Postprocedural hypothyroidism occurs when the thyroid doesn’t produce enough thyroid hormones as a result of a medical procedure, like surgery to remove all or part of the thyroid gland.
Postprocedural hypothyroidism is also known as postoperative hypothyroidism.
Procedures to remove the thyroid gland treat conditions like goiter, thyroid nodules, or thyroid cancer.
Hypothyroidism that develops after a medical procedure is treatable with thyroid hormone replacement therapy. Let’s review the symptoms, causes, diagnosis, and treatment of postprocedural hypothyroidism.
The thyroid is a small gland that sits in front of your windpipe. It releases hormones that help your body use energy.
It’s possible to develop problems with the thyroid gland, including when it produces too much hormone (hyperthyroidism) or not enough (hypothyroidism). You can also develop cancer or nodules on the thyroid gland.
The symptoms of postprocedural hypothyroidism are the same as traditional hypothyroidism. These include:
- fatigue (low energy)
- weight gain
- feeling cold
- slower heart rate
- muscle weakness
- pain and stiffness in your joints
- dry skin
To treat certain problems with the thyroid, a doctor may recommend a medical procedure to remove or destroy all or part of the thyroid gland.
Medical procedures to treat thyroid problems include:
- full removal of the thyroid gland (thyroidectomy)
- partial removal of the thyroid gland (hemithyroidectomy or lobectomy)
- thyroid ablation with radioactive iodine
Postprocedural hypothyroidism always occurs after thyroidectomy since the thyroid is the only organ that can produce thyroid hormones.
Postprocedural hypothyroidism may occur after hemithyroidectomy or thyroid ablation. In these cases, hypothyroidism may be temporary or permanent. Hypothyroidism can develop months to years after hemithyroidectomy.
In a 2017 study of 335 people treated with partial removal of the thyroid gland, about 64% of people experienced postprocedural hypothyroidism. For about 34% of people in the study, the hypothyroidism was temporary and spontaneously resolved.
The more thyroid tissue that’s removed, the more likely it is that you’ll develop postprocedural hypothyroidism.
Thyroid hormones affect nearly every function in the body. If left untreated, postprocedural hypothyroidism can cause serious complications with:
- body temperature
- heart health
- kidney health
- muscle weakness
Severe hypothyroidism can lead to a life threatening condition called myxedema crisis. Symptoms of myxedema crisis include:
- low body temperature (hypothermia)
- high blood pressure
- low heart rate
- decreased breathing
After your surgery or thyroid ablation, your doctor will routinely monitor your thyroid hormone levels.
Your doctor will monitor your thyroid levels after a thyroid procedure. It’s important not to miss your follow-up appointments to make sure your thyroid hormone levels are in a typical range.
If you’ve recently had thyroid surgery or radioactive ablation and you start noticing symptoms of hypothyroidism, like fatigue and weight gain, speak with your doctor about getting tested for hypothyroidism.
Hypothyroidism is a lifelong condition after thyroidectomy. Treatment involves taking a synthetic hormone called levothyroxine (Levoxyl, Synthroid). If you’ve had a thyroidectomy, you’ll start taking the medication the day after surgery.
It may take several weeks to start feeling better. You and your doctor will work together to figure out the best dose of the medication that addresses your symptoms.
After thyroidectomy, you must take this medication for the rest of your life. Your doctor will monitor your TSH levels regularly and adjust your dose of the medication as necessary.
Some, but not all, cases of postprocedural hypothyroidism caused by hemithyroidectomy or thyroid ablation are temporary and may spontaneously go away over time. You will need to take levothyroxine in the meantime.
It’s not always possible to prevent postprocedural hypothyroidism.
However, getting tested for hypothyroidism after your thyroid surgery and taking all medications as prescribed can help prevent symptoms and complications.
Once medications restore your hormone levels, symptoms of postprocedural hypothyroidism are likely to go away or at least become more manageable.
If you have postprocedural hypothyroidism, it won’t affect your quality of life, but you’ll have to take the thyroid medication permanently.
Postprocedural hypothyroidism occurs after medical procedures to remove part of all of the thyroid. You can manage it with medication. If you’re getting thyroid surgery, speak with your doctor about the risk of postprocedural hypothyroidism.
After your procedure, it’s important to follow up with your doctor for all recommended lab tests to ensure that thyroid levels are in a typical range.