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January 30, 2023 8 min read

Thyroidectomy is a surgery to remove all or part of the thyroid gland. It is an essential procedure for people suffering from thyroid disorders like thyroid cancer. But what happens after the surgery? What do you need to know about hypothyroidism and how to manage it? In this article, we'll be discussing everything you need to know about living with hypothyroidism after a thyroidectomy.

What is the thyroid?

The thyroid gland is the largest endocrine organ in the human body. It's a butterfly-shaped gland located in the neck just below the larynx. It releases thyroid hormones into the bloodstream. These hormones are responsible for controlling how quickly we burn energy (metabolism) and numerous other vital functions, such as heart rate and body temperature.

The two main types of thyroid hormones are triiodothyronine (T3) and thyroxine (T4). T3 is active in every cell in the body, while T4 acts as a precursor to T3 - it must be converted into its active form before it can be used by cells. When these hormones become imbalanced, various health issues can arise, such as fatigue, weight gain or loss, depression, or anxiety.

There are numerous types of thyroid disorders. But in general, problems with your thyroid function will result in hyperthyroidism or hypothyroidism. Hyperthyroidism is when your body makes too much thyroid hormone, while hypothyroidism is when there's too little thyroid hormone.

Treatment for thyroid problems may involve medication, surgery, or other therapy methods depending on the type of disorder.

What is thyroidectomy?

Thyroidectomy is a surgical procedure in which all or part of the thyroid gland is removed. It may be recommended if you suffer from certain benign (noncancerous) or malignant (cancerous) thyroid conditions, such as hyperthyroidism, goiters, cancerous nodules, or a large benign nodule that interferes with breathing or swallowing.

The procedure itself begins with general anesthesia and can take up to several hours depending on the size of the thyroid affected and whether partial or full removal is necessary. During this thyroid surgery, lymph nodes may also be taken out for further examination by a pathologist. Afterward, patients typically stay in the hospital for one to two nights for observation before being discharged with instructions on how to care for themselves at home.

Who needs thyroidectomy?

Thyroidectomy is a treatment option for those with malignant or benign thyroid disease. It's most commonly performed on people with thyroid cancer, including:

  • Papillary thyroid cancer is the most common type of thyroid cancer. It's slow-growing cancer that develops from follicular cells in your thyroid. It may develop in one of your thyroid lobes. This type of cancer belongs to the differentiated thyroid cancer category, which is a type of cancer that starts in the thyroid cells.

  • Follicular thyroid cancer is a rare type of thyroid cancer that usually occurs in people over the age of 50. It can sometimes be large and aggressive and spread to other parts of the body, such as the lungs and bones.

  • Medullary thyroid cancer occurs when cells that produce calcitonin, another thyroid hormone, grow out of control and become cancerous.

  • Anaplastic thyroid cancer is shaped as a painful and hard lump or nodule on your thyroid gland that quickly spreads to other parts of your body.

In addition to cancer, thyroidectomy is also commonly performed in individuals with other thyroid conditions, such as

  • Hyperthyroidism, or an overactive thyroid, is a condition that occurs when your thyroid gland produces too much hormone. Thyroidectomy is one of the treatment options, along with antithyroid drugs or radioactive iodine.

  • Thyroid nodules an abnormal growth of the thyroid cells. They are usually benign but can be a sign of cancer.

  • A goiter or an enlarged thyroid can make it harder for you to breathe and swallow if it grows large. It can also cause your thyroid to be overactive, leading to hyperthyroidism.

What you need to know about hypothyroidism after thyroidectomy

Partial or total thyroidectomy?

So how much of the thyroid gland must be removed? The answer varies among thyroid conditions. A partial thyroidectomy, a surgery to remove part of your thyroid gland, is often indicated in patients with a benign nontoxic thyroid disease like a large goiter that puts pressure on their trachea or food pipe.

Total or nearly total thyroidectomy treats papillary or follicular thyroid cancer, large multinodular goiter, or Graves' disease, which often leads to hyperthyroidism. Thyroid surgery to remove most of the thyroid gland can be followed by radioactive iodine therapy.

What is hypothyroidism?

Hypothyroidism, or an underactive thyroid gland, is a condition in which your thyroid gland does not produce enough thyroid hormones. Symptoms of hypothyroidism in the early stages are often not obvious, but over time it can lead to other medical conditions such as fatigue, cold intolerance, anxiety, depression, low heart rate, and hair loss. If left untreated, hypothyroidism can lead to fatal conditions like heart disease and myxedema coma, which is life-threatening.

How does thyroidectomy cause hypothyroidism?

The thyroid hormone is produced and released by your thyroid gland. If you undergo total thyroidectomy, your entire thyroid gland is removed. This means that your body loses the ability to produce thyroid hormones on its own. Thus, you won't have thyroid hormone in your bloodstream and experience symptoms of hypothyroidism. And to make sure your body continues to get thyroid hormones even without the gland present, you will need to take medication for the rest of your life.

However, if you have only part or half of your thyroid removed, the remaining thyroid gland will take over all the functions of a normal thyroid gland. Therefore, according to the American Thyroid Association (ATA), there is an 80% chance that you will not need to take thyroid medication, provided your thyroid hormone test shows optimal levels.

How can you recognize the symptoms of hypothyroidism after a thyroidectomy?

Symptoms of hypothyroidism after surgical removal of the thyroid are similar to those of hypothyroidism caused by other conditions. In general, they are nonspecific and may be present in people with other medical conditions. These include:

  • Weight gain

  • Tiredness

  • Cold intolerance

  • Dry skin

  • Hair loss

  • Constipation

  • Slow heart rate

  • Muscle cramps

  • Muscle pain and weakness

  • Irregular menstruation.

Some people with hypothyroidism have many of the symptoms listed above, while others have few or none.

How long does it take to become hypothyroid after thyroidectomy?

If you've had a thyroidectomy, it's likely that it can take up to two months before all of the thyroid hormones in your body are gone. Once that happens, your doctor will be able to assess whether or not you need any additional treatment for hypothyroidism. They'll monitor your condition and order thyroid function tests. If you experience symptoms of hypothyroidism and your test results indicate that you have low thyroid hormone, they may decide to prescribe thyroid hormone replacement therapy to help regulate your levels.

So, all in all, it can take up to two months before you know if you need any additional treatment for hypothyroidism. In general, however, those who have undergone total thyroidectomy will eventually need treatment for hypothyroidism.

How is hypothyroidism diagnosed?

The first thing your doctor will do is ask you if you experience symptoms of hypothyroidism, such as weight gain, hair loss, dry skin, fatigue, etc. Then, they'll order blood tests to measure levels of free T4 and thyroid-stimulating hormone (TSH).

TSH is a hormone produced by your pituitary gland to control the amount of hormone produced by your thyroid gland. Abnormally high TSH and low T4 levels are a sign that your body lacks the thyroid hormone or hypothyroidism. 

In some cases, thyroid hormone T3 is also considered. If T4 and T3 are at normal levels, but TSH is high, you may be diagnosed with subclinical hypothyroidism without obvious symptoms.

What are the treatment options for hypothyroidism?

Since your body has lost the ability to produce adequate levels of thyroid hormone, you'll need thyroid hormone replacement therapy. If you have a partial thyroidectomy, you may only need it temporarily. But those who undergo total thyroidectomy will likely need to take thyroid medication for life.

The goal of thyroid replacement therapy is to bring your thyroid hormone levels to back up to normal, so you can get your levels back up and get relief from hypothyroidism symptoms.

There are several medication options to choose from. These include:

1. Levothyroxine

The standard treatment for hypothyroidism is levothyroxine. Therefore, your doctor will likely prescribe you this medication when you're diagnosed with hypothyroidism after a thyroidectomy.

Levothyroxine is the synthetic version of T4. It's commonly available under the brand names Synthroid, Levothroid, Levoxyl, Unithroid, and Tirosint.

2. Liothyronine

Levothyroxine therapy assumes that your body can convert the hormone T4 into T3 for its own use. Why this conversion? Because T4 is inactive and acts as a reserve of thyroid hormone, while T3 is active and affects your bodily function. However, the conversion process doesn't always go smoothly in some people, leading to a deficiency of the hormone T3 in the body. In addition, some people have poor absorption of the T4 hormone.

That's why in some cases, your doctor will prescribe liothyronine (LT3), a synthetic version of the thyroid hormone triiodothyronine (T3). Cytomel and Liothyronine are two popular brands of LT3 in the US.

3. Natural desiccated thyroid

Natural desiccated thyroid (NDT) is a natural thyroid medication that contains both T4 and T3 hormones. It's preferred over liothyronine and levothyroxine because it already contains T4 and T3, so it more closely resembles the natural balance of hormones found in the human body.

Popular US NDT brands include Armour Thyroid, Nature-Throid, WP Thyroid, and NP Thyroid. You can also buy desiccated thyroid online: VitaliThy.

How does natural desiccated thyroid differ from synthetic thyroid hormone therapy?

The main difference between NDT and synthetic medication is, of course, the source. While synthetic medication like levothyroxine is manmade, NDT is more natural because it's derived from the dried pig thyroid gland. And instead of containing only one hormone, NDT contains all of the essential thyroid hormones, including T4, T3, T2, T1, and Calcitonin.

It's true that levothyroxine is the most common treatment for hypothyroidism. However, research has shown that up to 48.6% of hypothyroid patients who joined the study preferred NDT over levothyroxine as it improves their subjective symptoms, such as moderate weight loss.

Unfortunately, it can be hard to find NDT in pharmacies, and some doctors refuse to prescribe it due to negative marketing campaigns. But don't worry! You can try VitaliThy, a natural desiccated thyroid you can buy online. It meets the strict standards of the Good Manufacturing Practices of the Vietnamese Ministry of Agriculture. Many patients who have tried VitaliThy have reported more energy and relief from symptoms after using it.

How does hypothyroidism affect your quality of life?

One of the main ways hypothyroidism can affect your quality of life is by making you feel tired and sluggish all the time. You might have trouble getting out of bed in the morning or feel like you could fall asleep at any moment during the day.

Another way it can affect you is by making it hard to keep weight off. When your thyroid isn't working properly, your metabolism can slow down, making it easier to gain weight and harder to lose it.

Hypothyroidism can also cause a host of other symptoms like dry skin, hair loss, and sensitivity to colds. But don't worry; with the right thyroid hormone medication, you can manage your hypothyroidism and get back to feeling like yourself.

What are other ways that can help manage hypothyroidism?

The key to optimal thyroid levels is taking your medication consistently daily. Besides, you can also apply the following ways to improve your hypothyroidism.

  • Apply moisturizer regularly and shower for less than 10 minutes to improve dry skin caused by hypothyroidism.

  • Stick to a healthy diet, which includes ripe fruit, meats, eggs, chicken, tuna, etc.

  • Yoga and mindfulness help deal with stress and improve your TSH levels.

  • Regular exercise supports weight loss and improves constipation better.

  • Avoid using the phone before bed to have a better and deeper sleep, which avoids fatigue.

  • Supplement fiber from fruits and vegetables in moderation. Specifically, women should get 25 grams of fiber, and men should get 38 grams daily.

Conclusion: thyroid medication is important for hypothyroidism after a thyroidectomy

Thyroidectomy is a surgical procedure to remove all or part of the thyroid gland. It is performed on people suffering from benign or malignant thyroid conditions such as cancer, hyperthyroidism, goiters, and large benign nodules. The procedure can take up to several hours, and patients typically stay in the hospital for one to two nights for observation.

After the surgery, patients are at risk of developing hypothyroidism, a condition in which the thyroid gland does not produce enough hormones. Symptoms of hypothyroidism include fatigue, cold intolerance, anxiety, depression, low heart rate, and hair loss. To manage hypothyroidism, doctors may prescribe hormone replacement therapy. VitaliThy, a natural desiccated thyroid you can buy online, is one of the most effective treatments available.

Wojciech Majda
Wojciech Majda

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