HomeAnswersEndocrinologygraves' diseaseIs surgical removal of thyroid gland the only option for recurrent diffuse toxic goiter?

I get recurrent diffuse toxic goiter. Should I go for complete removal of thyroid gland?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Vinodhini J.

Published At April 17, 2020
Reviewed AtJanuary 5, 2024

Patient's Query

Hello doctor,

I am a 34-year-old male and have an issue with my thyroid gland. I was diagnosed with diffuse toxic goiter in 2005 (age 19), and ever since I have been on medical compensation (Thyrozol). I have taken 20 to 30 mg of Thyrozol for couple weeks, then gradually reduce the amount to zero. After a couple of weeks (month) symptoms were back, and I resumed to medication. Last recurrence appeared a month ago and my doctor recommended surgery, complete removal of thyroid gland. Currently, I am taking 30 mg of Thyrozol to prepare for surgery. As surgery leads to hypothyroidism is any other options I have in this situation?

Last tests results (before getting medications):

TSH - 0.008

T4 - 2.9

TSH receptor autoantibodies - 6.32.

Answered by Dr. Zulfiqar Ahmed

Hi,

Welcome to icliniq.com.

There are three ways to treat hyperthyroidism as what you are having. First is with medication and you are already taking that. Usually, it is given for 18 months but 50 % of people will have recurrence once they stop medications so the choice is to either continue the medication for life long or go to the other modality which is either thyroid surgery or radioiodine therapy. Now you are advised to have thyroid surgery which has two main complications one is complications during surgery including bleeding, infection, and losing voice due to recurrent laryngeal nerve damage and you will need thyroid hormone for the rest of your life for hypothyroidism. About radioiodine, it is one of the best treatments nowadays available right now. It has a very low chance of malignancy which may be negligible. It can cause hypothyroidism as well but it is over years. If your goiter is causing problem like you do not like its appearance or it makes difficult for you to breath which it can cause once it enlarges and obstructs the air pipe. So if that is the case you can go for surgery.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Zulfiqar Ahmed
Dr. Zulfiqar Ahmed

Diabetology

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