Doctors Lounge - Surgery Answers
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Forum Name: Surgery Topics
Question: thyroid goiter surgery
|perfectbunny - Wed May 26, 2004 8:22 pm||
:!::?: :!: Been seeing a doctor for a year for Hasimoto, hypothyroid and a goiter. Synthroid perscription goes up every 2 months.
Goiter is slightly smaller.
Symptoms worse. Hard to swallow/breathe sometimes.
Doctor says that since goiter is slightly smaller the medicine is working even though the symptoms are getting worse. She isn't sure if we should do surgery now.
When is a good time to have thyroid surgery and just remove it? I mean if the perscription goes up every time I see her, doesn't that say it isn't working? How much of a shrinkage in the goiter is significant? can it shrink out the outwards appearance and yet grow inside and not be noticeable???
Any advice. Getting tired of going in every two months for the same medicine that I can't tell is working. :?: :?: :?:
|Dr. Tamer Fouad - Thu May 27, 2004 12:17 pm||
There are two problems with Hashimoto's thyroiditis: 1. The goitre which is related to the disease process (lymphocytes infiltrating the thyroid gland and destroying it as well as causing it to enlarge in addition to increased levels of TSH which also cause the gland to enlarge). 2. Hypothyroidism (decrease in thyroxine levels in the blood as a result of the gland being destroyed by the lymphocytes).
Your goitre problem is gradually subsiding which although a good sign, is not happening fast enough. Your main problem is your thyroxin levels, which should have normalized by now. As the dose becomes more accurate the levels of another hormone in the blood called TSH will start adjusting and this will be followed by further decrease in the size of the goitre. What are your latest TSH results?
Thyroid surgery is not without risks and complications, I would'nt rush to it if I were you.
Check the following links:
I think the main problem is adjusting your synthyroid dose. If you were to undergo thyroidectomy you would still be left with the problem of adjusting your synthyroid dose. If after dose adjustment according to serum TSH levels you still have problems from your goitre, then surgery is unavoidable.
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