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Treatment for Overactive Thyroid

Thyroid Surgery

Surgery is another permanent treatment for overactive thyroid. However, it is used less often because of the greater relative risks compared to medicines and radioiodine therapy. Surgery for an overactive thyroid removes part or most of the thyroid gland.
Some reasons it may be recommended include:
  • To treat pregnant women who cannot tolerate antithyroid drugs
  • When very large goiters block the airways, making it hard to breathe
  • When antithyroid medicines are not well tolerated and the person is unwilling to use radioiodine
  • To treat cancerous thyroid nodules.
Before surgery, healthcare providers may temporarily bring the thyroid hormone levels into the normal range with antithyroid drugs. This presurgical treatment prevents a condition called thyroid storm -- a sudden, severe worsening of symptoms -- that can occur when people with hyperthyroidism have general anesthesia.
A few days before a scheduled surgery, healthcare providers may give nonradioactive iodine drops, such as Lugol's iodine or supersaturated potassium iodide. This extra iodine will help reduce blood supply to the thyroid gland and make the surgery safer.
When part of the thyroid is removed -- as a treatment for toxic nodules, for example -- the thyroid hormone levels may return to normal. But some people who undergo surgery may still develop hypothyroidism and need to take synthetic thyroid hormone.
If the entire thyroid is removed, a person will need lifelong thyroid hormone replacement therapy. After surgery, the healthcare provider will continue to monitor thyroid hormone levels.
Although uncommon, certain problems can occur with thyroid surgery. For example, the parathyroid glands could be damaged because they are located close to the thyroid gland. Parathyroid glands help control calcium levels in the body.
Damage to the laryngeal nerve, also located close to the thyroid gland, could lead to voice changes or breathing problems. When surgery is performed by an experienced surgeon, however, less than 1 percent of people have permanent complications.
Last reviewed by: Arthur Schoenstadt, MD
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