I would suggest having the surgery. I had a toxic adenoma and it was horrible, I wanted it out of my body. All I did was sleep, 12 - 16 hours a day, because the hyperthyroidism was so severe. It completely drained me. Mine was also quite large, about the size of golf ball, so it was visible. I guess I would ask you how much it affects your life right now. The surgery isn't that bad. You kind of look like Frankenstein for a while, but the scar fades. I had the surgery five years ago and I think after about a year, the scar wasn't even really visible. Also, it is not very painful, you're neck will be kind of sore and stiff for maybe two weeks, but then it's back to normal. I think that the other alternatives are much more life-style altering than having to take one tiny pill (and it is tiny) every day. I read the messages that other people wrote about changing your diet. If you're resisting the surgery because of having to be on medication for the rest of your life, think about how difficult it would be to change your diet so drastically. Good luck to you and your quest for health, I just have one more thing to tell you. If I had that choice to make today, I would wholeheartedly chose to have the surgery.