The thyroid gland lies in the front of the neck and produces a very important hormone called thyroxine, which regulates the metabolism of the body. A normal thyroid gland cannot usually be easily seen or felt.
Reduced production of thyroid hormone (myxedema)
It is quite common for the thyroid gland to become underactive and produce insufficient thyroxine. This may lead to tiredness, depression, weight gain and constipation. This condition is known as myxedema and can be easily diagnosed with a blood test and simply reversed by taking a daily supplement of naturally occurring thyroid hormone.
Increased production of thyroid hormone (thyrotoxicosis)
The thyroid gland may become overactive with the uncontrolled production and release of thyroxine. This will result in restlessness, increased appetite, weight-loss, difficulty in sleeping, feeling hot and sweaty and sometimes palpitations. Thyrotoxicosis is diagnosed by a blood sample and you will usually be referred to an endocrinologist, who will prescribe medication, and monitor the progress of the condition. In some people the over-activity of the thyroid will settle naturally in time, but in many the condition will persist. If thyrotoxicosis fails to settle, then a permanent cure for the condition is either an operation to remove the thyroid gland or treatment with radioiodine which destroys the thyroid tissue.
Thyroid enlargement or swelling (goitre)
Sometimes the thyroid gland can become enlarged producing a visible lump in the neck. Swelling of the thyroid gland is in most instances entirely benign, but it does need to be investigated by either an endocrinologist or specialist thyroid surgeon usually by ultrasound initially. Sometimes, a needle biopsy of the swelling will be organised to diagnose the cause of the thyroid swelling. It is extremely safe and will cause minimal discomfort. You may also need further blood tests to enable an accurate diagnosis to be made.
Sometimes the needle biopsy may either diagnose a tumour or suggest the possibility of a tumour. In this situation your consultant will recommend that the swelling is removed to obtain a definite diagnosis. This operation is known as a thyroidectomy. It is very important to understand that tumours or growths within the thyroid gland almost always run a very benign course, and prompt surgical removal and further non-invasive treatment achieve a permanent cure.
Thyroid surgery (thyroidectomy)
A thyroidectomy is the surgical removal of half or all of the thyroid gland. Operations are necessary to remove swellings that may be malignant, treat thyrotoxicosis or remove very large thyroid glands that are exerting pressure on the oesophagus or trachea. The operation on the thyroid is carried out through a curved horizontal incision in the lower central portion of the neck. Your surgeon will either remove one half of the thyroid or the whole of the thyroid gland. At the end of the operation the incision is closed with a stitch and a small tube is usually left in the wound for 24hr to drain any tissue fluid. You will usually need to stay in hospital for one or two nights.