Before thyroid surgery

This guide is about preparing, not deciding

Whether or not to have a thyroidectomy is a decision to make with your surgical and endocrine team based on your individual circumstances. This guide is for people who have already had that conversation and are now preparing for surgery - it covers what to organise, what questions to ask, and what to think about beforehand.

Practical preparation checklist

Your surgical team will give you pre-operative instructions specific to your operation. These general points are worth thinking about in advance:

• Fasting: you'll be told not to eat or drink for a period before the operation. Follow your team's specific instructions.
• Medicines: some medicines need to be paused before surgery. Go through your full list - including supplements - with your surgical team or anaesthetist. Don't stop anything without being told to.
• Antithyroid medicines: if you're on carbimazole or propylthiouracil ahead of surgery for hyperthyroidism, your team will tell you whether and when to continue or pause these.
• Arrange time off and support: most people stay in hospital for one to two nights and need one to two weeks before returning to light activities. Have someone at home for the first few days if you can.
• Prepare your home: loose, comfortable clothing that doesn't need to go over your head is useful. Have easy meals available and plan for limited lifting for the first week.
• Driving: you're unlikely to be able to drive for at least a week - make travel plans in advance.

Before the operation: questions to ask your surgeon

Write these down before your pre-operative appointment and take them with you:

• What type of surgery am I having - total thyroidectomy, hemithyroidectomy, or something else?
• How long is the operation, and how long will I be in hospital?
• What are the specific risks I should know about for my operation?
• What are the chances of voice change, and how is the recurrent laryngeal nerve protected?
• How will my parathyroid glands be managed, and what should I watch for with calcium afterwards?
• What happens to my thyroid medication after surgery - when do I start levothyroxine, and how is the dose determined?
• Will I need radioactive iodine after surgery, and if so, what does that involve?
• What does recovery look like - what can and can't I do in the first days and weeks?
• What wound care will I need?
• Who do I contact if I have concerns after discharge?

Questions about what happens after

• When will I have my first blood test after surgery?
• If I'm having surgery for cancer, what is the follow-up pathway?
• If some thyroid tissue remains, how will function be monitored?
• Is there a clinical nurse specialist or key contact I can reach if I have questions at home?

On the day: a few things to remember

• Bring a list of all your current medicines
• Remove nail varnish and jewellery before attending if your team asks
• Bring something comfortable to wear home
• Have someone who can take you home - you won't be able to drive

After surgery: when to seek help urgently

Your team will give you discharge instructions. Some symptoms after thyroid surgery need prompt attention:

• Bleeding or rapidly increasing swelling at the wound site - seek urgent help
• Tingling or numbness around the mouth, fingertips, or toes - this can be an early sign of low calcium and should be reported promptly
• Muscle cramps or spasms, twitching, or any tightness in your throat - treat these as urgent and seek help straight away, as they can mean calcium has dropped further
• Difficulty breathing or swallowing - seek urgent help
• Signs of infection (increasing redness, warmth, or discharge from the wound)

If in doubt, contact your ward, surgical team, or NHS 111.

More resources

The questions tool can help you build and organise your pre-surgery questions. See also before thyroid surgery: recovery and what to expect for a more detailed walkthrough of the recovery period.