2 Indications and current treatments

2 Indications and current treatments

2.1 Hyperthyroidism causes symptoms, which may include anxiety, weight loss, breathlessness, tiredness and eye problems. The overactive thyroid is usually enlarged and visible (goitre). The most common cause of hyperthyroidism is Graves' disease, an autoimmune disease in which antibodies stimulate the thyroid cells to secrete excess thyroid hormone. Other causes include toxic adenoma and toxic multinodular goitre.

2.2 First-line treatment for hyperthyroidism includes medication to reduce the production of thyroxine or radioiodine treatment to destroy some of the thyroid tissue. Surgical removal of the thyroid (partial or total thyroidectomy) can be used if treatment with medication is unsuccessful, if radioiodine treatment cannot be used (for example, in pregnancy) or if the size of the gland is causing problems in the neck.

2.3 Thyroid cancer usually develops slowly and the most common first sign is a painless lump in the neck. Other symptoms include hoarseness, swollen lymph nodes in the neck, difficulty swallowing or breathing, and pain in the throat or neck. The most common types of thyroid cancer are papillary and follicular thyroid cancer.

2.4 The most common treatment for thyroid cancer is partial or total thyroidectomy. This is sometimes followed by radioactive iodine treatment or radiotherapy.

2.5 Conventional (open) thyroidectomy is done through a transverse neck incision, typically 4‑8 cm long. Endoscopic techniques have been developed that use smaller incisions, with the aims of reducing pain after surgery and improving cosmesis.

  • National Institute for Health and Care Excellence (NICE)