In our clinical work, we often encounter many patients with thyroid nodules, most of whom do not know much about the disease they are suffering from. It is true that most thyroid nodules develop due to iodine deficiency, but a long-term high iodine diet can also stimulate thyroid tissue hyperplasia and nodules by increasing the level of thyroid stimulating hormones in the body. Because iodine is already added to our salt, long-term consumption of seafood with high iodine content, such as kelp, can also easily cause thyroid nodules. 2. Is it better to have a thyroid nodule with or without surgery? This depends on the size of the nodule, the results of the ultrasound examination and the results of the thyroid puncture. Generally speaking, surgery is recommended for thyroid nodules over 1 cm in diameter, especially for nodules over 1 or 5 cm. Nodules between 1 and 1.5 cm in diameter can be treated with thyroxine preparations for 6 to 9 months. If the nodule shrinks or does not continue to grow, surgery can be suspended and followed closely. However, nodules with sand-like calcifications found by ultrasound or papillary hyperplasia found by puncture or suspected cancer must be operated regardless of size. 3.Why do benign thyroid nodules easily recur after surgery? Some people need two or three incisions? The most common benign thyroid nodule in clinical practice is nodular goiter, which is a pathological change of the entire gland from the beginning of the lesion, with epithelial papillary hyperplasia and vascular regeneration leading to nodules due to the gradual expansion of the follicles. In long-standing cases, almost the entire thyroid gland is covered with nodules. Therefore, if the surgical excision is not complete, there is a high risk of residual hyperplastic thyroid tissue and microscopic nodules, and postoperative thyroxine suppressive therapy has limited effect on the residual lesions, so the postoperative recurrence rate is high. Moreover, once recurrence requires reoperation, the risk of surgery is 5 to 10 times higher than that of the initial surgery. In foreign countries, a more aggressive approach is taken to bilateral nodular goiter, with total resection on one side of the main lesion and total or near-total resection on the opposite side; moreover, normal thyroid function can be maintained after surgery with a small dose of thyroxine preparation. The advantages of this procedure are twofold: firstly, it completely avoids recurrence after surgery, and secondly, it avoids the risk and pain of reoperation for patients whose thyroid cancer is confirmed only after surgery. However, total thyroidectomy requires a high level of surgical demand, as it requires complete dissection of the bilateral recurrent laryngeal nerves and parathyroid glands to avoid serious complications. In recent years, our hospital has performed total/near-total bilateral thyroidectomy for bilateral diffuse nodular goiters with very satisfactory results. 4. Why do I speak normally but feel weak after thyroid nodule surgery? This is mainly because the thyroid nodules are often dissected to avoid damaging the recurrent laryngeal nerve during surgery, which may cause edema of the recurrent laryngeal nerve or affect its blood supply, resulting in the phenomenon of strained speech. However, this phenomenon will gradually disappear about 3 months after surgery as the edema subsides and the blood supply is restored. 5.Why does numbness in the hands and feet occur some time after thyroid nodule surgery? This is mainly due to the fact that the blood supply to the parathyroid glands is affected or the blood return to the parathyroid glands is blocked due to the necessity of cutting certain blood vessels during surgery for thyroid nodules. Numbness in the hands and feet can often be relieved by appropriate calcium supplements such as Calcium D tablets. This phenomenon will gradually disappear about 2 months after surgery as the blood supply is restored or the bruising subsides. 6.Why is the incision swollen and hard after thyroid nodule surgery? This is actually due to the normal edema reaction of the incision after surgery. Because of the extensive separation of the skin flaps above and below the incision during thyroid nodule surgery, this can easily cause edema in the tissues surrounding the incision. Especially in middle-aged and older women, the incision is easily edematous because the skin is loose and there is more fatty tissue. Patients should not be alarmed by this situation, as the edema is absorbed and the incision will gradually return to flatness within 2 months after surgery. 7. Why is there a pulling sensation in swallowing and sometimes even coughing after thyroid surgery? This is related to the normal scar contraction response after thyroid nodule surgery. This is because, although there is only a line like scar on the neck after thyroid nodule surgery, the actual surgical trauma is much larger than this scar. This scar, like the incision on the neck, requires a normal scar reaction to recover, and during the scar reaction the scar will contract and pull on the trachea near the scar, causing a pulling sensation when swallowing and even irritating the trachea and causing a cough. 8.What are the side effects of taking thyroxine preparations after surgery? Does it have any effect on the body when taken for a long time? The main side effects of taking thyroxine preparations are headache, heartburn and high blood pressure. There are two types of thyroxine preparations, one is synthesized from animal raw materials, such as thyroxine tablets. This type of drug is not very pure because of more impurities, so it is not easy to control the dose when taking it. The other is synthesized from artificial raw materials, such as eugenol. This kind of drugs because the preparation is more pure, so when taking the dose is easy to grasp. However, no matter what kind of drugs you take, you need to check your thyroid function regularly to avoid excessive doses and drug-related hyperthyroidism. As long as the dose is appropriate, long-term use of thyroxine preparations will not cause adverse effects on the body. 9.What are the precautions for taking thyroxine preparations? It is best to take thyroxine preparations in the early morning after waking up on an empty stomach, and eat breakfast about half an hour after taking the drug, so that the side effects of the drug can be minimized and the efficacy can be best. At the same time, avoid taking thyroxine preparations together with medications for stomach problems to avoid affecting the effectiveness of the medication. 10.What are the dietary requirements after thyroid nodule surgery? To reduce recurrence after thyroid nodule surgery, you should eat less seafood and avoid iodine-rich foods, such as kelp, shrimp and nori.