WHO SHOULD CONSIDER THYROIDECTOMY FOR MANAGEMENT OF GRAVES’ DISEASE?
Thyroidectomy should be considered for anyone with Graves’ disease (GD) and moderate-to-severe eye disease, or smokers with GD due to increased risk of exacerbation of eye disease after radioactive iodine. Women with GD who are pregnant, nursing, or who have young children at home would benefit from a surgical consultation in an effort to avoid radiation exposure to the home. Patients who are found to have an associated thyroid cancer or a nodule suspicious for thyroid cancer should undergo thyroidectomy as the primary treatment. Anyone with GD who is interested in a rapid resolution of hormone control and hopes to avoid a prolonged transition from hyperthyroidism to hypothyroidism would benefit from surgical consultation. Any patient with compressive symptoms due to the associated thyroid enlargement from their GD would benefit from surgical consultation. Patients who are having difficulty with hormonal control while on medications, or have experienced a severe side effect from anti-thyroid medications, may be referred for surgery.