Call us directly: 512-491-0017

12319 North Mopac Expressway, Building C, Suite 260, Austin, TX 78758 View Location

Jan 28

Are there other forms of treatment for known thyroid nodules?

Observation is one option to consider before moving forward with thyroid surgery, as not all nodules require surgery.

Some nodules will need to be biopsied. Once biopsied, some nodules will come back as benign, or not harmful to the patient. For patients with benign nodules with no compressive symptoms, Dr. Kroeker may recommend a follow-up thyroid ultrasound at 6 months, and then on a yearly basis to make sure that the nodules are not growing. Not everyone requires surgery.

As far as other treatments, there are no other treatments at this time to make thyroid nodules go away. It is not uncommon for fluid-filled thyroid cysts to fluctuate in size and sometimes completely disappear on follow-up thyroid ultrasound.

Jan 27

Why do patients need thyroid or parathyroid surgery?

Some people will have symptoms when it comes to thyroid nodules, but many people will not. The reasons Dr. Kroeker performs thyroid surgery are as follows: thyroid cancer, nodules that are suspicious for cancer, nodules (multiple or single) in the thyroid that are causing compressive symptoms, and hyperthyroidism.

Your thyroid is intimately associated with the trachea and esophagus, as it is located directly on top of these structures. Compressive symptoms are caused by the thyroid “pushing” on the esophagus or trachea, which narrows the lumen. Patients may have dysphagia, which is when a patient has difficulty swallowing food or pills. Patients may also experience a choking sensation or shortness of breath when they lie down flat. Or the patient might have a hard time breathing while working out because those nodules can compress the trachea, narrowing the windpipe.

These compressive symptoms can also affect your recurrent laryngeal nerve, which innervates your vocal cords. If a patient has a large multinodular goiter that is compressing a nerve, a patient might have voice changes or hoarseness.

Patients who notice symptoms usually have larger thyroid nodules that they can feel or they are having any of the above compressive symptoms—food getting stuck at the upper level of the neck, problems breathing, or voice changes.

If a patient has metastatic cancer, a patient could find a lymph node further out in the lateral neck. But many patients never know or experience any of these symptoms prior to diagnosis. A lot of nodules are found incidentally on ultrasounds for other reasons.

Jan 21

Do I need to change my diet or medication before or after thyroid/parathyroid surgery?

There is not typically a need for a patient to change their diet before or after thyroid surgery. However, surgery patients may need a thyroid hormone pill once a day after surgery.

Once a patient has had their entire thyroid removed they will absolutely need a thyroid hormone pill, once a day, for the rest of their life. That will be a brand new medicine for them following surgery.

If a patient only has one of the thyroid lobes removed, there’s about a 20-percent chance that the other lobe (which is still working) may not make enough thyroid hormone for the patient. In instances where the remaining thyroid lobe is not making enough thyroid hormone for the patient, the patient would need to take a thyroid hormone pill once a day every day for the rest of their life.

Jan 21

What happens to my blood calcium levels following parathyroid or thyroid surgery?

15-percent of the time, after a total thyroidectomy, the parathyroid glands will temporarily shut down secondary to “bruising”. The half-life of parathyroid hormone is so short that by the time a patient gets to the recovery room Dr. Kroeker will check a parathyroid hormone level and calcium level. This usually allows Dr. Kroeker to know whether or not the parathyroid glands are working.

15-percent of the time, the parathyroid hormone level will be low, and calcium levels will drop, which means that Dr. Kroeker will start a patient on calcium and vitamin D supplementation. The remaining 85-percent of the time, the parathyroid hormone and calcium levels will be normal. Dr. Kroeker will check calcium levels right after surgery in the recovery room, again that evening, and finally in the morning just to make sure that the calcium levels are stable.

If a patient only has half of their thyroid removed, then their calcium levels should not drop. We each have at least four parathyroid glands, and one parathyroid gland is all that is needed to have a normal parathyroid hormone level. If a patient has two parathyroid glands that have not been disturbed on the side that was not operated on, then they should be working fine. In this case, the patient would not require calcium and vitamin D supplementation.