Thyroid nodules: should they be removed or left untreated?

Many people with thyroid nodules think it's better to just have them removed to ease their burden, rather than continuing monitoring. But some people are afraid of thyroid surgery because they think they'll have to take medication for the rest of their lives? It sounds reasonable, but it's not true.

A thyroidectomy surgery - Photo: Provided by the hospital.

Medication, if needed, is part of treatment that helps patients live healthy lives and maintain stable hormones, not a lifelong "shackle."

Dr. Tuan

So, should I have my thyroid removed to feel better, or should I avoid surgery because I'm afraid I'll have to take medication for the rest of my life?

The thyroid gland is not something superfluous to be discarded.

Dr. Nguyen Xuan Tuan, a lecturer at the University of Medicine and Pharmacy, Vietnam National University , Hanoi , said that many people, upon discovering they have thyroid nodules, think: "I'll just have them removed to be safe; leaving them untreated might turn into cancer." While this sounds reasonable, it's actually very dangerous.

The thyroid gland is not something superfluous to be discarded; it is a vital endocrine organ that controls the body's entire circadian rhythm.

It secretes T3 and T4 hormones that affect the cardiovascular system, digestion, warmth, memory, mood, and reproduction. A deficiency in thyroid hormones can lead to fatigue, weight gain, dry skin, hair loss, coldness, depression, menstrual irregularities, decreased libido, and even increased risk of miscarriage.

Many patients who undergo thyroid surgery have to take hormone replacement therapy for life, but adjusting the dosage is very difficult: too much can cause anxiety, tremors, and insomnia; too little can lead to lethargy and weight gain. Not to mention, if the surgery is not properly indicated, patients may lose their thyroid gland, experience metabolic disorders, and suffer psychological distress, ultimately leading to more suffering.

Therefore, when a thyroid nodule is detected, the first thing to do is not to "request surgery," but to find out whether the thyroid nodule is benign or malignant, whether surgery is necessary, whether a lobe or the entire thyroid gland will be removed, and which surgeon will perform the operation.

"The thyroid gland is to be preserved, not removed. Only when it can no longer be preserved should we consider removing it," said Dr. Tuan.

Do I have to take medication for the rest of my life after surgery?

In clinical practice, doctors also encounter many patients who fear, "After surgery, will I have to take medication for the rest of my life?" In fact, this is a common misconception that needs to be understood correctly.

Firstly, not everyone who has thyroid surgery has to take medication for life: If the entire thyroid gland is removed, the body no longer has glandular tissue to secrete thyroxine (T4) hormone, so levothyroxine must be taken for life. This is a way to compensate for the physiological hormone, not to become "drug-dependent".

However, if only one lobe of the thyroid gland (one side) is removed, more than 70% of patients do not need long-term medication. The remaining lobe can produce enough hormones for the body on its own. If medication is needed, the dose is very low, completely safe, and easy to control.

Secondly, having only one thyroid lobe is sufficient for a healthy life: The thyroid gland is an organ with excellent compensatory capabilities. When only one lobe remains, the remaining thyroid tissue will increase the synthesis of T3 and T4 hormones to meet the body's needs, a self-regulating mechanism based on the principle of homeostasis. Therefore, after surgery, the patient is not "dependent on medication" and the body can regulate itself normally.

Thirdly, if only the nodule is removed while the thyroid gland remains intact, there is almost no impact: In many cases of benign thyroid nodules, the doctor only removes the nodule or cuts the lobe containing the nodule, leaving the healthy thyroid tissue intact. In this case, the thyroid gland continues to function normally.

Except in cases of pre-existing autoimmune thyroiditis (Hashimoto's), where thyroid tissue is gradually destroyed, the risk of hypothyroidism is high even without surgery. Therefore, don't let the fear of "taking medication for life" delay proper treatment. The real concern isn't the medication itself, but the progression of the disease: enlarged thyroid nodules causing compression, difficulty breathing, difficulty swallowing, or even cancerous transformation.

HA TUONG

Source: https://tuoitre.vn/u-tuyen-giap-cat-hay-de-20251028014602617.htm