Is Total Thyroidectomy Advisable When Having Multi Nodular Goitre?

Posted on Mon, 30 Mar 2015

Question: I have a multinodular goiter with stable nodules having been biopsied. However, my two latest scans (last year and a couple of week ago) are showing possible lymph nodes. My endocrinologist didn't feel comfortable doing the biopsy of these because they are directly above and below the thyroid, but not directly on it. The thyroid surgeon I saw believes that due to the placement of the nodes, they will be difficult to biopsy. Because I have an extremely tender-to-the-touch thyroid and the need for yearly scans and biopsies, he is recommending total thyroidectomy. On one hand, I would be happy to get rid of the thing because it is so uncomfortable (even a light scan causes me discomfort for days after). On the other hand, I have read countless anecdotal accounts of individuals having a difficult time adjusting to life after a thyroid removal due to low energy, weight control, and hair loss issues even though properly medicated. Those three reasons would be my only hesitation in having it removed because I have already been on replacement for 20 years. I am a 55 year old female. I understand that the burden is on me to make this decision. One doctor doesn't mind monitoring me ad infinitum and the other thinks it should go for a better quality of life. If you were my doctor, what would you encourage me to do?

Answered by Dr. Chobufo Ditah (1 hour later)

Brief Answer:
I will recommend total thyroidectomy!

Detailed Answer:
Hi and thank you so much for this query.

I am so sorry to hear about this goiter and all the inconveniences this has caused you. I have reviewed your information fully and at this time, total thyroidectomy is my recommendation. It is true that after surgery there could be some difficulties, however, that happens in a very tiny proportion of the population. Most persons enjoy a better life and I will advice that you go for this. if this were a common side effect, believe me many more persons would never accept thyroid surgery. Unfortunately, many people do not tell their good stories and mostly the few post online and this creates real chaos in most persons who visit websites that are not very very representative of what goes on in the real patient and medical communities.

I hope this helps, I wish you well. Thanks for using our services and feel fee to ask for more information and clarifications if need be.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar