Hyperthyroidism: When an Overactive Thyroid Requires Surgical Treatment

Hyperthyroidism is a condition in which the thyroid gland becomes overactive and produces excessive amounts of thyroid hormones. These hormones control many essential body functions, including metabolism, heart rate, and temperature regulation. When the gland produces too much hormone, the body’s systems speed up—often leading to disruptive and sometimes dangerous symptoms.

The Role of the Thyroid Gland

The thyroid is a small, butterfly-shaped gland located in the front of the neck. It is part of the endocrine system and plays a vital role in regulating the body’s metabolism. Hyperthyroidism occurs when this gland overproduces thyroid hormones (T3 and T4) leading to a state of heightened metabolic activity.

Signs and Symptoms of Hyperthyroidism

Symptoms of hyperthyroidism can vary, but may include:

  • Rapid or irregular heartbeat (palpitations)
  • Unexplained weight loss
  • Increased appetite
  • Diarrhea
  • Nervousness, anxiety, or irritability
  • Tremors (shaking hands or fingers)
  • Heat intolerance and excessive sweating
  • Difficulty sleeping
  • Fatigue or muscle weakness
  • Goiter (enlarged thyroid gland)
  • Changes in menstrual patterns

If you are experiencing a combination of these symptoms, it is important to speak with your healthcare provider for further evaluation and possible surgical referral.

Types of Hyperthyroidism

There are two common types of hyperthyroidism.

One type is caused by a hyperactive nodule within the thyroid gland, also known as a “hot nodule.” This is typically diagnosed with a specialized nuclear medicine scan.

The other common type of hyperthyroidism is caused by antibodies, or self-made molecules, that stimulate the entire thyroid gland to overproduce thyroid hormone. This condition is usually called Grave’s disease, and it is typically diagnosed with a lab test that looks for the specific antibodies that overstimulate the thyroid.

When Surgery May Be Indicated for Hyperthyroidism

Surgery is usually indicated for a hot nodule. A thyroid lobectomy, or removal of the thyroid half that has the hot nodule, is the standard treatment for most hot nodules. The other half of the thyroid will continue to produce a normal amount of thyroid hormone in most individuals.

Surgery or radiation therapy are both options for treating Grave’s disease. There are risks and benefits to both treatments. A discussion with Dr. Justin Malek can help you decide which treatment would be most desirable for your unique situation. If surgery is the preferred route, the whole thyroid gland will need to be removed. Leaving a portion of the thyroid behind in Grave’s disease can result in persistent hyperthyroidism.

Both thyroid lobectomy and total thyroidectomy are considered very safe and effective treatments. Most patients are able to go home the same day.

How is Surgery Performed?

Both lobectomy and total thyroidectomy are performed through a minimally invasive neck incision. Care is taken to preserve all of the important structures in the neck during removal of the thyroid. The incision is typically concealed within a natural neck line and closed with a plastic surgery-type closure using dissolvable suture to minimize scarring.

What can I expect after surgery?

Most patients can go home the same day as surgery. You may shower after surgery and resume most normal day-to-day activities within 24 hours. The only restrictions include avoiding heavy lifting or straining for 1 week and avoiding underwater activities for 2 weeks. Most pain is controlled with an ice pack and acetaminophen. You may be given a prescription for additional pain medication, thyroid hormone supplementation, or calcium supplementation. Dr. Justin Malek will review your new prescriptions with you before and after surgery.

Hypothyroidism vs Hyperthyroidism

Hypothyroidism is the opposite of hyperthyroidism and is a condition in which the thyroid gland does not produce enough thyroid hormone. It is a condition that does not generally require surgery and is managed by a primary care physician or endocrinologist through medication and regular monitoring.

Expert Surgical Consultation in Birmingham, AL

If you have been diagnosed with hyperthyroidism and are exploring surgical treatment options, contact board-certified general surgeon Dr. Justin Malek in Birmingham, AL. He has completed additional specialized training in endocrine disorders requiring surgery at Emory University and would be happy to review your specific case to determine if surgery could be helpful for you.

Call (205) 595-8985 to schedule an appointment at our general and endocrine surgery clinic in Birmingham, AL today.