Q: Is taking thyroid hormone medication for life dangerous?
A: It is not dangerous if taken according to the prescribed dosage by the doctor, as it is an essential hormone that the body needs for the normal functioning of various organs. However, if the thyroid hormone levels in the body are higher or lower than normal, the body’s functions in many systems will be abnormal.
Q: Are there any foods to avoid or be cautious about if you have thyroid disease?
A: It is not necessary to avoid or abstain from any foods. You can eat normally and there is no need to take any supplements.
Q: If there is a lump in the neck, how can I know if it is thyroid cancer?
A: The risk factors that raise suspicion of thyroid cancer include occurring in people under 20 years old, being male, having a lump that keeps growing, difficulty swallowing, and difficulty breathing. If you have these risk factors, you should see a doctor. The most accurate way to determine if it is thyroid cancer is to remove the lump for examination or to have a fine needle aspiration biopsy performed by a specialist.
Q: Is it true that after thyroid surgery, you will lose your voice?
A: Normally, the thyroid gland lies very close to the nerves that supply the vocal cords above the trachea. Thyroid surgery carries a 1-5% risk of injury to these nerves, depending on the size of the lump. The larger or more inflamed the lump, the higher the risk of nerve injury. The risk of nerve injury is almost the same between open surgery and endoscopic surgery nowadays. If these nerves are injured, it will cause hoarseness, not complete loss of voice. The hoarseness may be temporary (3-6 months if the injury is partial or just bruising) or permanent (in cases where the nerve is completely cut in two). During surgery, the surgeon will try their best to preserve these nerves and avoid injury unless there is an unavoidable circumstance.
Q: What is the difference between open surgery and endoscopic surgery?
A: The most obvious advantage of endoscopic surgery compared to open surgery is that there is no scar on the neck. However, wherever the surgical incision is made, there will be a scar there. For example, endoscopic surgery through the armpit will leave a scar in the armpit fold, through the nipple will leave a scar at the junction between the nipple and the skin, and through the mouth the scar is hidden in the groove between the lower teeth and lower lip, resulting in 100% no visible scar on the skin. Additionally, endoscopic surgery has faster recovery and less pain than open surgery.
Q: After thyroid surgery, if there is numbness, should I take calcium?
A: The parathyroid glands produce parathyroid hormone, which affects calcium levels in the blood. There are two parathyroid glands located close to each thyroid lobe on each side. In surgery removing one thyroid lobe, this problem usually does not occur because the parathyroid glands on the other side remain. The problem usually occurs in patients who have both thyroid lobes removed, where the parathyroid glands may also be removed, causing low blood calcium and resulting numbness. The surgeon will try to preserve all four parathyroid glands. Another case is when the parathyroid glands are preserved but the blood supply to them is temporarily disrupted during surgery, causing temporary reduced function, which usually recovers over time.
Q: After thyroid removal surgery, do I need to continue taking medication?
A: If only one side is removed, it is not necessary to take hormone medication because the remaining thyroid lobe can function normally (in fact, as little as 4 grams of thyroid tissue can function). However, if both sides are removed, the patient must take small white thyroid hormone tablets for life.
Q: How large can a neck lump be before endoscopic surgery is not possible?
A: For endoscopic surgery through the armpit, the suitable thyroid size is no more than 6-7 cm and can only be done on one side. If there are lumps on both sides, surgery must be done through both armpits. For endoscopic thyroid surgery through the mouth, the size should not exceed 10 cm and can be done on both sides. Always remember, the larger the size, the more difficult the surgery and the lower the success rate of endoscopic surgery.
Q: Can hyperthyroidism be treated with surgery?
A: For hyperthyroidism, current recommendations are to start treatment with medication for 2 years. Surgery is considered only if after more than 2 years of medication the hormone levels remain high, there is exophthalmos or other complications from hyperthyroidism, allergy to medication, or inability to tolerate the medication.
Q: How should I prepare before and after surgery?
A: Before surgery, you can eat normally with no food restrictions except avoid supplements like fish oil or cod liver oil because they can increase bleeding risk. Try not to catch a cold before surgery as anesthesia cannot be administered if you have a cold. After surgery, during the first 24 hours, avoid forceful sputum expulsion, strong coughing, or shouting as these increase the risk of bleeding. Other than that, you can follow normal activities.
