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Would Surgical Removal Of A Goiter Help Reduce Symptoms Of Hyperthyroidism?

Posted on Wed, 22 Aug 2018

Question: I would like to know if surgical removal of the goitre/thyroid gland will take away the symtoms of body pain and other problems being caused by Hyperthyroidism.
Is it advisable to go for the Surgery.
Will It be easier to deal with Hypothyroidism which i will become after the surgery.

Answered by Dr. Minal Mohit (32 minutes later)

Brief Answer:
Surgery is not the recommended treatment now a days.

Detailed Answer:

Hello,

I have reviewed your query and here is my advice.

Hyperthyroidism needs to be corrected and converted to either euthyroid or hypothyroid as the case may be. For this we have three options
1. surgery is one of them
2. radio iodine ablation
3. medical management.

Surgery is only indicated if the goiter is very large, causing compression symptoms.

Symptoms of body pain will persist with hypothyroid status as well. It will only be normalized with normal thyroid levels. Hypothyroidism is definitely easier to handle both for the doctor and the patient as well as less deleterious to health of the patient.

Regards.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Minal Mohit (57 minutes later)

my goitre is not very large.
Medical management - What medication can i take for the body pain, stiffness of joints. my tSH levels are not going up.
What will be the next steps for me to convert Hyperthyroidism to Euthyroid /hypo. is radioactive iodine therapy safe.

Answered by Dr. Minal Mohit (1 hour later)

Brief Answer:
XXXXXXX is safe.

Detailed Answer:

Hello Madam,

You must attain normal thyroid balance either through anti thyrox or XXXXXXX as of symptoms, you may take Vit D, Vit B12, Calcium.

Kindly let me know:
1. How long you have been hyperthyroid?
2. What are present medicines?
3. What is present TSH and FT4?

Regards.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Minal Mohit (59 minutes later)

I have been hyperthyroid for the last 8 years
I am taking Neomercazole 5 mg

THYROID STIMULATING HORMONE (TSH) 0.55
FREE TRIIODOTHYRONINE (FT3) 3.4
FREE THYROXINE (FT4) 1.13

Answered by Dr. Minal Mohit (5 minutes later)

Brief Answer:
Seems a normal report.

Detailed Answer:

Hello Madam,

The report seems normal.

Can we try bringing Neo-Mercazole to 2.5 mg for next 3 months and recheck the values?

If they continue to be good we can stop the drug, if they worsen, we can plan either XXXXXXX or again hit with full dose.

Regards.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Minal Mohit (2 hours later)

whenever i have stopped neomercazole the tsh drops to 0.27. i have tried this in the past.

is it ok to increase the dose straight to 2.5 from 0.5 mg - which B12 tablets should i take

Answered by Dr. Minal Mohit (13 hours later)

Brief Answer:
Dose is not increasing, it is decreasing.

Detailed Answer:

Hello Madam,

Dose is being decreased from 5 mg to 2.5 mg. There is no dose of Neo-Mercazole as .5 mg.

We will have to try as I told you, if TSH drops we will plan ablation, you can't continue Neo-Mercazole for life.

B12 - Becotrol by Pfizer, Matilda from Lupin or any other.

Take care.

Dr. Minal Mohit, Endocrinologist

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