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People who have a thyroidectomy are well-acquainted with having a hyperactive (overactive) thyroid. But, once you wake up from surgery, you immediately have the opposite problem—a hypoactive (underactive) thyroid. The treatment options are entirely different in both conditions, as are the symptoms. And when it comes to changes in your weight, you may be surprised at what can happen once you start taking thyroid medication. Suppose you are losing weight after thyroidectomy. In that case, you are not alone, and there is usually an underlying reason why you are having this experience.
A thyroidectomy is a surgery where the thyroid gland is partially or entirely removed. Thyroidectomy is used to treat thyroid disorders like thyroid cancer, goiter (a noncancerous enlargement of the thyroid), or an overactive thyroid (hyperthyroidism).
How much of the thyroid gland is removed during thyroidectomy depends on the reason for surgery. Suppose you only require a partial thyroidectomy where only part of your thyroid is removed. In that case, your thyroid may still work normally after surgery. If you need a total thyroidectomy where your entire thyroid gland is removed, you'll develop hypothyroidism (an underactive thyroid). This condition requires treatment with thyroid hormone replacement medication to support your thyroid's natural function.
The thyroid is sometimes referred to as the body's powerhouse because it regulates metabolism. Its primary purpose is to make and secrete thyroid hormones, which tell cells how to use and store energy.
Hypothyroidism is characterized by a general slowing of body systems. Symptoms of hypothyroidism include:
- Weight gain
- Fatigue and lethargy
- Cold intolerance
- Irregular, slow heartbeat
- Irregular menstrual periods
Other treatments for thyroid cancer
Most thyroid cancers can be cured, especially if they have not metastasized to other parts of the body. The goal of treatment for thyroid cancer is to remove or destroy as much of the cancer as possible to prevent it from growing, spreading, or returning. You'll want to work with your cancer treatment team to choose a treatment plan that considers the type and stage of cancer and your overall health.
Treatment options for thyroid cancer might include:
- Radioactive iodine treatment
- External beam radiation therapy
- Targeted drug therapy
Other treatments for hyperthyroidism
There are several treatment options for hyperthyroidism. You'll want to work with your healthcare provider to determine the best option based on your age, medical history, current health, underlying causes, and the severity.
Treatment for hyperthyroidism might include:
- Radioactive iodine therapy
- Anti-thyroid medications
Note: Paloma Health focuses exclusively on hypothyroidism. Hyperthyroidism, we believe, is better treated with in-person sessions. Since Paloma Health uses telemedicine, we cannot take your blood pressure or heart rate, which is critical to monitor in the case of hyperthyroidism.
Risks of thyroidectomy include damage to your vocal cords and parathyroid glands. Additionally, you'll likely need lifelong treatment with thyroid medication after a thyroidectomy. If your parathyroid glands also are removed, you'll need medication to keep your blood calcium levels normal.
Your weight will likely change after you have a thyroidectomy. Because you will have hypothyroidism after your thyroid gland is removed, many thyroid patients assume they will experience weight gain. However, this is not always the case. Yes, some people will see their weight slightly increase, but weight may remain unchanged, or you may even lose weight.
Unusual changes in your weight can occur after surgery if you are on the incorrect dose of thyroid hormone replacement medication. People with hypothyroidism need to take thyroid hormone replacement medication to "replace" the hormone no longer made by the thyroid. Finding the correct dose to balance your thyroid levels can be challenging and often requires titration over several weeks before you land on the best dose for you.
If your dose is too high, you may be creating a hyperthyroid state because too much medication is in your system, so it is likely you could lose weight. Likewise, if your dose is too low, you may gain weight after a thyroidectomy.
As you can see, the correct dose of thyroid medication is paramount. Not only can the wrong dose affect your weight, but it can throw off just about every system in your body.
Regular thyroid function tests will be required after you have a thyroidectomy. These tests will measure your TSH, T3, and T4 levels. Your doctor may also check other labs depending on why you have the thyroidectomy in the first place and also monitor for other complications like damage to the parathyroid gland.
You will also need to test your thyroid function periodically once you are on the correct dose of medication. In addition, certain factors may require you to change your dose, such as significant changes in your weight, pregnancy, and some health conditions.
Working with a physician specializing in hypothyroidism who understands different thyroid medication options is extremely helpful, as not all people tolerate and thrive on the same type of thyroid medication.
Taking the correct dose of thyroid medication is key to being at a healthy weight after thyroidectomy. However, medication is not the only thing you should do to keep your weight in check.
Get regular exercise
Having hypothyroidism sometimes means it is harder to get moving. But, moderate exercise several times a week is important for keeping your body and mind healthy. If joint or muscle pains or fatigue are getting in the way of your exercising, it may be time to check your thyroid hormone levels.
Eat a nutritious diet
What we put in our bodies certainly impacts how it performs. A diet high in sugar and unhealthy fats will surely slow you down and make you unwell. However, getting plenty of protein, healthy fats, whole grains, fruits, and vegetables can ensure you get the macronutrients and micronutrients you need to feel good and stay healthy.
Stress is often a silent cause of weight gain and weight loss. Find you are experiencing unexpected changes in your weight. It may be time to evaluate your stress load and make changes.
A note from Paloma Health
Suppose you are new to hypothyroidism after treating hyperthyroidism with thyroidectomy or generally struggle with thyroid-related weight issues. In that case, our thyroid physicians are ready to help you find an answer. Our doctors take a holistic approach to treating the thyroid and collaborate with thyroid nutritionists to help you achieve a healthy weight.