Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentComplicationsPreventionFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Complications
Prevention
Frequently Asked Questions
This article discusses the symptoms, causes, diagnosis, and treatment of postprocedural hypothyroidism.
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Symptoms of Postprocedural Hypothyroidism
Inform your healthcare provider about any of the following symptoms after thyroid surgery, since they are a sign of abnormal thyroid levels:
Causes of Postprocedural Hypothyroidism
Thethyroid glandis a hormone-producing organ located at the base of the neck. It is responsible for making the thyroid hormones,thyroxineandtriiodothyronine, which are involved in important metabolic processes throughout the body. Problems with the thyroid gland, such ascancer,goiter(enlarged thyroid), ornodules, may require surgery to remove all or part of the thyroid gland.
Postprocedural hypothyroidism is expected after the removal of the entire thyroid gland (a total thyroidectomy) since it is the only organ that can produce thyroid hormones. People who have had their entire thyroid gland removed must take medication to replace thyroid hormones.
Thyroid hormone levels may also be low after the removal of just part of the gland (known as hemithyroidectomy or lobectomy). Low thyroid levels in this setting can be temporary or permanent.In one study of people undergoing hemithyroidectomy in South Korea, thyroid function normalized after an average of one year in 2 of 3 people with hypothyroidism.
Thyroid ablation with radioactive iodine is another therapy that causes postprocedural hypothyroidism. It is sometimes used to treat an overactive thyroid, goiter, and thyroid cancer.When used to treat thyroid cancer, postprocedural hypothyroidism is always expected.
Rates and Risk Factors for Postprocedural Hypothyroidism
The rate of postprocedural hypothyroidism after thyroidectomy depends on how much of the thyroid gland is removed. In a total thyroidectomy, the rate is 100%. In hemithyroidectomy, 20% to 30% of people will require thyroid hormone replacement medication.
Risk factors for postprocedural hypothyroidism after hemithyroidectomy include the following:
How Is Postprocedural Hypothyroidism Diagnosed?
Hypothyroidism does not always cause symptoms, which is referred to assubclinical hypothyroidism. Thankfully, simple blood tests can reveal a diagnosis of hypothyroidism regardless of the presence of symptoms.Thyroid stimulating hormoneandthyroxineblood levels are measured routinely after thyroid surgery to determine if thyroid supplementation is needed and to guide the dosing of the medication.
Treatment of Postprocedural Hypothyroidism
It is important that postprocedural hypothyroidism is diagnosed early to prevent complications of low thyroid levels. Fortunately, treatment of hypothyroidism is possible with medication.
Thyroid hormone replacement is available as an oral medication in pill or liquid form, and the dose is adjusted based on levels of thyroid hormones.
Complications of Postprocedural Hypothyoridism
Thyroid hormones are involved in many metabolic processes, and low thyroid hormone levels can cause many symptoms:
After thyroid surgery, thyroid hormone levels are routinely monitored for timely treatment, and longstanding or severe hypothyroidism can be avoided.
Preventing Postprocedural Hypothyroidism
It is not always possible to prevent postprocedural hypothyroidism, since you cannot control how much of the thyroid gland needs to be removed.
Summary
Postprocedural hypothyroidism is a condition of low thyroid hormone that is not uncommon—it oftentimes is an expected consequence—of thyroid surgery. In some cases, postprocedural hypothyroidism may be temporary.
Hypothyroidism is diagnosed with blood tests. Treatment involves taking thyroid hormone replacement medication and getting occasional blood tests to monitor thyroid hormone levels.
A Word From Verywell
Try to take it at the same time each day on an empty stomach. Always tell your healthcare provider about any other medications or supplements you are on and if you have been prescribed any new medications, since thyroid medication may not be absorbed as well when given with other medication.
If you become pregnant, your medication dose will likely need to be increased and monitored carefully.
After a total thyroidectomy, postprocedural hypothyroidism is expected indefinitely and requires thyroid hormone replacement therapy. After hemithyroidectomy, postprocedural hypothyroidism may be temporary.
Removal of the entire thyroid gland (total thyroidectomy) always results in hypothyroidism and requires supplementation of thyroid hormones with medication. Partial thyroid removal (hemithyroidectomy or lobectomy) can also cause hypothyroidism. Hypothyroidism after a lobectomy may be permanent or temporary.Even if thyroid levels remain normal after surgery, hypothyroidism can develop months to years after surgery.Learn MoreThyroid Surgery Recovery, Side Effects, and Complications
Removal of the entire thyroid gland (total thyroidectomy) always results in hypothyroidism and requires supplementation of thyroid hormones with medication. Partial thyroid removal (hemithyroidectomy or lobectomy) can also cause hypothyroidism. Hypothyroidism after a lobectomy may be permanent or temporary.Even if thyroid levels remain normal after surgery, hypothyroidism can develop months to years after surgery.
Learn MoreThyroid Surgery Recovery, Side Effects, and Complications
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Thyroid Association.Hypothyroidism (Underactive).American Thyroid Association.Thyroid surgery.Tsai SH, Chien SC, Nguyen PA, et al.Incidences of hypothyroidism associated with surgical procedures for thyroid disorders: a nationwide population-based study.Front Pharmacol. 2019;10:1378. doi:10.3389/fphar.2019.01378American Thyroid Association.Radioactive iodine.Hartl DM, Guerlain J, Breuskin I, et al.Thyroid lobectomy for low to intermediate risk differentiated thyroid cancer.Cancers (Basel). 2020;12(11):3282. doi:10.3390/cancers12113282American Thyroid Association.Post Operative expectations.Endocrine Society.Thyroid and parathyroid hormones.Medline Plus.Levothyroxine.Park S, Jeon MJ, Song E, et al.Clinical features of early and late postoperative hypothyroidism after lobectomy.The Journal of Clinical Endocrinology & Metabolism.2017;102(4):1317–1324. doi:10.1210/jc.2016-3597
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Thyroid Association.Hypothyroidism (Underactive).American Thyroid Association.Thyroid surgery.Tsai SH, Chien SC, Nguyen PA, et al.Incidences of hypothyroidism associated with surgical procedures for thyroid disorders: a nationwide population-based study.Front Pharmacol. 2019;10:1378. doi:10.3389/fphar.2019.01378American Thyroid Association.Radioactive iodine.Hartl DM, Guerlain J, Breuskin I, et al.Thyroid lobectomy for low to intermediate risk differentiated thyroid cancer.Cancers (Basel). 2020;12(11):3282. doi:10.3390/cancers12113282American Thyroid Association.Post Operative expectations.Endocrine Society.Thyroid and parathyroid hormones.Medline Plus.Levothyroxine.Park S, Jeon MJ, Song E, et al.Clinical features of early and late postoperative hypothyroidism after lobectomy.The Journal of Clinical Endocrinology & Metabolism.2017;102(4):1317–1324. doi:10.1210/jc.2016-3597
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Thyroid Association.Hypothyroidism (Underactive).American Thyroid Association.Thyroid surgery.Tsai SH, Chien SC, Nguyen PA, et al.Incidences of hypothyroidism associated with surgical procedures for thyroid disorders: a nationwide population-based study.Front Pharmacol. 2019;10:1378. doi:10.3389/fphar.2019.01378American Thyroid Association.Radioactive iodine.Hartl DM, Guerlain J, Breuskin I, et al.Thyroid lobectomy for low to intermediate risk differentiated thyroid cancer.Cancers (Basel). 2020;12(11):3282. doi:10.3390/cancers12113282American Thyroid Association.Post Operative expectations.Endocrine Society.Thyroid and parathyroid hormones.Medline Plus.Levothyroxine.Park S, Jeon MJ, Song E, et al.Clinical features of early and late postoperative hypothyroidism after lobectomy.The Journal of Clinical Endocrinology & Metabolism.2017;102(4):1317–1324. doi:10.1210/jc.2016-3597
American Thyroid Association.Hypothyroidism (Underactive).
American Thyroid Association.Thyroid surgery.
Tsai SH, Chien SC, Nguyen PA, et al.Incidences of hypothyroidism associated with surgical procedures for thyroid disorders: a nationwide population-based study.Front Pharmacol. 2019;10:1378. doi:10.3389/fphar.2019.01378
American Thyroid Association.Radioactive iodine.
Hartl DM, Guerlain J, Breuskin I, et al.Thyroid lobectomy for low to intermediate risk differentiated thyroid cancer.Cancers (Basel). 2020;12(11):3282. doi:10.3390/cancers12113282
American Thyroid Association.Post Operative expectations.
Endocrine Society.Thyroid and parathyroid hormones.
Medline Plus.Levothyroxine.
Park S, Jeon MJ, Song E, et al.Clinical features of early and late postoperative hypothyroidism after lobectomy.The Journal of Clinical Endocrinology & Metabolism.2017;102(4):1317–1324. doi:10.1210/jc.2016-3597
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