Home Health Thyroid Diseases – Causes, Symptoms, and Treatment

Thyroid Diseases – Causes, Symptoms, and Treatment

Thyroid, the practical guideThyroid Diseases - Causes, Symptoms, and Treatment

The thyroid is an endocrine gland essential to the proper functioning of the body. However, it can be a victim of various pathologies that sometimes require until it is removed. Existing treatments are rather effective and allow to continue living even without the thyroid.

This site will help you, in all independence and with simple words, to better understand to choose well …Thyroid Diseases - Causes, Symptoms, and Treatment

Thyroid function

Thyroid function: hormonal secretion

The thyroid gland produces essentially thyroxine or tri-iodothyronine (T4) and tri-iodothyronine (T3) which circulate in the blood and play a crucial role in cell function.

Another hormone, calcitonin, is also produced in smaller amounts by C cells (located between thyroid vesicles). It participates in the regulation of calcium metabolism throughout the body by decreasing the level of calcium present in the blood.

It works in partnership with PTH produced by the parathyroid glands.

Overall, the thyroid:

  • provides the body with the energy it needs to function at its best;
  • regulates the functioning of the organs so that they “rotate” at the appropriate speed.

For this, the thyroid will synthesize its hormones before secreting them into the bloodstream.

Hormonal synthesis of the thyroid

To synthesize its hormones, the thyroid uses:

  • an amino acid: tyrosine;
  • the iodine.

Although present in minute quantities, iodine is captured and concentrated by the thyroid. Coupled with tyrosine, it becomes thyroxine.

Secretion of thyroxine

The secretion of thyroid hormones is placed under the control of the pituitary gland and a particular hormone: TSH (thyroid-stimulating hormone). The pituitary gland itself is stimulated by the hypothalamus via another hormone: TRH.

  • It should be noted that the pituitary gland functions as a feedback mechanism. This means that a constant control of the level of hormones in the blood allows it to launch or on the contrary to stop the hormonal production of the thyroid (or any other endocrine gland, for that matter).
  • Most of the thyroid hormones are secreted into the blood as thyroxine. This T4 represents approximately 80% of thyroid secretions.

They travel in the body by being coupled to transport proteins:

  • TBG (for thyroxin binding globulin);
  • TTR (for transthyretin) or TBPA (for thyroxin binding Prealbumin);
  • albumin.

However, a tiny fraction of these hormones (0.3% T3 and 0.03% T4) circulate in the blood in free form (without protein). It is this small portion that constitutes the active form of thyroxine, directly exploitable at the cellular level.

  • It will be this free form which alone will have an important diagnostic value in medical examinations.
  • With a relatively weak action, T4 can become much more powerful by converting into cells into triiodothyronine (T3).

Role of thyroid hormones

In their free form, the thyroid hormones penetrate the nucleus of the cells and allow the synthesis of a large number of proteins. Thyroid hormones also increase cellular metabolism.

Thus, the thyroid hormones will include:

  • manage energy production at the cellular level:
    • by stimulating energy expenditure,
    • producing heat (regulating body temperature);
  • control the reflexes by making the body more sensitive to catecholamines (adrenaline for example);
  • play a crucial role in development and growth;
  • allow maturation:
    • central nervous system (myelin synthesis),
    • cartilage conjugation (bone growth);
  • manage the transformation of food into organic compounds;
  • regulate the calcium level (amount of calcium present in the blood) by limiting it;
  • regulate the metabolism of:
    • protein,
    • carbohydrates,
    • lipids by accelerating their use by the cells of the body;
  • increase:
    • heartbeat,
    • blood pressure ;
    • sweating.

Hormones T3 and T4 play many other roles at:

  • dander (hair, hair, nails);
  • teeth ;
  • skin ;
  • of the digestive tract.

Parathyroid

Description of parathyroid glands

The parathyroid glands, located near the thyroid gland, are 4 (sometimes double), usually two superior and two inferior.

Measuring about 3 mm, their thickness is about 5 mm.

They play a vital role in the functioning of several organs, including:

  • kidneys ;
  • bones ;
  • the duodenum (part of the digestive tract that follows the stomach).

These small glands, located in pairs, most often on the back side of the side lobes of the thyroid gland (in 85% of cases), act on the body by releasing a hormone: parathyroid hormone (PTH).

Role of PTH

Parathyroid hormone (or PTH for parathyroid hormone) is used to regulate the levels of calcium and phosphorus in the blood.

  • By a feedback mechanism (via the blood that passes through the lower thyroid artery), when blood calcium levels decrease, the parathyroid glands will be stimulated to produce more PTH.
  • Conversely, an increase in calcium levels in the blood will result in a decrease in hormone production.
  • Parathyroid hormone has an antagonistic action to that of calcitonin, produced by the thyroid.

Renal role

PTH, at the renal level:

  • participates in the transformation of vitamin D to give it its active form;
  • promotes calcium reabsorption;
  • blocks the reabsorption of phosphorus.

Bone role

PTH participates in osteolysis (bone resorption) which results in the release of calcium and phosphate.

Intestinal role

In the duodenum, PTH activates the absorption of calcium, via vitamin D transformed at the renal level. The blood calcium level is thus regulated.

Parathyroid pathologies

Like the thyroid, the parathyroid glands are likely to have pathologies whose origins are poorly known.

  • Thus, they can grow and release much too much parathyroid hormone, resulting in hyperparathyroidism.
  • Conversely, hypoparathyroidism can occur when the parathyroid glands do not function well enough. This results in a lack of PTH which in turn causes hypocalcemia.

Thyroid pathology

The thyroid diseases are favored by some relatively well-identified risk factors that should be known.

Heredity of thyroid pathology

It has been shown that these thyroid diseases occur regularly in people of the same family.

This is particularly significant with regard to goiters and autoimmune pathologies (mostly Basedow’s disease).

However, depending on the case, the family grounds can favor thyroid diseases without it being systematically the same pathology that appears. For example, there will be a family history of thyroid cancer in a patient with a thyroid nodule or hypothyroidism, for example. In addition, women are four times more likely to be victims of thyroid disease than men. men. In fact, 80% of patients are women.

Thyroid disease: iodine deficiency

The second factor favoring thyroid pathologies is environmental. This is iodine deficiency. Indeed, thyroid and iodine are intimately related.

  • Iodine is only present in very small quantities in our diet, but the thyroid needs it to function.
  • Iodine deficiency increases the risk of developing thyroid nodules and goiters.

Salt contains a small amount, but it is especially recommended, to overcome this deficiency, to consume seafood products:

  • sea fish (cod, sardines, mackerel, etc.);
  • shellfish ;
  • algae, etc.
Note: Excess iodine is also harmful. Moreover, the real deficiencies are extremely rare in the industrialized countries.

Irradiation and thyroid pathologies

One of the most frequently mentioned risk factors for thyroid cancer is radiation or exposure to radioactive radiation.

The factor of increase of this pathology would be 80% for a dose of 1000 millisieverts. Sensitivity in girls is two to three times higher than in boys (a risk that gradually decreases until it disappears from the age of 35).

Note: studies carried out following the passage of the Chernobyl radioactive cloud do not establish any causal link between this event and the increase in the number of thyroid cancers in France. However, this cause cannot be totally ruled out (the Ukrainian children have not been spared).

The consequences of accidents such as those of Chernobyl, Fukushima or bombs dropped on Hiroshima and Nagasaki are not the only cases of irradiation. Indeed, the rays used in medicine (radiography and CT) can also increase the risk of thyroid cancer.

Diet and problems with the thyroid

The consumption of too much iodine is also harmful. Thus, if the consumption of food such as crustaceans and seafood can help fight a deficiency, a diet essentially composed of this type of food would, on the other hand, be likely to promote thyroid cancer.

  • Similarly, the excess of iodine found in Japan and attributed to the excessive consumption of algae could be at the origin of cases of hypothyroidism found in the archipelago.
  • A number of foods (called “goitrogens”) are also incriminated in the appearance of thyroid pathologies.

It’s about :

  • cruciferous:
    • cabbages (cauliflower, Brussels sprouts, red cabbage, white …),
    • broccoli,
    • radish,
    • rutabaga, etc. ;
  • soy (which inhibits thyroid hormones);
  • green tea (it could block the conversion of T4 to T3 in the liver);
  • cassava (especially poorly cooked);
  • millet;
  • sweet potatoes;
  • peanuts.

Thyroid and pollutants

Pollution is also mentioned as being able to favor the appearance of the thyroid pathologies. In particular, chemical pollutants and pesticides are mentioned.

Similarly, some drugs are cited as possibly causing thyroid cancer. This is particularly the case with:

  • pentobarbital;
  • griseofulvin;
  • spironolactone.

Other medications or allopathic treatments that promote the risk of hypothyroidism would be:

  • lithium;
  • amiodarone;
  • drugs to treat hyperthyroidism;
  • treatment with radioactive iodine;
  • radiotherapy.

In general, products containing iodine such as Betadine or some contraceptive pills could promote thyroid diseases.

Tobacco and thyroid pathology

Smoking can also promote the occurrence of certain thyroid diseases: goiter, Graves’ disease (hyperthyroidism). This would be due to the “goitrogenic” substance present in tobacco. But while smoking promotes the occurrence of hyperthyroidism, it rather plays a protective role against hypothyroidism.

In addition, smoking by the mother during breastfeeding is likely to decrease the amount of iodine present in breast milk. The infant’s thyroid may be affected.

In addition, smoking will be particularly detrimental:

  • in case of hyperthyroidism due to:
    • the increase in the conversion of thyroxine (T4 to T3) and therefore the decrease in the effectiveness of anti-thyroid treatment,
    • increased stress;
  • in case of Graves’ disease due to:
    • the risk of increasing exophthalmia,
    • greater risk of relapse if anti-thyroid treatment is discontinued;
  • in case of hypothyroidism or Hashimoto thyroiditis, as hypothyroidism can get worse (or it can be masked by a lack of symptoms).

Stress and thyroid

Although medically, the role played by stress in thyroid problems remains rather vague, its participation in the occurrence of these diseases has been highlighted.

Some therapists, decoders (practitioners in biological decoding or Biodecoding), rely exclusively on this aspect to treat thyroid pathologies, with sometimes spectacular results.

Independently of the daily stress, the thyroid pathologies would be due to an emotional conflict.

The conflict that can cause thyroid disease is related to time:

  • everything goes too fast and we do not find the time to do everything (hypothyroidism);
  • everything is idling while we are hyperactive ( hyperthyroidism ).

Ask people who have thyroid conditions, you will find in a considerable number of cases that in the weeks or months before the onset of symptoms, the person has experienced an emotional conflict of this kind.

Of course, to exploit this data, to call on a competent decoder therapist is necessary.

A headache and thyroid diseases

Regardless of all these factors, people who suffer from frequent headaches have a 21% increased risk of developing hypothyroidism.

Those who have frequent headaches even see their risk increased by 41%.

Rheumatoid Arthritis Maternal and Thyroid Diseases

According to a Danish study conducted over 13 years, mothers with rheumatoid arthritis (RA) increase the risk of having their child with thyroid or parathyroid disease, or other chronic diseases such as rheumatoid arthritis or epilepsy by a factor of 2.2.

For the authors of the study, this relationship could be explained by ”  the relationship in terms of autoimmunity between RA and thyroid disorders  .” It is therefore interesting that doctors and pediatricians take a close interest in children born to mothers with RA.Thyroid Diseases - Causes, Symptoms, and Treatment

Thyroid disease

Thyroid diseases: general

Nearly 5 million French people are affected by a thyroid pathology, so it is important to have a glimpse of these and their consequences.

There are two main types of thyroid diseases: hypothyroidism and hyperthyroidism.

To these are added the thyroiditis which are inflammations of the thyroid gland.

  • These attacks are common, especially in women.
  • Thyroiditis can be either autoimmune or non-autoimmune.

Autoimmune thyroid diseases

There are very specific thyroid diseases that fall into the broad categories of hypo and hyperthyroidism.

Basedow’s disease

The Graves’ disease is a chronic autoimmune disease. The immune system of the patient will produce antibodies that will stimulate the hormonal production of the thyroid, resulting in hyperthyroidism.

This disease is the most common cause of hyperthyroidism.

Thyroid Hashimoto

The Hashimoto’s thyroiditis, she will mainly result in hypothyroidism.

Frequently marked by goiter, this pathology is often associated with other autoimmune diseases.

Autoimmune polyendocrinopathy

The polyendocrinopathy autoimmune is marked by the combination of a set of conditions that lead to an inadequate secretion of various hormones by affecting the endocrine system.

This pathology is usually accompanied by other diseases affecting the thyroid, especially Hashimoto’s thyroiditis.

Non-autoimmune thyroid diseases

These are thyroiditis that is part of non-autoimmune thyroid diseases.

Acute thyroiditis

The acute thyroiditis is infectious.

It remains exceptional and is usually secondary to a bacterial infection by:

  • the bacillus of Koch;
  • Staphylococcus
  • a streptococcus.

Latrogenic thyroiditis

The iatrogenic thyroiditis includes a set of different thyroiditis having a drug-induced.

The most commonly encountered are due to a treatment:

  • amiodarone;
  • lithium;
  • alpha interferons;
  • interleukins-2.

Other thyroid conditions

Thyroiditis of De Quervain

The thyroiditis de Quervain ‘s thyroiditis, subacute that evolves in three phases:

  • hyperthyroidism;
  • hypothyroidism;
  • back to normal (euthyroidism).

It is different from other non-autoimmune thyroiditis.

Chronic thyroiditis of Riedel

The chronic thyroiditis Riedel (Riedel or fibrous thyroiditis) is both rare and benign.

In this disease, the thyroid gland will lose flexibility and fibrosis.

Thyrotoxicosis

The thyrotoxicosis represents all the physical manifestations due to the excessive presence of thyroid hormone in the bloodstream.

  • Thyrotoxicosis indicates hyperthyroidism manifested in particular by an acute thyrotoxic crisis.
  • It is necessary to distinguish the thyrotoxicosis from the factitious thyrotoxicosis, consecutive to an excessive consumption of substances generally intended to make to lose weight. This is more of an iatrogenic thyroiditis.

Thyroid cancer

There are several forms of thyroid cancer.

Most often, it is an adenoma. Less frequently, we are faced with a carcinoma.

The following cancers are found:

  • adenocarcinomas:
    • papillary (75% of cases),
    • vesicles (5%),
    • follicular (5%);
  • anaplastic (with modification of the glandular tissue);
  • medullary (they affect the thyroid C cells), which account for up to 10% of thyroid cancers.

Parathyroid

The parathyroid glands are likely to be affected by two major pathologies:

  • the hyperparathyroidism;
  • the hypoparathyroidism.

Thyroid symptoms

It is essential to differentiate the symptoms that suggest hypothyroidism or hyperthyroidism, especially since these are sometimes obvious to distinguish. In general, it should be noted that:

  • all that corresponds to a slowdown corresponds to hypothyroidism;
  • anything that leads to increased metabolism is similar to hyperthyroidism.

Symptoms of hypothyroidism

It is important to know how to identify the symptoms of hypothyroidism. It is possible to classify them into genres:

  • signs of general hypofunction;
  • skin symptoms;
  • neuromuscular symptoms;
  • the associated signs.

General malfunction

In hypothyroidism, the drop in thyroid hormone levels causes a decrease in tone throughout the body.

We find:

  • asthenia (generalized fatigue);
  • an excessive need for sleep
  • abnormal weight gain (while feeding remains unchanged)
  • excessive sensitivity to cold;
  • a slowdown in brain function:
    • troubles and loss of memory,
    • difficulty concentrating,
    • dyslexia;
  • slow heart rate (bradycardia)
  • slowing of transit (tendency to constipation and bloating).

Skin symptoms of hypothyroidism

Signs of hypothyroidism in the skin and mucous membranes are quite characteristic of the disease.

This entails:

  • a skin that can be:
    • cold,
    • dried,
    • blade,
    • thick,
    • infiltrated (tendency to water retention resulting in poor drainage);
  • a puffy face;
  • damaged integuments:
    • brittle or striated nails,
    • dry hair,
    • Hair loss;
  • mucous membranes in poor condition resulting in:
    • a modified voice (low and hoarse) with the involvement of the pharynx and vocal cords,
    • hearing loss, the quality of hearing decreasing with the involvement of the eardrum.

Neuromuscular symptoms of hypothyroidism

At the neuromuscular level, we find, in case of hypothyroidism:

  • a psychomotor slowing down;
  • a decrease in tone;
  • cramps and muscle stiffness
  • paresthesia (tingling in the limbs);
  • muscle spasms

Associated signs

The clinical signs associated with hypothyroidism are diverse and varied.

It can be:

  • menstrual cycle disorders;
  • pericarditis or heart failure;
  • hypercholesterolemia;
  • depressive tendency;
  • decreased libido.

Specific clinical signs

Some clinical signs are fairly specific to hypothyroidism and immediately guide the diagnosis.

These include thyroid goiters and generally an increase in the volume of the thyroid gland.

Clinical signs in children

In children, the main symptoms are:

  • stopping growth (or a marked slowdown);
  • difficulties in eating;
  • constipation;
  • a disturbed sleep.

Clinical signs in infants

In infants, finally, there is sometimes a mental retardation. However, the screening usually carried out allows rapid care which limits the consequences for the child.

Good to know: In a Danish study, mothers with rheumatoid arthritis (RA) increased the risk of having their child with thyroid or parathyroid disease by a factor of 2.2, which would lead to early detection of a number of children.

Symptoms of hyperthyroidism

In hyperthyroidism, the thyroid gland works in overgrowth. By secreting excess hormones, it will boost many functions of the body.

Note: this abnormally increased production of hormones (hyperammonemia) causes both tissue and metabolic pain: thyrotoxicosis.

Signs of general hyperfunction

With the excess of thyroid hormones, we find:

  • an increase in heart rate (tachycardia)
  • stress;
  • excitement;
  • hyperactivity;
  • diarrhea;
  • an abnormal weight loss (while the diet remains unchanged) since the body consumes more energy than usual.

Note: in 2% of cases hyperthyroidism can lead to weight gain.

Cutaneous and mucosal symptoms

Among the cutaneous symptoms of hyperthyroidism, some are quite significant:

  • the exophthalmos (bulging eyes);
  • a skin:
    • hot,
    • moist,
    • thinned;
  • fine and brittle hair.

Neuromuscular symptoms

We find muscular symptoms that reflect the tissue suffering:

  • muscle weakness (following muscle wasting)
  • amyotrophy;
  • difficulty in moving his eyes (due to exophthalmia).

Associated signs

The associated signs are quite significant changes made at all levels by the excess of thyroxine:

  • aggression;
  • irritability;
  • emotional hypersensitivity, but also sensitive (especially to light);
  • changing mood;
  • insomnia;
  • intolerance to heat with:
    • hyperactive (severe and frequent sweating),
    • thermophobia.

Other thyroid pathologies

Other thyroid diseases will present symptoms that are similar to one or other of the two major thyroid diseases just mentioned.

Hashimoto’s disease

The Hashimoto ‘s hypothyroidism autoimmune. The diagnosis is done through the aspect that makes the thyroid to ultrasound.

Basedow’s disease

Conversely, Graves’ disease is similar to hyperthyroidism, although it is also an autoimmune disease.

  • The exophthalmos is quite significant for this disease even if it can be of late onset and/or unilateral (only one eye is concerned).
  • Goiter is usually easily palpable.
  • Marked mood changes appear (cyclothymia, we go from euphoria to sadness).
  • Anxiety attacks and paranoia can also occur.Thyroid Diseases - Causes, Symptoms, and Treatment

Thyroid cancer

The thyroid cancer is relatively rare. It can come in many forms and have multiple causes.

Thyroid cancer: general

It mainly concerns the rather young people (3 times more women than men), but it represents only 1% of all cancers, or 4,000 people per year in France (a figure that has been steadily increasing since 1970).

There are 4 main categories of thyroid cancer:

  • papillary cancers, which represent about 70% of them (and which are the least dangerous);
  • vesicular (or follicular) cancers which constitute 10% of thyroid cancers and which mainly concern people around 40 years old;
  • medullary carcinomas (which affect C cells), or CMT (medullary thyroid carcinoma), which account for 5% of the attacks and which are hereditary for 25% of them;
  • Anaplastic (undifferentiated) cancers, which are serious, mainly concern the elderly and represent less than 5% of cases.

The first two are well differentiated, which means that they do not affect the cells to the point of destructuring them and make them lose their ability to fix iodine. When they are detected early enough (as is increasingly the case today), the prognosis is rather good.

Number of thyroid cancers / 100,000 people worldwide (2008-2012 period)
Type of thyroid cancerWomenMen
Papillary cancers13.863.75
Vesicular cancers0.980.49
Spinal cord carcinoma0.330.22
Anaplastic cancers0.090.06
All thyroid cancers combined15.264.52

Risk factors and causes of this cancer

With regard to thyroid cancer, the most frequently mentioned risk factor is irradiation:

  • as part of a radiotherapy treatment (X-rays are generally not sufficient to cause cancer);
  • through radioactive iodine.

Several epidemiological studies estimate that the Chernobyl accident, regularly mentioned, would not be involved.

With regard to the causes one will retain:

  • a family history (especially for spinal forms), between 3 and 5% of patients who had a parent also suffering from thyroid cancer  ;
  • iodine deficiency (the cause of goiter )
  • conversely, an excess of iodine: either by the diet or by a medicinal treatment  ;
  • repeated exposure to X-rays (medical personnel);
  • certain thyroid diseases: thyroiditis of Hashimoto, thyroidal nodule.

The emotional aspect highlighted in the biological decoding of diseases is also quite significant and could explain many thyroid pathologies whose origin remains obscure for classical medicine.

In the case of cancer, it is an intense emotional conflict, always linked to a notion of speed and lived:

  • quite unexpectedly;
  • in a dramatic way;
  • in isolation;
  • without an immediate solution.

Diagnosis of thyroid cancer

There are various medical tests to identify thyroid cancer.

  • Ultrasound allows, in case of a nodule, to specify its nature (liquid, solid or mixed), its size, whether it is unique or not.
  • Cytopuncture (in liquid nodules or cysts) allows fluid examination.
  • Scintigraphy can determine whether it is a hot or cold nodule (cancer risk).

The diagnosis can be made with more certainty (reliability of 95%) following a microscopic examination of the sample taken during the puncture. This examination will also determine the type of cancer.

The biological thyroid test makes it possible to identify the medullary cancers thanks to the calcitonin dosage.

Note: 75% of thyroid cancers diagnosed in recent decades are overdiagnosed (papillary tumors do not cause symptoms or life-threatening risk if left untreated). Thus, 470,000 women and 90,000 men would have been overdiagnosed and have received unnecessary treatment in 12 countries over 20 years, including about 50,000 French.

SYMPTOMS

Two symptoms must lead to consulting a doctor to ensure that you do not develop thyroid cancer  :

  • the presence of a nodule or ganglion at the base of the neck;
  • the modification of the prolonged voice (several weeks) without a particular cause.

Unfortunately, thyroid cancer is very often asymptomatic. It is most often accidentally discovered during examinations intended for other explorations: cervical ultrasound or CT scan, for example.

Treatment of this cancer

The treatment of thyroid cancer involves the thyroid surgery. It aims to remove all or part of the thyroid gland according to its reach, the extent of it and its location.

Surgical treatment

It is usually the removal of the thyroid that is preferred because the risk of recurrence in case of partial removal is very common. The operation also doubles as lymph node dissection which aims to eliminate all thyroid cells still present and which are likely to develop new cancer.

About one month after the intervention, a drug treatment is instituted. It is a cure of iodine 131 intended to destroy the residual thyroid cells.

In parallel, it becomes essential to set up a replacement treatment aimed at ensuring the role that thyroid cells should play. This is usually a thyroxine treatment.

Drug approach

Lenvatinib (Lenvima®) may also be used in patients with locally advanced or metastatic differentiated thyroid carcinoma refractory to progressive radioactive iodine.

This treatment is effective in 22 to 68% of cases (depending on whether it is a metastatic thyroid cancer or a differentiated thyroid cancer) and it leads to a reduction of the tumor.

There is also an increase in the progression-free survival of the disease (respectively 10.6 to 31.8 months against 4 in normal time). This prolonged survival also affects some patients with multiple metastases.

The most common side effects of Lenvatinib are hypertension, decreased appetite, hand-foot syndrome, fatigue, proteinuria, stomatitis, and diarrhea.

Prognosis

The prognosis of thyroid cancers is good. This is even truer when he is spotted quickly and intervenes in a young patient. In this case, healing is virtually assured, although regular follow-up must be in place for life.

People who have had a CMT, for example, have an average survival of 70% within 10 years of treatment, even though 57% of patients are not cured immediately after surgery.

On the other hand, the risks are slightly increased when the tumor is detected late (it is already somewhat extended) and it concerns an elderly person. In this case, post-treatment cancer progression cannot be ruled out. However, the treatment of possible metastases seems to give good results.

Followed

Follow-up is necessary, especially in cases of papillary and vesicular cancers. It consists of a blood test that verifies TSH (its level must be stable around 0.1), T3, T4, calcium, thyroglobulin (which must be zero), possibly anti-TG antibodies likely to distort the previous result.

Follow-up should be conducted as follows: every 6 months for the first two years and thereafter, for life every 2 years.

With regard to spinal cord cancers, the blood tests will verify:

  • the dosage of calcitonin (when the double rate within 6 months leads to death, which is extremely rare);
  • the rate of carcinoembryonic antigen.
Note: psychological help can be provided to the patient, especially with the help of a social worker.

Treat thyroid pathologies

Thyroid treatment

Thyroid Treatments: Different Treatments

The allopathic treatment of thyroid pathologies can successfully manage most thyroid diseases whatever they are. Several approaches exist depending on the exact disease, the two main ones being drug treatment and thyroid surgery.

Medication treatment of the thyroid

The first approach to pathologies of the thyroid gland is medicated.

Medicine does not know how to cure most of the thyroid diseases, like hypothyroidism for example, but it manages to contain them, to control them in part.

hyperthyroidism

In the case of treatment of hyperthyroidism, it is initially essential to return to normal functioning.

For this, there are:

  • anti-thyroid drugs that are intended to prevent the thyroid gland from producing hormones since they are already present in excess (the treatment is light and short for primary hyperthyroidism, but important and long for Graves’ disease );
  • radioactive iodine treatments that will destroy certain thyroid cells so that they stop producing hormones ( thyroid nodules and persistent cells of thyroid cancer are affected).

Hyopothyroidie

The treatment of hypothyroidism aims to replace the failed system by offering replacement hormones.

  • These are synthetic hormones, but they act exactly like the hormones naturally produced by the body if it functioned normally.
  • It is thyroxine (T4) which is the most imitated. Levothyroxine Sodium (Levothyrox) is available in tablets to be taken daily and most often for life.
  • In some cases, you may prescribe T3 (called Cynomel or TA3).

Medical monitoring

Medical monitoring is essential for performing a thyroid checkup and ensuring:

  • that the dosage of the drug is adapted;
  • that the levels of anti-receptor TSH antibodies (in case of hyperthyroidism ) are good.

Indeed, the needs of the body are likely to vary according to different factors (age, pregnancy, etc.).

This is usually an annual report.

Note: De Quervain’s thyroiditis is treated with corticosteroids or with anti-inflammatory treatment.

surgical treatment of thyroid diseases

The thyroid surgery can be used in various cases.

The operation is indicated in the case:

  • the treatment of thyroid cancer  ;
  • the treatment of a thyroid nodule (cancerous or progressing nodules, in particular);
  • a goitre (or nodule) that is truly disabling and interferes with breathing, for example;
  • Graves’ disease resistant to drug treatment or recidivism in the short term;
  • intolerance to anti-thyroid treatment;
  • impossibility or refusal of treatment with radioactive iodine.

It could be :

  • either a total thyroidectomy (one removes the thyroid gland) or almost total (one gram of thyroid tissue is preserved on the left as well as on the right);
  • a partial removal :
    • subtotal thyroidectomy (most of the gland is removed, but a small portion of thyroid tissue is left in place),
    • lobectomy (one thyroid lobe is removed leaving the other),
    • Nodulectomy (we remove only the part of the thyroid that is affected).

Thyroid diseases and alternative medicine

Thyroid pathologies can also be approached in alternative medicine with varying but extremely interesting results.

They generally come in addition to conventional allopathic treatment.

Thyroid and homeopathy

The homeopathy is able to offer different solutions to people who also suffer as well hyper hypothyroidism.

In addition to relieving a number of symptoms, it is also able to:

  • to stimulate the natural production of thyroid hormones;
  • contrary to curbing production.

Thyroid and diet

The diet plays a significant role in thyroid diseases and a number of foods should be avoided as much as possible. Others, conversely, must be privileged to promote the proper functioning of the thyroid gland.

Generally:

  • it will be necessary to avoid:
    • cruciferous (cabbage),
    • soy,
    • Peanuts ;
  • on the other hand, we can without fear consume food such as:
    • garlic,
    • onion,
    • the fish,
    • the crustaceans,
    • the seaweeds.
Note: Some supplements such as magnesium chloride or selenium can also be very helpful in fighting hormonal system disorders.

Hydrotherapy and thyroid pathologies

Hydrotherapy is an approach of choice in the treatment of thyroid pathologies.

It consists of combining several rules of hygiene of life which can, after some time, bear fruit.

It will be :

  • take baths to relieve the patient;
  • use plaster of seawater to reduce goitre or exophthalmia ;
  • to perform sitz baths;
  • to perform arm baths.

In general, iodine treatments may also be useful in some cases.

Decoding disease biology and thyroid

For biological decoding and from a psycho-emotional point of view, thyroid diseases are due to a related conflict:

  • if you need to do it faster:
    • “I do not have time to do everything,”
    • “Everything is going too slowly around me,”
    • “I have to speed up to do everything I’ve planned.”

Logically the thyroid will seek to produce more to meet this need: it is hyperthyroidism.

  • If necessary to slow down:
    • “I do not see the days go by,”
    • “Everything is going too fast around me,”
    • “People are doing everything fast, I can not keep up.”

Always so logically, the body will seek to slow down. As he has no grip on the outside, he intervenes on his own functioning: it is hyperthyroidism.

  • Of course, this is only a very schematic operation that is related to the personal and transgenerational history of each.
  • Especially since there are sometimes identification conflicts and memorized biological cycles that complicate this seemingly very simple system.

Hyperthyroidism treatment

Several treatments for several hyperthyroidisms

There are several types of hyperthyroidism and therefore several treatments, each adapted to the pathology concerned. We will first distinguish treatments for primary hyperthyroidism and treatments for Graves’ disease (the most common hyperthyroidism of all).

In all cases, treatments will be curbing treatments aimed at regulating the production and secretion of thyroid hormones.

What varies from one disease to another is the duration of the treatment and the dosage of the drugs.

The tablets used are:

  • neo-mercazole;
  • Basdene;
  • PTU (Propyl-Thyracil or Proracyl).

Treatment of primary hyperthyroidism

In the case of primary hyperthyroidism, it may be a short-term treatment and a light dosage.

  • The exact dosage will depend on the intensity of hyperthyroidism. In any case, the prescription will not exceed 40 mg, an already relatively high dose.
  • Stopping treatment occurs as soon as the thyroid gland regains proper functioning.

Treatment of Graves’ disease

The case of Graves’ disease is quite different from that of primary hyperthyroidism.

This time we will conduct an attack treatment assay from the outset very important.

  • It will last for nearly 2 months.
  • During the first month, white blood cell counts will be monitored every 10 days (due to potential side effects).

The treatment will then be progressively reduced under supervision according to:

  • the level of anti-TSH receptor antibodies;
  • thyroid hormone levels.

The treatment will only be seriously reduced after a significant decrease in the level of antibodies, but in all cases still very gradually.

Note that the treatment brake will eventually lead to hypothyroidism. In this case treatment of hypothyroidism at the treatment of a hyperthyroidism (ie Levothyrox and a treatment of a break) is considered.

We will stop the replacement treatment last and always very gradually to avoid a relapse.

Radioactive iodine treatment

It is also possible to carry out treatment with radioactive iodine treatment in the case where:

  • the patient has an intolerance to other drugs;
  • the initial treatment is ineffective.

Treatment of De Quervain thyroiditis

With regard to De Quervain’s thyroiditis, the treatment is very different from the hyperthyroid treatment since it is a corticosteroid treatment or with non-steroidal anti-inflammatory drugs, which is classic for inflammation.

Side effects of treatment of hyperthyroidism

The antihypertensive treatments of hyperthyroidism are not trivial and they can lead to a number of side effects that should be known:

  • allergies;
  • leukopenia (drop in the number of white blood cells).

When a side effect occurs, stopping treatment is always considered.

  • With regard to radioiodine treatment, the side effects are even more important as it can lead to sterility.
  • In addition, these treatments are harmful in case of pregnancy, both for the mother and for the child. It is therefore important to take precautions to avoid as much as possible to get pregnant in case of treatment.

Note: some treatments leave traces in the body even when stopped. It is, therefore, preferable to allow a period of a few months before considering pregnancy after stopping treatment.

Hypothyroidism treatment

Substitution hormones

The drugs used to treat hypothyroidism are hormone replacement therapy. They complement the thyroid hormones (T4 especially) or replace them completely when the thyroid gland does not produce anymore.

All hypothyroidism will be treated with the following medications that are to be taken daily.

Levothyrox

Levothyrox is the most known and most commonly used hypothyroidism medicine (3 million people in France).

Attention: in March 2017, Levothyrox changed the formula, with an identical active ingredient but with a withdrawal of lactose in favor of mannitol.

dosageOld colorNew color (= new formula)
25 μgGreenGreen (no change)
50 μgOrangeGrey
75 μgNavy bluePurple lilac
100 μgPinkDark blue
125 μgYellowSky blue
150 μgSky blueRed
175 μgLight blueOrange
200 μgCarmineBrown carmine

In 2017, a petition was launched by many French patients complaining of significant adverse effects of the new formula: intense fatigue, headaches, and weight gain.

For any question related to this change, the National Agency for Drug Safety (ANSM) has set up a toll-free number: 0 800 97 16 53. In addition, the ANSM advises people experiencing adverse effects related to the introduction of the new version of Levothyrox to consult their doctor, who can readjust the dosage if necessary.

Levothyrox pregnant women are invited to control their TSH within 4 weeks after taking the new formula.

Other medicines

Following the petition, the ANSM announced that from mid-October 2017, health professionals and patients suffering from thyroid disorders will have new drugs:

  • Levothyrox tablet new formula (Merck laboratory);
  • L-Thyroxin Henning tablet (Sanofi laboratory);
  • since the end of 2017, Thyrofix (Unipharma laboratories) is also marketed in four strengths: 25, 50, 75 and 100 μg;
  • as a last resort, Euthyrox tablet (Merck laboratory), a medicine equivalent to the old Levothyrox formula.

The latter drug is only available for a limited duration and quantities (not beyond 2018), the ANSM advises against its prescription. If it is nevertheless performed (for example in some patients who continue to experience adverse effects with the new Levothyrox formula), it must imperatively be after September 14, 2017, and specifically mention the specialty “Euthyrox” to be able to give rise to its dispensation in pharmacy.

Other drugs used to fight hypothyroidism are:

  • the Cynomel that can be associated with Levothyrox when the conversion from T4 to T3 is insufficient;
  • TA3 which like Cynomel can be associated with Levothyrox to bring a T3 supplement;
  • Euthyral includes both T4 and T3, but is therefore difficult to assay;
  • L-Thyroxine (SERB laboratory), unlike other drugs, is in the form of drops which facilitates the dosage (for the treatment of congenital hypothyroidism of newborns or for persons with a swallowing disorder, for example ) but that can be used by all patients.

In principle, it is not necessary to take T3-based treatments since the body itself converts from T4 to T3.

However, when a conversion problem exists, the T3 treatments will be indicated. Same thing if a problem of assimilation of the T4 is observed.

Note: Sometimes supplementing with T3 slightly stimulates the body to start producing it normally afterward.

Taking Levothyrox

For optimal effectiveness of Levothyrox, it is recommended:

  • to take it upon waking, on an empty stomach and half an hour before breakfast (the presence of food reduces by one third the absorption by the digestive tract);
  • to take no other medicine within two hours.

The dose of Levothyroxine can be modulated according to the feeling by decreasing or increasing the doses, but never exceed one half of a tablet of 25 micrograms only (ie 12.5 micrograms). Any changes must be very progressive.

In any case, you should never stop or change your treatment without medical advice.

In addition, do not worry if during the first shots (during 3 weeks) a number of reactions occur:

  • a headache ;
  • nervousness;
  • insomnia;
  • transit disorders;
  • palpitations.

Indeed, given the crucial role played by thyroid hormones, these manifestations are normal with the resting of the thyroid gland when hormonal supplementation arrives.

This does not mean that we switch to hyperthyroidism as these symptoms would suggest.

  • Similarly, the reappearance of typical symptoms of hypothyroidism in the month following the taking of the replacement therapy is normal. It takes time for the body and treatment to “settle”, especially since Levothyrox will not be fully active in the body until after 6 weeks of intake.
  • This type of reaction can be observed each time one readjusts his treatment (by decreasing or increasing it) since the thyroid has to readjust, hence the importance of making only incrementally progressive variations. Levothyroxine is a synthetic thyroid hormone called “narrow therapeutic margin”, the thyroid balance being sensitive to very small dose variations.

Note that Levothyrox can influence:

  • the goiter  ;
  • the thyroid nodules  ;
  • the thyroid cancer.

Thyroid and homeopathy

Principles of homeopathic treatment of the thyroid

Some homeopathic treatments can be of great help to some people with thyroid disease.

It is, however, necessary to take them at the first proven symptoms of thyroid pathology.

The two main ones are:

  • Iodum;
  • Thyroid.

We note that in homeopathy:

  • low dilutions stimulate the body and play on recent and acute diseases;
  • high dilutions promote its slowing down and treat chronic diseases.

Thus, the treatment will be adjusted according to the evolution of symptoms.

  • Moreover, as always in homeopathy, the action is global, hence the need to continue treatment over a long period.
  • This aid does not dispense to consult a specialist thyroid, on the contrary (even if it is generally resistant to the use of homeopathy). The idea is to combine allopathic treatments with homeopathic remedies.
  • In addition, only an experienced homeopath will be able to deliver the most appropriate treatment.

Iodum

Derived from iodine, this homeopathic treatment of the thyroid is suitable for the management of hyperthyroidism. In fact, homeopathic dose iodine is sometimes able to treat this disease.

Iodum and its derivatives (Arsenicum Iodatum, Calcarea Iodata, Kali Iodatum, Natrium Iodatum, Sulfur Iodatum) should be used when presenting the typical symptoms of this pathology:

  • signs of general hyperfunction;
  • tachycardia;
  • diarrhea;
  • slimming;
  • goiter  ;
  • exophthalmia  ;
  • stress;
  • irritability;
  • emotional hypersensitivity;
  • insomnia;
  • intolerance to heat with:
    •  diaphoresis (severe and frequent sweating),
    • thermophobia.

If these symptoms are relieved by cold and/or physical activity, then Iodum is especially indicated.

Since it is a hyperthyroidism, it will be necessary to use high dilutions (from 12 to 30 CH). This is a true background treatment.

The Vespa Complex No. 46 Lehning laboratories are also interesting to take 20 drops 3 times a day.

Thyroid

This homeopathic remedy for the thyroid is suitable for both hypo and hyperthyroidism.

  • It is more subtle to use than Iodum and will be prescribed by professional homeopaths as needed.
  • In case of hypothyroidism, we will move towards low dilutions (less than 9 CH).

Determine the right homeopathic treatment for the thyroid according to the symptoms

The following homeopathic solutions are to be adopted according to the symptoms of each one and respecting the rule:

  • low dilutions to stimulate;
  • high dilutions to brake.

In alphabetical order, we will remember:

  • Oriental Anacardium in 9 CH for:
    • memory loss (3 granules three times a day),
    • irritability (idem),
    • stress (between 3 and 5 gr three times a day),
    • depression (5 grams three times a day),
    • overwork ;
  • Graphites (in combination with Pulsatilla) in case of hyperthyroidism to reduce disorders (a dose of 15 CH per week):
    • digestive (as well as weight gain),
    • dermatological
    • articular
    • gynecological (including hot flashes);
  • Kali Carbonicum (in combination with Thuya and Silicea) to treat asthenias (severe fatigue) with edema;
  • Kali Iodatum can be used in combination with Arsenicum Iodatum, Calcarea Iodata and/or Natrium Iodatum to treat the hyperthyroidism that accompanies:
    • a Goitre,
    • of thyroid nodules,
    • of neurasthenia,
    • slimming,
    • heart problems;
  • Natrum Sulfuricum if disorders (morning diarrhea, edema of the lower body) are increased in case of humidity;
  • Nux Moschata in case of hypothyroidism with:
    • drowsiness (after emotional shock or annoyance),
    • loss of memory,
    • digestive disorders (bloating, constipation);
  • Sepia against hypothyroidism that comes with:
    • the descent of organs,
    • of pessimism,
    • hormonal insufficiency (all endocrine glands may be involved),
    • skin disorder (eczema, psoriasis).

Parathyroid gland disorders can be relieved thanks to Parathyroïdinum which will fight against the disorders aggravated by overwork, loneliness and the storm that are:

  • tetany;
  • decalcification;
  • osteoporosis;
  • spasmophilia;
  • palpitations.

Thyroid and Iodine

Hydrotherapy and thyroid

The hydrotherapy can be an interesting ally in the treatment of thyroid diseases even if you have to persevere with it.

The term hydrotherapy covers many practices that are not all used in the management of thyroid diseases.

As part of the treatment of thyroid pathologies in alternative medicine, hydrotherapy will:

  • to help find restful sleep through warm baths before going to bed or stomping in cool water for about 2 minutes (possibly in warm water if your feet are cold);
  • reduce goiters by applying compresses of seawater fifteen minutes each day (for lack of sea water you can salt fresh water);
  • to relieve the eyes in case of exophthalmia (again with the aid of a compress);
  • to relieve the heart in case of cardiac arrhythmia by performing arm baths every afternoon for about a minute.

Daily hydrotherapy

It is also recommended:

  • to pass a wet and cool glove on the body every morning;
  • to do sitz baths with fresh water;
  • to do footbaths;
  • to walk barefoot;
  • trampling in the morning dew (even in the snow or in the sea when at the water’s edge).

Of course, these elements, if they can be beneficial in everyday life, are not enough to provide lasting healing and it will be necessary to accompany them with a proper lifestyle (take the air, rest, enjoy the sun, do exercise) and a suitable diet.

Marine Plasma

Marine Plasma recommended by René Quinton allows to play at the level of the organism by:

  • renewing the internal environment;
  • purifying it;
  • regenerating it;
  • balancing it.

It can have an action on the dysfunctions that affect the thyroid gland as well as those that affect the parathyroid glands.

Isotonic seawater (diluted with fresh water) has no specific contraindication and is in the form of injections:

  • subcutaneous;
  • intramuscular;
  • IV.

These are usually performed every other day (two or three times a week).

The absorption of seawater, it is to be reserved for cases of hypothyroidism, it is not recommended for people suffering from hyperthyroidism.

Iodine and thyroid

Iodine naturally participates in the functions of the thyroid in normal times, it is in a way its fuel.

Iodine as a supplement

It may also be necessary to increase iodine consumption in the event of proven iodine deficiency (rare in industrialized countries).

This can be done by consuming:

  • seafood (fish, crustaceans, lumpfish eggs);
  • seaweed:
    • the laminar alga (Laminaria Japonica),
    • the dulse,
    • kelp (Fucus vesiculosus);
  • plants particularly charged with iodine.

This completion treatment is distinguished from the treatment of the thyroid with radioactive iodine.

The latter is intended to control, among others, hyperthyroidism. It is also involved in thyroid cancer treatment suites.

Note: On the other hand, iodine overloads can occur (for example, in case of algae abuse). Generally, these anomalies, transient, go unnoticed. They must be avoided, however, because an excess of iodine leads to an increased production of peroxidase which in turn will capture more iodine (if the anti-TPO antibodies function poorly). In the end, we risk hyperthyroidism.

Iodine in the aftermath of thyroid cancer

In the aftermath of thyroid cancer may have to be administered to patients with iodine 131.

The principle is as follows: residual thyroid cells (following a removal of the thyroid ) will capture iodine 131 and will be directly destroyed by the radiation emitted by it when it disintegrates.

To promote the fixation of this isotope at the level of thyroid cells:

  • either hypothyroidism is maintained (the patient does not take any replacement therapy) with all the symptoms that suppose;
  • either rhSTR (recombinant human TSH) is used by intramuscular injection, which gives the same results without stopping taking thyroxine.

Given the toxicity (radiation) of iodine-131, the patient is hospitalized, isolated in a special chamber.

This treatment is of course prescribed in pregnant women.

Thyroid surgery

To prepare the operation of the thyroid

The thyroid surgery is a treatment of choice for many thyroid diseases and is even one of the procedures performed in Europe.

It is necessary to prepare this operation by going first to a specialist of the thyroid, an ENT surgeon or endocrinologist. You will be told which anesthesiologist you will consult.

As with any surgical procedure that requires general anesthesia, the doctor will check with you for your weight, height, possible allergies, medical history (family, personal) and the treatments you are taking. This information allows the anesthesiologist to prepare the best injection he will give you and to give you the necessary information (do not smoke, fasting, etc.).

Note that some hospitals offer hypnosis interventions.

Operation of the thyroid proper

Once anesthetized, the surgeon will make a horizontal incision of 2 to 8 cm at the level of the lower neck, at the fold of the skin.

Depending on the thyroid disease and the diagnosis that has been made the surgeon will remove the thyroid (total thyroidectomy) or part of the thyroid gland only:

  • Nodulectomy: removal of a small portion of the gland;
  • lobectomy: removal of a single lobe;
  • lobo-isthmectomy: removal of a lobe and part of the isthmus;
  • isthmectomy: removal of the isthmus

It is possible that an extemporaneous analysis is carried out, which can lead the surgeon to intervene differently.

If cancer cells are found, for example, the surgeon can perform a total thyroidectomy (removal of the entire thyroid gland) while a lobectomy was planned, for example.

It may also be necessary to perform ganglion dissection to eliminate the risk of subsequent cancer.

Classical thyroid surgery

Several surgical methods exist. The thyroid surgery classic is used when the amount of tissue to be removed is large or if the operation promises to be complex.

Traditional practice causes the practitioner to remove the incised skin and muscles to have a direct approach to the gland.

Whenever possible the surgeon seeks to preserve the surrounding structures, which is possible thanks to a monitoring system that allows the therapist to identify areas to respect:

  • laryngeal and recurrent nerves;
  • parathyroid glands  ;
  • thyroid arteries, etc.

Minimally invasive surgery

This method is preferred when possible:

  • when the amount of tissue to be removed is small;
  • when the surgeon has the necessary skills;
  • when the hospital equipment allows it;
  • when this approach is suitable for the patient.

With minimally invasive thyroidectomy, the surgeon is video-assisted.

  • A small incision 3 cm long in the neck or arm allows sliding a mini magnifying camera. A second incision, just as small, makes it possible to introduce a tube with a sharp edge.
  • This second tube is the surgical tool that will be used to remove parts of the thyroid gland.
  • It is also possible today to perform a robot-assisted intervention. With this approach, the surgery visualizes in three dimensions and in an enlarged way the region which it approaches.

Robotic assistance allows you to perform extremely precise gestures, which allows you to:

  • to limit the risk of damage to surrounding structures;
  • to limit postoperative pain;
  • to recover more quickly;
  • to have a scar more discreet still than with the classic approach.

On the other hand, it is not really suitable for cancer, because surgeons prefer:

  • have an overview of the gland and surrounding ganglia
  • remove all the gland at once rather than in small successive pieces.

The surgical act itself

Surgery

Whatever the method used (traditional or minimally invasive), the surgical procedure consists in first clambering the arteries to stop the circulation at the level of the gland.

  • The practitioner then separates the trachea from the gland to dislodge and remove (all or part).
  • The incision is closed with staples or wires, drains (plastic pipe a few millimeters in diameter) are sometimes laid for two days.
  • The intervention for a total ablation lasts from 1h30 to 2h and a little more if one carries out a dissection ganglionic.

In post-operative

The skin closure is performed with a resorbable material for which no postoperative intervention is necessary.

  • Most often the scar following the procedure looks like a wrinkle of the neck; she is therefore discreet. It is sometimes more marked, but rarely.
  • If you have had minimally invasive surgery the scar is tiny and often goes unnoticed.
  • Healing is complete within 6 to 12 months.
  • Following the intervention, the patient stays in the hospital for one or two days, and replacement therapy is usually instituted (usually Levothyrox).
Note: If the parathyroid glands have also been removed, treatment to manage calcemia and phosphatemia will be needed. However, thanks to indocyanine green angiography, it is possible to know in advance if the parathyroid glands are properly vascularized. This avoids the routine prescription of calcium following the operation.

Complications during the intervention

Like any surgical procedure, zero risk does not exist. In addition, the operation of the thyroid, although frequent, remains a matter of specialists.

The most common risks are those common to all operations on the one hand:

  • hemorrhage, especially since the thyroid is very vascularized;
  • infection (local abscess) in less than 1% of cases;
  • those related to anesthesia.

On the other hand, those, more specific, related to thyroid surgery:

  • pains:
    • cervical (due to the position maintained during the operation),
    • at the throat,
    • swallowing;
  • edema of the area (for 1 to 3 months);
  • hematoma of the neck (in less than 1% of cases);
  • voice impairment (usually transient, but lasting from a few weeks to a year) due to recurrent nerve involvement, which may result in:
    • a hoarse voice,
    • an aphonia,
    • a weakness of the voice;
  • paralysis of a recurrent nerve (for 1 to 3 months, definitive in less than 1% of cases) with:
    • breathing difficulty during exercise
    • Swallowing disorders (especially fluid)
  • a problem of calcemia due to the involvement of the parathyroid glands (we find a transient hypoparathyroidism in 7% of cases).

Living without thyroid

Resume a normal life without the thyroid

activities

Resuming your usual activities is usually possible one to two weeks after your thyroid surgery.

It will be necessary however to remember that one is in convalescence and to avoid certain activities during that time.

Thus, it is inadvisable to:

  • lift heavy objects to avoid inconvenience as well:
    • muscle (at the level of the cervical muscles),
    • concerning the scar;
  • to drive (to wait to be able to turn the head without pain and without tension at the cicatricial level);
  • resume a sport.

Each case being particular it is especially essential to know how to listen to your body and to respect it.

It is likely that the hospital’s medical staff will advise you on exercises designed to promote recovery. They are important to practice so as not to risk suffering from residual stiffness in the cervicodorsal level.

Food

As far as food is concerned, it may have been a problem for the first time. Make it easy for you to eat foods that are soft and easy to swallow.

Take time to eat slowly and drink regularly and in quantity.

Psyche

It is usually the psychic symptoms that will be the most important and the most complicated to take care of.

It’s usually Graves’ disease that we do not come out unscathed. Even after treatment is in place, disorders such as lack of self-confidence, anxiety, and stress tend to persist.

In all similar cases, undertaking psychotherapy in addition to medical treatment can be quite profitable.

Treatment follow-up

It will be necessary to go to the fixed appointment with the specialist of the thyroid and/or the surgeon to control:

  • healing ;
  • your hormone levels ( thyroxine ).

Do not hesitate, during these consultations, to take all the information concerning the possible resumption of your activities (deadlines to be observed in particular).

  • It will of course, following this operation, take a substitution treatment in case of thyroidectomy in particular (most people who have undergone a subtotal thyroidectomy is also concerned).
  • This hormone treatment (usually Levothyrox) is essential for a normal life and not suffer from lack of thyroid hormones.
  • It is quite easy to take, it is small tablets to swallow every day and for life.

For optimal efficiency, the ideal is:

  • to take it upon waking, on an empty stomach and half an hour before breakfast;
  • to take no other medicine within two hours.

The dosage will be adjusted over time so that it is as suitable as possible. In any case, any change in quantity must be made as gradually as possible.

Controls on hormone levels should be regular.

Just after a thyroidectomy

After removal of the thyroid, it is necessary to take a little time to recover and consider life without a thyroid gland.

  • It is usually quite easy to resume one’s life as before by following a few simple rules and putting in place exercises to facilitate the resumption of one’s activities.
  • Recovery is different, however, depending on whether you have had traditional or minimally invasive thyroid surgery.

In case of traditional surgery

It is longer to recover from traditional surgery than following minimally invasive surgery.

This can lead to different symptoms, which in most cases tend to fade in the following weeks or months.

The most common complications are:

  • an alteration of the voice (usually transient, sometimes lasting for up to a year) by recurrent nerve involvement, which may lead to:
    • a hoarse voice,
    • an aphonia,
    • vocal fatigue,
    • a weak voice (difficulty speaking loudly)
  • a problem of calcemia (hypocalcemia) due to the involvement of the parathyroid glands  (we find a transient hypoparathyroidism in 7% of cases), which can lead to:
    • paresthesia (numbness, tingling) of the lips, hands, and feet;
    • a reluctance,
    • neuromuscular reactions: spasms, cramps, tetany,
    • headaches,
    • psychological reactions: anxiety and depression.

In case of minimally invasive surgery

The risks are the same, but they are much rarer. In addition, the fact of not having to remove the muscles of the neck to have access to the area of intervention limits the possible pains that could have caused the surgeon.

  • In both cases, it is possible to have the neck swollen and/or tense after the operation. This is often due to the prolonged position maintained during the procedure.
  • This type of tension fades as healing occurs.

Special care of the scar

It will be necessary, in the first days consecutive to a thyroid surgery, to take into account its scar.

  • Do not worry about a possible swelling or the appearance of a small hematoma. On the other hand, if the swelling is consequent, do not hesitate to contact your surgeon to avoid any risk of infection.
  • The behavior to adopt regarding the scar depends on the dressing that has been put in place.
  • Over time, usually, three weeks after the procedure, the scar will be hard and closed.
  • In case of tightness, the application of a hypoallergenic cream moisturizes the skin, soften and promote healing.

 

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