Total thyroidectomy
Removal of the entire thyroid gland - results in permanent hypothyroidism requiring lifelong levothyroxine.
A total thyroidectomy is an operation to remove the whole thyroid gland - the most extensive form of thyroid surgery.
It is most commonly performed for: thyroid cancer (to remove all tumour tissue and enable radioactive iodine treatment and thyroglobulin surveillance afterwards); large or compressive goitres; Graves' disease as a definitive treatment option; and other selected conditions.
Because the entire thyroid is removed, the body has no means to produce its own thyroid hormone. Levothyroxine replacement is therefore required for life, beginning immediately after surgery. For thyroid cancer, the levothyroxine dose is sometimes set slightly higher to suppress TSH and reduce stimulation of any residual cancer cells - a decision the specialist team will make.
The main surgical risk specific to total thyroidectomy relates to the parathyroid glands - four tiny structures near or behind the thyroid that regulate blood calcium. Removing all thyroid tissue increases the risk of inadvertent parathyroid disturbance, which can cause temporary or, rarely, permanent hypoparathyroidism with low blood calcium. Calcium levels are monitored carefully after the operation.
Common questions
What happens to my parathyroids if my thyroid is removed?
Related terms
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