It Regulates Practically Everything
January is Thyroid Health Month
Weighing less than an ounce, the butterfly-shaped thyroid gland is located low in the front of the neck. It is below the pharynx (voice box), wrapping around the larynx (windpipe). The thyroid helps regulate metabolism by controlling various endocrine system glands. 
Think of the thyroid like a command center that makes efficient use of the energy we possess. An underactive thyroid gland (hypothyroidism) can manifest the following symptoms:
- Difficulty with learning
- Dry, brittle hair and nails
- Dry, itchy skin
- Heavy and/or irregular menstrual flow
- Increased frequency of miscarriages
- Increased sensitivity to medications
- Pervasive fatigue
- Puffy face
- Sore muscles
- Weight gain and fluid retention
If these are the symptoms of hypothyroidism, how do people function after surgical removal of their thyroid gland?
My mother had her thyroid removed in the early 1960s. As a child, I was reminded by the characteristic 1-inch horizontal neck scar that she initially tried to conceal with jewelry but eventually faded. Hence, I have seen that life without the gland is possible. Even so, considering its importance, thyroidectomy is a last resort.
Thyroidectomy Reasons and Possible Complications
In 2014, 15,888 thyroidectomies were performed on Medicare patients in the United States.  There are three primary reasons for surgically removing the thyroid gland. They are: thyroid cancer, noncancerous thyroid enlargement (goiter), and overactive thyroid (hyperthyroidism). 
The most common complication after total or near-total thyroidectomy is hypocalcemia secondary to hypoparathyroidism, which occurs in about a third of cases. In a multi-center retrospective study of 1792 post-surgical patients, 48.3% developed postoperative hypoparathyroidism at discharge. Of these, 14.5% cases were permanent.  Many times, the complication is asymptomatic.
When symptoms develop, they can range from mild paresthesias to painful tetany and even life-threatening complications, such as laryngeal spasm or arrhythmia.
How to Function Without a Thyroid
How is life following a thyroidectomy possible? In the sense that people can live without them, the thyroid gland is “expendable.” By making adjustments to a hormone-replacement prescription, an endocrinologist can regulate the patient's metabolism. Doctors also advise regular exercise and vitamin supplements.
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- Your Thyroid Gland is More Important Than You Might Think. utmedicalcenter.org
- Francis DO, Randolph G, Davies L. Nationwide Variation in Rates of Thyroidectomy Among US Medicare Beneficiaries. JAMA Otolaryngol Head Neck Surg. 2017;143(11):1122-1125. doi:10.1001/jamaoto.2017.1746
- Thyroidectomy: Why it's done. mayoclinic.com
- Díez JJ, Anda E, et al. Prevalence and risk factors for hypoparathyroidism following total thyroidectomy in Spain: a multicentric and nation-wide retrospective analysis. Endocrine. 2019 Nov;66(2):405-415. doi:10.1007/s12020-019-02014-8. Epub 2019 Jul 17. Erratum in: Endocrine. 2019 Oct 22;: PMID: 31317524.
- Photography by zilli licensed from iStock Photo.
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