis"). However if too little of the thyroid hormones are secreted then the body cells work slower than normal, and you have underactivity or ‘hypothyroidism’.

What are the parathyroid glands and how do they affect calcium levels?

The parathyroids, normally four in number, are attached to the thyroid. They produce parathyroid hormone (PTH) and this regulates the concentration of calcium in the blood. Normal calcium levels in the blood are essential for healthy bones, as well as for general well-being

What is a thyroidectomy?

A thyroidectomy is the removal of all of the thyroid gland (total thyroidectomy). You may need to have this done because you have a swelling or enlarged gland (goitre) or for treatment of an overactive thyroid (Graves' disease or toxic nodular goitre).

Why is thyroidectomy performed?

Thyroidectomy is sometimes recommended for patients with an overactive thyroid (hyperthyroidism), such as Graves' disease. Thyroidectomy generally cures the problem, though you will need to take thyroxine afterwards. Thyroidectomy is also done when there is a consideration for thyroid cancer from previous biopsies.

Is it a safe operation and what are the side-effects?

The total removal of the thyroid gland means that you will need to take replacement hormone tablets called thyroxine (or T4) every day for the rest of your life, otherwise, you will experience symptoms of an underactive thyroid (hypothyroidism). Thyroxine tablets are the size of a sugar sweetener and contain exactly the same chemical normally made by the thyroid gland. When taken as instructed, thyroxine tablets have no side effects. With monitoring by your specialist centre and/or your general practitioner (GP) you will be able to lead an active and normal life.

The parathyroid glands are not usually removed or damaged at a thyroidectomy operation. But sometimes one or more of the parathyroid glands is unavoidably removed, or their blood supply is affected, and then the calcium levels may fall below normal. If this happens you will be advised to take calcium tablets and sometimes vitamin D also. Usually, this is only temporary, but sometimes it is permanent (it is called hypoparathyroidism).

Will it affect my voice?

The thyroid gland lies close to the voice box (larynx) and the nerves to the voice box. Following your surgery, you may find that your voice may sound hoarse and weak and your singing voice may be slightly altered, but this generally recovers quite quickly. In a very small number of cases, this can be permanent.

When can I return to normal activities?

You will need up to two weeks off work (sometimes longer) to recover depending on the nature of your work.