The thyroid gland is found in the lower part of the neck between the larynx (Adam’s apple) and the sternum.
It is the part of the endocrine system that regulates our metabolism through the hormones it produces (T3 and T4). Thyroid hormones help our body to manage the produced energy so as to regulate body’s temperature and normal function of the heart, the brain, the muscles and other organs.
- Hyperthyroidism: a condition in which an overactive thyroid gland is producing an excessive amount of thyroid hormones resulting in tachycardia, diaphoresis, arrhythmias, weight loss, etc.
- Hypothyroidism: a condition in which the gland does not produce enough amount of thyroid hormones resulting in drowsiness, bradycardia, obesity etc.
Thyroid nodules are abnormal growths of thyroid cells that form lumps within the thyroid gland. Their size varies from a few millimeters up to centimeters. They do not cause symptoms unless they grow in size, causing pain, difficulty swallowing or shortness of breath. They are usually benign, while a 10% mask malignancy.
The abnormal enlargement of the thyroid gland is called goiter. It is sometimes visible. A goiter can occur in a gland that is producing too much hormone (hyperthyroidism), too little hormone (hypothyroidism) or in a gland that has inflammation.
Thyroid gland tests
For the diagnosis of the thyroid gland disorders, the most common tests we perform are:
- Blood tests T3, T4, TSH, thyroid antibodies
- Thyroid Ultrasound
- Thyroid scan with radioactive iodine
- FNA (a fine thin needle is inserted into the thyroid, and aspirates cells to be evaluated for malignant transformation)
These tests reveal functioning or morphology disorders of the thyroid gland.
The thyroid cancer is the most common endocrine cancer. There are no usual symptoms. It most often occurs in people with a family history of thyroid cancer, in individuals exposed to radiation in the past, while the risk in the general population increases with age. Treatment is surgical removal accompanied sometimes by administering radioactive iodine to destroy any remaining thyroid cells.
When thyroidectomy is recommended?
- in a Large goiter that causes pressure symptoms
- Toxic goiter (diffuse swelling of an overactive gland)
- Toxic adenoma (solitary nodule that overreacts)
- Multinodular goiter
- A nodule or nodules that grow in size and they are suspicious or positive for malignancy.
- Diagnosed Thyroid Carcinoma
What are the risks from the surgery? Postoperative care
Total thyroidectomy is the treatment of choice. The surgery should be performed by a qualified surgeon, because the gland is in direct contact with the recurrent laryngeal nerves and the parathyroid glands. Laryngeal nerve injury results in a hoarse voice and damage to the parathyroid glands causes hypoparathyroidism with symptoms of paresthesia, an unpleasant tingling sensation around the mouth and in the hands and feet.
Essentially all patients are discharged from the hospital the next day returning to normal activity. After a total thyroidectomy, the patient can no longer make thyroid hormone. This hormone is given, in pill form, by mouth.