A thyroidectomy, is a term simply meaning removal of the thyroid and can be ordered as a complete or partial removal of the gland. The most common reason thyroid removal is recommended, is in cases when malignancy (cancer) is found in the thyroid gland. Thyroidectomies are also ordered in severe cases of hyperthyroidism or Grave’s Disease when the over-production of thyroid hormone cannot be controlled through oral medications. In cases like these, removal or “ RAI-ablation” (destruction of the gland by radioactive iodine) may be recommended.

What about cases of hypothyroidism? Are there instances when thyroidectomies are ordered for patients who are hypothyroid? Patients with hypothyroidism symptoms that are not well controlled through thyroid hormone therapy may ask this question. In my case for example, I can say that my hypothyroid and neurological type symptoms from thyroid autoimmunity and the resulting hypothyroidism, improved significantly with thyroid hormone therapy but still occur intermittently in mild phases. Other patients are less fortunate and may continue to experience severe symptoms despite treatment. What Doctors often point out to, hypothyroid patients with difficult-to-resolve symptoms, is the fact that the disease itself has no cure and they can only be treated for the thyroid hormone imbalance it causes.

Doctors will not usually opt to refer a patient for a thyroidectomy, except in last resort cases. Surgeries carry risks and Doctors avoid them when a non-surgical treatment can instead be administered. If a Hashimoto's patient (autoimmune caused hypothyroidism) has a problem with not being able to be leveled out on thyroid hormone therapy and their ongoing blood retests for monitoring their treatment show continual wide fluctuations in the thyroid hormone levels (from normal to hypothyroid) on a set dose, they sometimes resort to thyroidectomies in these rare cases. Even more extreme cases are when Hashimoto's patients, also have the antibodies that causes Grave's Disease (TSI – autoimmune hyperthyroidism) and they go from hypothyroid to hyperthyroid, then back again, they might opt to remove this patient's thyroid gland but might first try a treatment called "block & replace". It is a relatively new treatment and still considered experimental in some medical circles but Doctors like to try everything possible, before referring a patient for thyroidectomy surgery.

I've gotten frustrated enough at problem-symptoms at times during my treatment for hypothyroidism to want my thyroid surgically removed as well. You might be surprised at how many patients have also contemplated this but most of us will just have to accept the results we get from hormone replacement therapy, which is often not perfect and sometimes even a little disappointing but far better than no treatment.

Thyroidectomies are only ordered when they are completely necessary.


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