There’s a good chance a doctor has already uttered the word “thyroidectomy” to you if you’re reading this. Is getting your thyroid removed a big deal? The most straightforward answer is yes, it is a huge deal. It's a decision that will impact your body for the rest of your life.

Thyroid surgery can be a necessary, life-saving procedure for diseases like thyroid cancer, but many patients in online support groups report a concerning trend that suggests some endocrinologists are too eager to recommend thyroid removal for non-cancerous conditions. 

This article explains why having your thyroid removed is a big deal and explores the pros and cons of thyroidectomy so that you can have more productive conversations with your endocrinologist. 

Figuring Out Why Getting Your Thyroid Removed is a Big Deal: Weighing the Pros and Cons of Thyroidectomy

Making any major medical decision requires weighing the benefits and risks. Some of the popular arguments in favor and against thyroid removal include:

The Potential Pros of Thyroid Removal

A thyroidectomy can offer significant relief to the right candidates. This includes:

• Definitive treatment: Thyroid surgery provides a permanent solution for patients with conditions like hyperthyroidism, particularly when caused by Graves’ disease. It removes the source of excess hormones that are responsible for the patient’s symptoms. It could be a welcome alternative for patients who haven’t had success with anti-thyroid medications or those who have experienced adverse side effects from prescriptions like levothyroxine. 
• Eliminates cancer: Removing the thyroid is the standard treatment if your thyroid nodules are cancerous. Removing the thyroid gland gets rid of the cancer and, depending on the stage, may be the only treatment you need. 
• Relieving physical symptoms: A large goiter (enlarged thyroid) can cause discomfort, difficulty swallowing, or even trouble breathing. Removing the thyroid can immediately relieve this physical pressure. Goiters have been noted to change in size, however, due to factors such as correcting iodine deficiency. 

The Cons and Risks of Thyroid Surgery

The risks of having your thyroid removed go way beyond a scar on your neck. Some of the main things to consider include:

• Lifelong hormone replacement: Your body loses the ability to produce thyroid hormone if your thyroid gland is removed. This means you’ll need to take a daily hormone replacement pill such as levothyroxine for the rest of your life to avoid symptoms of hypothyroidism (an underactive thyroid or missing thyroid in your case) like fatigue, weight gain, and depression. Some patients report having a lower quality of life after a thyroidectomy, even with medication, and struggle to find the ideal dosage that makes them feel “normal” again. 
• Permanent voice changes: Your thyroid is nestled next to the nerves that control your vocal cords, and these nerves can be damaged during the surgery. This can lead to permanent hoarseness in your voice, a weakened voice, or difficulty speaking. It’s a serious risk to consider when making your decision. 
• Damage to parathyroid glands: Located behind your thyroid, these four tiny glands help regulate your body's calcium levels. You can develop hypoparathyroidism if these glands are accidentally removed or damaged during surgery, which leads to low calcium, which, in turn, causes numbness, tingling, muscle cramps, and, in severe cases, seizures. 
• Other surgical risks: As with any surgical procedure, thyroidectomies carry the standard risks of bleeding, infection, and anesthesia-related complications. 
  
  

The Red Flags: When to Slow Things Down

It’s your body, and you have every right to be an active participant in your healthcare journey. You should be concerned if your doctor suggests thyroid removal before exploring less invasive options for non-cancerous conditions like hyperthyroidism, especially since research shows it can be induced by iodine supplementation. 

Likewise, if your physician is pushing thyroid removal simply because you have a non-cancerous goiter, this is also something to question further such as evaluating your iodine intake as many physicians will assume that your iodine intake is appropriate if you live in the US. They may fail to consider that some patients with a history of eating iodine excess note that they have identified that iodine-rich foods make them feel ill and avoid these foods. 

Some patients have even reported to us that they believed iodine was “bad” or that they had an iodine “allergy” when they were trying to communicate that iodine-rich foods were making them nauseous. 

Our founder, Marion Davis, had this same experience after iodine-induced hyperthyroidism once her TSH resurfaced of feeling nauseated eating any iodine-rich foods, but this slowly dissipated over a period of nearly a year as her body cleared the iodine excess.  

Other red flags to watch out for include:

• Your endocrinologist frames the surgery as the “easy” option because managing your medication is “too complicated.” Your care should be individualized, not streamlined for your doctor’s convenience. 
• The doctor tells you, "hyperthyroidism is never reversible." While this holds for some conditions, it’s not universal. For example, iodine-induced hyperthyroidism and hypothyroidism can be managed and, even, reversed by identifying the source of a patient’s excess iodine and addressing it. 
• The physician dismissed questions you have regarding exploring root causes and alternative treatments, like anti-thyroid drugs such as Methimazole or symptom management drugs such as beta-blockers.

Your Action Plan: What to Do Before You Decide

Make sure you’ve done your homework before consenting to irreversible thyroid surgery.

• Ask your doctor questions such as "Why is a thyroidectomy the best option for me right now?" Their answer should be specific to your diagnosis, symptoms, and overall health.
• Discuss the full range of treatment options available to you. This includes alternatives like anti-thyroid medications or radioactive iodine treatment. Ask about the pros and cons of each procedure regarding your unique health. Specifically ask your physician to list approaches to treatment from lowest risk to highest risk, and how severe your current health status is. Be careful about fearmongering. If your physician cannot clarify that you have a condition that puts you at great immediate risk that justifies choosing the most intensive, high-risk approach to treatment, this can indicate a mismatch in how the physician is approaching your care that might not be putting your best interests first. 
• Get a second opinion. It can help confirm the first recommendation you received, giving you peace of mind, or offer a less invasive alternative that wasn’t previously considered. 
• Investigate the root cause. Ask your doctor to help you understand the underlying reason for your thyroid issues. Is it Graves' disease? Thyroid nodules? What caused the nodules? Could the hyperthyroidism be related to iodine intake or other factors? You can't fix a problem you don't understand.

Don't Go It Alone: Arm Yourself with Knowledge

Figuring out if thyroid surgery is right for you can be overwhelming, and some patients end up getting rushed into deciding before they have a clear understanding of what’s going on in their bodies. There are often many emotions involved with doctors pushing fearfulness and driving patients into emotion-based decision-making instead of creating a situation where both physician and patient can make calm and rational decisions, exploring risks and benefits fully.

That’s why we’ve created resources like our course, Are You Consuming Too Much Iodine? Excess Intake & Thyroid Disorders, to help you bridge the gap between Dr. Google and your doctor’s office. 

Our course is designed specifically for you if your physician has been dismissive of your questions regarding iodine and the impact of other root causes on your thyroid health. It will help you understand the complex relationship between iodine and your thyroid gland so that you can walk into your next appointment armed with intelligent questions. 

You have the right to question care recommendations provided by your physician. You have the right to understand. And you absolutely have the right to be armed with the latest research when making healthcare decisions. Sign up for our newsletter for updates as new resources are released.