Dr Maré du Plessis answers the most common questions asked about Thyroid Health.
What are the most common thyroid problems?
Thyroid conditions are broadly divided into functional and structural problems. Functional disorders include hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Structural problems relate to physical changes in the gland, such as thyroid nodules, goitre (enlargement), or thyroid cancer.
What is the difference between hyperthyroidism and hypothyroidism?
Hyperthyroidism occurs when the thyroid produces too much hormone, often causing symptoms like weight loss, anxiety, and a rapid heart rate. Hypothyroidism is when the gland is underactive, leading to fatigue, weight gain, and low energy levels. These conditions are usually managed medically by endocrinologists.
When do you need thyroid surgery?
Surgery is typically required for structural thyroid problems. This includes suspicious thyroid nodules, confirmed thyroid cancer, or an enlarged thyroid (goitre) causing compression symptoms such as difficulty swallowing or breathing. Surgery may also be considered in hyperthyroidism if medical therapy fails or is not suitable.
What are thyroid nodules and are they dangerous?
Thyroid nodules are lumps within the thyroid gland. Most are benign and not dangerous. However, some may be cancerous or have suspicious features, which is why ultrasound imaging and, if necessary, a needle biopsy are used to assess them.
How is thyroid cancer diagnosed?
Diagnosis usually involves an ultrasound scan followed by a fine needle aspiration biopsy. In some cases, if results are inconclusive, part of the thyroid may be surgically removed (thyroid lobectomy) to establish a definitive diagnosis.
What are the symptoms of thyroid cancer?
Many thyroid cancers present as a painless lump in the neck. In some cases, patients may experience compression symptoms such as difficulty swallowing, a sensation of pressure in the neck, or breathing difficulties.
What is a goitre?
A goitre is a benign enlargement of the thyroid gland, often with multiple nodules. It may cause visible swelling in the neck and, in some cases, compression symptoms. Not all goitres require surgery – only those causing symptoms or concern.
Can you live without a thyroid?
Yes. Patients can live completely normal lives without a thyroid gland, provided they take lifelong thyroid hormone replacement medication. These medications are safe, effective, and widely available.
What are the risks of thyroid surgery?
One of the main risks involves the parathyroid glands, which regulate calcium levels. These can be temporarily affected during surgery, leading to low calcium levels, but this is usually managed effectively and often resolves over time.
What is radioactive iodine treatment?
Radioactive iodine is a treatment used in certain thyroid conditions, particularly thyroid cancer and hyperthyroidism. The thyroid absorbs iodine naturally, so when radioactive iodine is administered, it selectively targets and destroys thyroid tissue.
Is thyroid cancer treatable?
Most thyroid cancers, particularly papillary and follicular types, are slow-growing and have an excellent prognosis. Treatment typically involves surgery and may include radioactive iodine. Long-term survival rates are very high.
What should I do if I feel a lump in my neck?
Any new lump in the neck should be evaluated by a healthcare professional. This usually involves a clinical examination and an ultrasound scan to determine whether further investigation is needed.
Read more about the Thyroid Swelling (Goitre) condition and the Thyroidectomy surgery.