Hashimoto’s Thyroiditis: Is Surgery Necessary As Part Of Treatment?

Hashimoto’s disease also known as Hashimoto’s thyroiditis is an autoimmune disorder that occurs when the immune system attacks the body’s tissues. This is often preceded by hypothyroidism, a condition where insufficient thyroid hormones are produced for various functions in the body. 

The thyroid hormones, thyroxine (T4) and triiodothyronine (T3), play a role in regulating the body's metabolism, heart rate, temperature, skin, brain function, breathing and ability to burn calories. The very first indication of Hashimoto’s thyroiditis is a swollen front neck due to the presence of an enlarged thyroid gland, known as goiter. 

According to information provided online, goiters are painless but could lead to difficulties in breathing and swallowing if it grows bigger in size. Fatigue, hair loss, muscle and joint pain are some of the other signs of the disorder. Excessive iodine, radiation exposure, genetic factors and sex hormones are some of the main causes behind the autoimmune disorder.

Usually, excess or lack of thyroid hormones are treated with drugs for a few months since it takes a while for the symptoms to disappear. Sufferers can lead a normal life with medication and by being under the observation of doctors for a while. It is important to note that not all cases of Hashimoto's disease occur due to hypothyroidism.

The former is a problem with the overall immune system and the later only concerns the thyroid glands. Both conditions are treated differently. But 90 percent of people who suffer from hypothyroidism are known to have Hashimoto's disease. 

For example, actress Gina Rodriquez changed her lifestyle after she was diagnosed with the disorder at the age of 26. Earlier at the age of 19, when she was diagnosed with hypothyroidism, she was at sea on how to treat the condition. But today with the help of a nutritionist, she has bounced back more than ever, owing to all the fame and success she gained through the hit show, ‘‘Jane The Virgin’’.

In other less fortunate cases, if the goiter does not shrink despite medication, then it becomes necessary to undergo surgery to remove a portion of the gland. 

Is surgery necessary to cope with Hashimoto’s disease?  

In a study published this year by the Annals of Internal Medicine, the benefits of thyroidectomy (surgical removal of the gland) versus thyroid medication were compared in patients with Hashimoto’s thyroiditis in Norway’s Telemark Hospital. 

The participants were between 18 and 79 years old. They were being treated with hormone replacement therapy and antibody medication, so anti body levels had normalized. Despite receiving treatment, many of the patients still did not regain complete vitality. They still experienced bodily pain, fatigue and lacked complete recovery of emotional and mental health.  

The study that was completed in 18 months had 147 participants, of which 73 participants went through with the thyroidectomy. While the remaining continued to be treated with medication.

The result showed remarkable improvement in the health of the participants who underwent surgery. Antibody levels normalized, fatigue and overall quality of life had greatly improved. “Total thyroidectomy improved health-related quality of life and fatigue, whereas medical therapy did not,” the study’s conclusion read. 

Hypothyroidism Hypothyroidism is more common among women compared to men. It is also more likely to occur in people older than 50. David Perry/Unsplash