Life after thyroidectomy requires continuous medical follow-up to adjust hormone replacement doses like levothyroxine, ensuring hormonal balance and a healthy, stable life while preventing potential health issues and achieving optimal long-term results.
Definition of thyroidectomy
The thyroid gland is a butterfly-shaped endocrine gland located in the front of the neck, just below the Adam’s apple. It plays a major role in producing and secreting hormones that control many essential functions throughout the human body, such as regulating heart rate and the speed of fat burning.
The amount of resection during the procedure depends on the reason for the procedure, as the gland may maintain normal function in a partial resection, while in a total resection, you will need daily thyroid hormone replacement therapy to restore gland function.
Thyroidectomy is a simple surgery performed under general anesthesia through a small horizontal incision in the front of the neck. In Turkey, it can be performed through a 3-4 cm incision using minimally invasive techniques, including laparoscopic thyroidectomy and robotic thyroidectomy.
When is thyroidectomy indicated?
Thyroidectomy is used in many cases, including:
- Thyroid cancer: The most common reason for thyroid surgery is the removal of the gland along with the tumor cells, which is the primary treatment for thyroid cancer.
- Hyperthyroidism: A condition of excessive thyroid hormones in the blood due to Graves’ disease, nodules, a healthy tumor in the gland, or other causes that is associated with a permanent increase in the amount of thyroid hormone; removing part of the gland reduces the overactivity of the gland.
- Enlarged thyroid gland (goiter): The thyroid gland is removed because it is so large that it may affect the airway or the process of swallowing food.
- Multinodular polyp: This leads to excessive thyroid hormone secretion as well as issues related to its large size and the possibility of it becoming cancerous.
Possible side effects of the procedure
Risks of thyroidectomy are rare:
- Bleeding and thrombus formation
- Sepsis or sore throat
- Blocked airways due to bleeding
- Airway injury during surgery
- Voice changes or hoarseness may be due to damage to the laryngeal nerve
- Hyperthyroidism due to a spike in thyroxine levels during or shortly after the procedure
- Damage to the parathyroid glands and low levels of parathormone (which controls blood calcium levels)
What happens after a thyroidectomy?
After surgery, the patient is transferred to a recovery room where they are monitored for recovery from surgery and anesthesia. Some patients may need to have a drain placed under the incision in the neck, and this drain is usually removed the next day.
Because the patient develops symptoms of hypothyroidism, such as dry skin, fatigue, and weight gain, they must transition from a state of natural hormonal activity (Euthyroid) to a complete dependence on synthetic hormones, known as Levothyroxine.
This medication is used as a permanent replacement therapy to compensate for T4 deficiency and is taken for life, with the goal of reaching TSH target values and maintaining the body’s metabolic homeostasis.
Physical changes after thyroidectomy
Upon returning home, you can return to daily activities. However, you should wait 10 days to two weeks before doing any strenuous activities such as lifting weights or playing violent sports.
The human body undergoes a number of physical changes, including:
- Changes in weight and energy: Weight gain varies depending on the reason for the surgery.
- Possible hair loss or dry skin: Caused by hormonal imbalances in the body.
- Impact on mood or concentration: Mood swings such as anxiety and depression.
- Symptoms of under- or over-dose of hormone replacement.
- Muscle aches, pains, stiffness, or muscle weakness.
- Slow heart rate.
Medical follow-up and life after thyroidectomy
There are several rules that the patient must follow after the surgical resection, including:
- Regular visits to assess the proper dosage of the hormone: Regular doctor visits are required to determine the proper dosage of hormone replacement therapy, as the dosage varies from 25 to 100 based on the patient’s health status and blood hormone levels.
- Periodic tests for TSH and T4: Periodic tests to measure these hormones, to ensure that the medication is having the desired effect as a compensator in regulating thyroid function.
- The importance of regularity in taking the medication on an empty stomach: To ensure proper absorption without the effects of food.
Nutrition and lifestyle after thyroidectomy
Life after thyroidectomy allows you to eat and drink normally, but mild swallowing difficulty may occur initially, so start with liquids and soft foods like purees. A balanced, low-sugar diet with vegetables, lean proteins, and low-sugar fruits is recommended. Avoid taking calcium or iron supplements at the same time as hormone therapy—separate them by 4 hours to prevent absorption interference.
Can life after thyroidectomy be lived normally?
Once a patient is discharged from surgery, they may think that their battle with the disease is over. However, past patient experiences clearly show that there is a deterioration in quality of life after thyroidectomy that lasts for several months before gradually improving over the five years following surgery.
It has been observed from previous trials that this decline is more pronounced in patients who underwent conventional surgery compared to those who underwent surgery via distal access (such as the armpit or behind the ear), with lower physical well-being scores, especially those who underwent total thyroidectomy. In contrast, patients with distal access surgery were more satisfied with their appearance than those with traditional surgery.
Patients who received radioactive iodine treatment had a decreased sense of taste, especially those who temporarily stopped taking hormonal therapy (levothyroxine) as part of hormonal withdrawal, and also developed sleep issues, self-identity disorders, and feelings of distress three months after surgery, compared to patients stimulated with synthetic TSH.
One of the complications that appears after surgery is also: Temporary or permanent calcium deficiency, which negatively affects the patient’s physical ability, especially during the first three years after surgery.
In addition, there is a range of symptoms that persist without significant improvement, most notably:
- Weight gain
- Sensitization to cold or heat
- Voice changes
- Fluid retention in the body
Psychologically, many patients suffered from anxiety and mood disorders before surgery, and these symptoms persisted after the operation, but gradually improved with time and careful psychological and medical follow-up.
Interestingly, issues associated with the appearance of the neck as a result of the surgical effect did not improve significantly over time.
Life after thyroidectomy requires a commitment to regular medical follow-up to adjust hormone levels through periodic analysis, and regularity in taking the correct treatment contributes to improving the quality of life for patients, minimizing side effects, and helping them adapt better after surgery.
Sources:
- Authors. (2023). Title of the article. Journal Name, Volume(Issue), page numbers.
- MedlinePlus. (n.d.). Thyroidectomy: After your surgery. U.S. National Library of Medicine. Retrieved July 9, 2025, from
