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December 14, 2022 10 min read

Getting a major surgery like a thyroidectomy can leave you feeling lost and confused, especially when it comes to understanding what life would be like after the surgery. One thing for sure is that you'll need thyroid hormone replacement therapy to help you feel better and maintain your health after surgery. But what is thyroid hormone replacement? Can it help you live a normal life after a thyroidectomy?

Don't worry; we've got your back! In this article, we'll provide you with the details of what happens after your surgery, specifically about thyroid hormone replacement. We'll break it down into a few simple steps so you can feel informed and at ease.

What is thyroidectomy?

Thyroidectomy is the surgical removal of your thyroid gland - a butterfly-shaped gland located in the front of your neck. The thyroid gland produces hormones that control every part of your metabolism, from your heart rate to how quickly you burn calories.

There are two types of thyroidectomy, including total thyroidectomy and partial thyroidectomy. In a total thyroidectomy, a surgeon removes your entire thyroid gland. On the other hand, partial thyroidectomy only removes part of your thyroid gland.

Why is thyroidectomy necessary? A patient lies on an operating table with a female surgeon standing nearby. The patient's neck is illuminated by a bright light, highlighting the area to be operated on. The doctor is wearing scrubs and latex gloves, his face serious as he prepares for the procedure

Why is thyroidectomy necessary?

Thyroidectomy is performed to treat certain thyroid conditions. Your doctor may recommend you undergo this surgery if you have the following conditions:


Thyroid Cancer

Thyroidectomy is the primary surgical treatment for thyroid cancer. Both undifferentiated and differentiated thyroid cancer require this surgery. Differentiated thyroid cancer includes papillary and follicular thyroid cancer, while undifferentiated thyroid cancer includes anaplastic thyroid carcinoma. The surgery is also required for metastasis to the thyroid from cancer that occurs in the other parts of the body, like lung cancer.

Depending on the severity of your thyroid cancer, your surgeon may remove part or all of your thyroid gland.

Thyroid nodules

A tiny lump or growth of thyroid cells in your thyroid gland, known as thyroid nodules, is another reason why you may undergo thyroidectomy. Thyroid nodules are typically benign (noncancerous). Sometimes, however, they can be malignant (cancerous) and affect your thyroid function. If your doctor finds that your thyroid nodules are cancerous or at increased risk of being cancerous, you may need a thyroidectomy.


A goiter is an enlarged thyroid gland. Your thyroid gland may enlarge completely, or it may develop one or more thyroid nodules. If you have a goiter, you may find a lump in front of your neck and feel a tightness in your throat area. Since this condition impairs your thyroid function, you'll likely experience a thyroid condition. Some people who have a goiter may experience hyperthyroidism, while others have hypothyroidism.

Sometimes, goiters can go away on their own without any treatment. However, if it grows large enough, it can put pressure on your esophagus and trachea. As a result, you'll find it hard to breathe and swallow. In this case, your doctor may recommend a thyroidectomy.


Also known as overactive thyroid, hyperthyroidism is a condition that occurs when your thyroid gland produces and secretes too much hormone. The main treatment goals are to reduce the amount of the hormone the body produces and lessen the severity of symptoms.

Thyroidectomy is often the last treatment option if you don't get better with anti-thyroid drugs or if you don't want to undergo radioactive iodine therapy.

Thyroidectomy is also recommended for those who struggle with hyperthyroidism due to Graves's disease.

What happens after thyroidectomy?

You can live a normal life after a thyroidectomy. But depending on how much of your thyroid gland is removed, you might need lifelong treatment.

Complete thyroidectomy

If you underwent total or near-total thyroidectomy, you no longer have a thyroid gland. This means that your body can no longer produce thyroid hormones. Keep in mind that thyroid hormones are important. Without them, you'll have hypothyroidism and experience symptoms like fatigue, dry skin, fatigue, and weight gain. Therefore, you'll need thyroid hormone replacement medication for the rest of your life.

Partial thyroidectomy

With partial thyroidectomy, thyroid hormone therapy might not be necessary as the remaining thyroid tissue will resume normal thyroid function. However, if you're already on thyroid medication prior to surgery or your blood test result shows that the remaining thyroid isn't producing enough thyroid hormones.

What is thyroid hormone replacement after total thyroidectomy?

The thyroid gland produces and releases two main hormones: the 'active' triiodothyronine (T3) and the 'inactive' thyroxine (T4). These hormones are vital to your body's proper function as they affect nearly every cell in your body. In addition to regulating your metabolism, the thyroid hormones also control your heart rate, blood pressure, and body temperature.

Inadequate levels of thyroid hormones can cause significant health problems like fatigue, weight gain, and infertility. It may increase your risk of developing other health conditions like heart disease and obesity as well. That's why after thyroidectomy, particularly total thyroidectomy, you'll need to take thyroid hormone replacement therapy. These are medications that work by replacing the hormones that your thyroid would normally produce and help maintain normal metabolism. They also help lower the risk of cancer coming back.

What types of thyroid medication are available for people without a thyroid gland?

There are various types of thyroid hormone replacement medications available out there.

The most commonly prescribed medication is levothyroxine, which is the synthetic version of the hormone T4. Some of the most popular brands for levothyroxine are Synthroid, Unithroid, and Levoxyl. However, some patients find that taking T4-only medications doesn't provide relief from hypothyroidism symptoms. Therefore, liothyronine, or the synthetic version of T3, is added in combination with levothyroxine.

But besides levothyroxine and liothyronine, there's another popular alternative among patients: natural desiccated thyroid (NDT). This medication already contains both T4 and T3 in it, so a lot of patients find it to be more effective than levothyroxine. Aside from T4 and T3, NDT also has other hormones that are produced by the thyroid gland, such as diiodothyronine (T2), iodothyronamine (T1), and calcitonin.

Moreover, you don't need to take two medications at once since NDT already has a more "complete" profile than its synthetic counterparts.

A lot of people who are looking for a natural alternative also prefer NDT since it is made of dried porcine (pig) thyroid gland. Plus, many brands of NDT, such as VitaliThy, are free from allergens like gluten and lactose, making them safe for many people. Another advantage is that you can buy natural desiccated thyroid online.

What happens if you don't take medication after a thyroidectomy?

It's extremely important to take thyroid medication after your thyroid is removed. Without it, you will experience hypothyroidism symptoms and even serious long-term effects.

Some of the symptoms of hypothyroidism you'll likely experience include fatigue, cold intolerance, memory problems, depression, weight gain, infertility, low libido, constipation, irregular menstrual cycle, hair loss, changes in blood pressure, muscle weakness, and joint pain.

You'll also have an increased risk of heart disease and infection. Failing to take thyroid medication for a long time can potentially lead to a myxedema coma, an extreme complication that can be fatal.

There's no good reason to stop taking thyroid medication when after thyroid surgery, like thyroidectomy. Thyroid medications like NDT are safe and effective, with very few side effects, when you take them in the right dose.

When should you start taking thyroid hormone replacement after thyroidectomy?

Again, this depends on how much of your thyroid gland is removed. If the surgery removes your entire thyroid gland, you might need to take thyroid medication as soon as possible and for the rest of your life. For partial thyroidectomy, your doctor will arrange for blood tests and blood pressure to check your thyroid function about six to eight weeks following your surgery. If you have normal thyroid function and thyroid hormone levels, you likely won't need to take thyroid medication.

What is the average dose of thyroid medication after thyroidectomy?

The dose of thyroid medication varies from person to person. Your doctor will do careful blood testing to find the correct dose for you. The blood test will show the levels of your thyroid hormone and thyroid stimulating hormone (TSH) secreted by the pituitary gland. As its name suggests, thyroid stimulating hormone is a type of hormone that "stimulates" your thyroid, meaning it regulates the amount of hormone your thyroid releases. Elevated TSH levels indicate that you don't have enough thyroid hormones in your blood or that your dose needs to be increased.

Aside from blood testing, doctors may also determine the dose based on the patient's body weight, independent of body mass index (BMI)

The dose adjustments of levothyroxine and NDT may be made a few times until you feel your best. Even if you find your correct dose today, you'll likely need to get other dose adjustments in the future since hypothyroidism can be progressive.

The average initial levothyroxine dose is 50 to 100 mcg per day. The dose might be increased over time to between 100 and 200 mcg per day.

For NDT, the usual initial dose is 30 mg per day. You might increase 15 mg per day every 2 to 3 weeks until you feel your best. The average dose is 60 to 180 mg/day.

Some people, such as elderly patients or those with heart disease, may need to start levothyroxine and NDT in a lower dosage.

An appropriate dose of thyroid medication is very important. Insufficient or excessive dosage can result in unwanted side effects. If your dosage is too low, you'll experience hypothyroidism symptoms. On the other hand, excessive dosage may cause you to experience hyperthyroidism symptoms.

What is the average dose of thyroid medication after thyroidectomy?

Can you have hyperthyroidism after thyroidectomy?

Yes, it's possible to have hyperthyroidism following a thyroid surgery like a thyroidectomy. For total thyroidectomy, hyperthyroidism is usually caused by an excessive dosage of thyroid medication.

You may experience some of the following symptoms if you have hypothyroidism due to too much thyroid medication:

  • Cardiac symptoms (rapid heartbeat )

  • Feeling shaky and/or nervous.

  • Weight loss or increased appetite.

  • Diarrhea and more frequent bowel movements.

  • Thin, warm, and moist skin.

  • Sleep issues.

  • Increased neck size and swelling due to an enlarged thyroid gland (goiter).

  • Hair loss and texture changes (brittle).

  • Eyes bulging (common with Graves' illness).

  • Muscle weakness.

If you feel any of the symptoms above, be sure to contact your doctor right away. They may adjust your dose until you have normal levels of thyroid hormones.

How to live a healthy life after thyroidectomy?

Thyroid surgery, especially total thyroidectomy, is a major operation. It might seem scary, but don't worry. Most people do very well after their thyroid surgery and can return to their usual activities. Here are some of the ways you can lead a healthy and active life after your thyroid surgery:

Follow-up care

Follow-up care is essential after thyroidectomy. You usually need about one to two weeks to recover before you can resume your daily activities and work. For the first two weeks, it's important to avoid any strain on your neck. This means that you shouldn't lift any heavy objects, exercise, or eat foods that are hard to swallow.

Your doctor may advise you to do some gentle neck and shoulder exercises to lessen any potential long-term stiffness. It's important that you do these exercises daily as instructed.

Thyroid medications

As explained above, you will need to take thyroid medication for the rest of your life after total thyroidectomy. Taking thyroid medications like levothyroxine and NDT every day may seem daunting. But keep in mind that this medication is essential to help you lead a healthy and active life without a thyroid gland. Since they work by replacing the missing thyroid hormones that your own body can no longer make. Thus, they'll help you regulate your metabolism and ease symptoms of hypothyroidism, such as fatigue, weight gain, and joint pain.

Aside from taking the right dose, thyroid medication also needs to be taken the right way in order for it to be effective. Whether you take levothyroxine like Synthroid or NDT supplements like VitaliThy, it's important that you take your medication on an empty stomach.

The most common time to take your thyroid medication is in the morning, as soon as you wake up, about 60 minutes before breakfast. However, you can adjust it depending on your schedule. If taking your meds in the morning is not the best option for you, you can do it at night at bedtime, about 3 to 4 hours after your last meal of the day.

Nutrient-rich diet

Although medication is the first line of treatment for hypothyroidism, having a healthy diet and lifestyle can help improve your symptoms too.

There is actually no single "best" diet for hypothyroidism, but adding and eliminating certain foods after your partial or total thyroidectomy may help improve your symptoms. Be sure to add lots of fruits like berries, apples, pears, peaches, citrus fruits, grapes, bananas, and pineapple into your diet. Gluten-free grains, like rolled oats and brown rice, as well as seafood, eggs, and chicken, are also good to enhance your health.

Avoiding gluten and dairy might be beneficial, but you don't need to cut them off completely from your life. The best way to find a healthy diet that'll supply you with all the nutrients you need is by talking to your doctor or a nutritionist.


Try to keep as active as you can since exercise can relieve many hypothyroidism symptoms, help you lose weight, improve your muscle mass, protect your joints, and enhance your cardiovascular health.

Since hypothyroidism can cause joint pain, you can try low-impact exercises like yoga, walking, swimming, biking, and Pilates. These exercises help you stay active while minimizing stress on your joints like the hip, knee, and back.


Thyroid surgery can negatively affect the parathyroid glands, which are two pairs of tiny glands located at the bottom of your neck behind the thyroid. These glands produce parathyroid hormone, which helps maintain the balance of calcium in your bloodstream and other tissues that needs calcium to function properly.

When your parathyroid glands aren't working normally, you'll have a condition called hypoparathyroidism or low levels of parathyroid hormones. This can lead to low levels of calcium, causing you to experience symptoms like muscle cramps, anxiety, and irregular heartbeat. If not treated, low calcium can eventually result in dental problems, hair loss, cataracts, and more.

That's why taking calcium supplements, and vitamin D can be very important for you after thyroid surgery.

You might also need to take supplements to support your thyroid hormones. One supplement you may want to consider taking is selenium, which is an essential nutrient for the conversion of T4 to T3. You can also consider taking iodine because even when you don't have a thyroid gland (iodine is stored in the thyroid gland), this nutrient can help you reduce the risk of cancer.

The bottom line

After thyroidectomy, your life is going to be a little different, But this doesn't mean you can't live a normal, healthy life. With lifestyle changes and hormone replacement therapy like VitaliThy, you'll be able to enjoy life to the fullest like you used to.

Wojciech Majda
Wojciech Majda

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