My husband needs to have one of his parathyroid glands removed as he has a parathyroid adenoma which is causing medical issues. He has been told the surgeon may need to remove a portion of his thyroid (hemithyroidectomy) to access the "diseased" gland.
Does anyone have experience of having a portion of their thyroid removed? Does it significantly effect the production of thyroid hormones (I guess it depends on the amount removed?)? Is there anything he'd be advised to do prior to surgery - e.g. full thyroid blood panel? For noting, he doesn't have issues with his thyroid.
Any advice gratefully received. Many thanks
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MCDW
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Even though there are currently no concerns with thyroid I would recommend your husband get a full thyroid function.
Doctors tend to look at TSH (thyroid stimulating hormone) and conclude it this is in range so will thyroid hormones.
Important FT4 (free thyroxine) & FT3 (free triiodothyronine) are tested.
It is possible the remaining gland compensates for the missing half but you need to establish a pre surgery benchmark prior to any operation as it will be difficult to accurately compare afterwards without a full history.
Post surgery results may appear to be “in range” but very different to where your husband feels well.
Also test for thyroid antibodies TPO & TGab (Thyroid Peroxidase antibodies) & (Thyroglobulin antibodies)
Important to test folate, ferritin & B12 if not already done.
When he has a repeat Parathyroid hormone (PTH) test he will need calcium,(possibly phosphate) & vitamin D tested together at same time to assess properly. Usually this must be done at a hospital as labs need to process test quickly.
Might be quicker to arrange a private test. As Doctor often won’t / can’t test everything. Such as FT3 and key nutrients - (folate, ferritin, vitamin D & B12)
See List of companies offering different options, some packages include thyroid function, key nutrients and thyroid Antibodies. Others basic function only. some also have discount codes available.
You order test online the kits arrives via post sample taken by finger prick (extra fee for private venous draw). Post back and results available online quite quickly.
Totally agree with PurpleNails, get full thyroid test so he knows what is normal for him before he has the operation. I had 7/8ths of my thyroid gland removed and was left with just 1/8th to pick up the slack. That didn't work at all and I became really unwell over the next 2 years before I received some Levothyroxine. At least if your husband knows what his thyroid levels are then once he has had the operation if the part of thyroid gland he has left doesn't provide the amount he needs then he can be medicated to bring his levels to what they were pre-op.
Hi, I had a tumour on my thyroid and had a hemithyroidectomy as the surgeon couldn't remove the tumour alone. I didn't know much about thyroid function and didn't have any tests beforehand. The surgery itself went well and wasn't painful at all. The nurses kept offering me morphine and in the end I had 2 paracetamol to stop their concerns! I had a drain in situ for 24 hours and spent one night in hopsital. I had 2 weeks off work and was fine after that to return to a physical NHS job. I had one blood test 2 weeks after surgery which was fine and the other side has compensated ever since. That was 5 years ago and I still feel great. I hope your husband has an experience like mine and doesn't worry about it.
I agree with PurpleNails and Doestewart; make sure your husband gets full thyroid testing beforehand so he has a bench mark to compare to for any further tests after his op.
In August 2022 I had an hemithyroidectomy due to a suspicious nodule that was too big to remove on it's own so I had my right half of my thyroid removed. The surgeon hoped the other half would compensate but it didn't.
So I'm now prescribed Levothyroxine. Don't rely on the hospital to do full testing; I was told they would as I'd had FT3 tested earlier in the year by them but they didn't. They only did basic thyroid tests beforehand.
Your husband's thyroid function may be totally fine after his op, like some of the other member's that have replied to your post but best to be prepared just incase it's not.
When I had my thyroidectomy the surgeon removed the parathyroids and implanted them some place else and then removed the thyroid …. If the parathyroid is the ONLY PROBLEM and the doctor is skilled I would think he could just remove the sick parathyroid without removing the thyroid.
I would definitely do a complete thyroid test and vitamin panel because I would think this will mess up his Vitamin D levels.
IF your husband IS affected by hypothyroidism having lost a portion of his thyroid, one of the things that could be affected is his vitamin and minerals levels. This is because hypothyroidism usually causes low stomach acid and therefore affects nutrient absorption from the diet.
So, for the sake of argument, let's suppose your husband's ferritin level pre-surgery is 400 with a reference range of 30 - 650. His result is approx 60% through the range.
If, a few months after surgery, his ferritin level is 150 with the same reference range, he will have a result which is approx 20% through the range. He may be more tired/fatigued than usual but since his result is in range doctors will ignore it, imply his fatigue is "all in his head", and might even offer him anti-depressants, or he will be told to go and exercise more and/or lose weight (if relevant).
Doctors think any result for anything which is in range is absolutely fine, and many of us are left to our own devices to fix ourselves.
Having a good history of relevant tests before surgery will reap rewards later if your husband starts to feel less well.
Thank you all for all your really helpful comments. I'll sort the full thyroid panel - but I have a concern due to the postal strikes delaying the sample back to the lab. I'll speak to Medichecks to see what the best approach is under the circumstances.
I always use this service whenever I return a test to any testing company, whether there are strikes or not. I don't want my blood sample to languish in a post box or sorting office for several days because I think it might affect the accuracy of any results.
Be aware that there are several times that can be guaranteed - there is no advantage to paying lots more money to get the test box to the lab any earlier in the day. If staff haven't arrived for work there might be nobody available to take delivery.
I always take my boxes to the Post Office myself. It is worth asking the Post Office you wish to use what time last collection is from that Post Office. So, for example, if the last collection is 4pm then make sure to get your parcel to the Post Office by 3.30pm.
Also, to take account of the working days and hours at the lab, please carry out the blood collection and post your test box back to the lab on Monday or Tuesday. This then gives the lab time to process your sample(s) before the weekend.
I concur with everything purplenails as said, in my case I had to have full thyroidectomy in May 2019 because my thyroid was toxic, I was having thyroid blood taken twice a week up until my thyroidectomy.
In July 2019 my calcium went overactive and in early 2020 both my calcium and pth went overactive, 2 endos said i probably have primary hyperparathiyroidism.
I had to pay privetly to see a parathyroid surgeon as the nhs don't understand parathyroid problems much, the private surgeon diagnosed normocalcemic hyperparathiyroidism, and found a 7mm nodule in my neck, he asked what my pth and calcium were before my thyroidectomy op , I had no idea as the surgeon who performed my thyroidectomy didn't check my pth or calcium, only checking my calcium level after my thyroidectomy as the parathyroid glands can become hypo so calcichewes are given, so in your husband's case I would as purplenails suggest get all bloods done, TSH, T3, T4.. PTH, calcium phosphate, magnesium, you need a base line of your husbands thyroid function before any thyroid tissue is removed, they should be doing his pth and calcium before the op and this can be tested right after the parathyroid gland as been removed
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