# Effects of thyroidectomy



## thegriz445

Hello, I'm a 22 year old healthy female and just found out that I have to have a total thyroidectomy next month. A few years ago during a CT scan for something completely unrelated, the doctor found a 2 cm nodule (it still doesn't bother me at all, and I had never even noticed it). I have had it monitored since then, but my latest biopsy returned under the "suspicious" category, and my doctor said there is about a 50% chance it is cancerous and therefore must be removed. They won't know for sure until the thyroid is removed--then, if it is cancerous, I will have to undergo radioactive iodine treatment. Despite all of this, my thyroid function and levels have always been normal. I am very worried about the effects of the surgery, and have many questions. As I don't know very much thus far, I would appreciate any insight.

Will I experience a weight gain? (I'm hoping not, since my thyroid levels have always been normal)

Will I have to change my diet? (I already have several severe food allergies, including nuts, soy, and all fish and fish oil, including omega 3)

Will this affect child-rearing? (Eventually, I would like to have several children)

What is the recovery time like? (I am a full-time student)

I would greatly appreciate any feedback. Thank you very much


----------



## Lovlkn

> Will I experience a weight gain? (I'm hoping not, since my thyroid levels have always been normal) *If you are properly medicated on replacement you will not liklely gain weight. My thyroid was removed 10 years ago when I was 40 and I weigh within 2 lbs of what I weighed the day of my surgery/*
> 
> Will I have to change my diet? (I already have several severe food allergies, including nuts, soy, and all fish and fish oil, including omega 3)* No need to change your diet other than adding more fruits and veggies ( as I know how you college students eat ;-))*
> 
> Will this affect child-rearing? (Eventually, I would like to have several children) *Again, if you are properly medicated on replacement doses you should not have any issues.*
> 
> What is the recovery time like? (I am a full-time student) *If you begin replacement medications within a day or 2 of surgery - based on 1.7mcg per kilogram of weight , you will hopefully stabilize quickly. I struggled with fatigue and it was found I was deficient in Ferritin and Vit D - you may want to have your ferritin and Vit D, B-12 levels checked prior to any surgery as many of us on this board have been found deficient in them and it could save you alot of discomfort during your recalibration phase post op.*
> 
> I would greatly appreciate any feedback. Thank you very much


It will be very important for you to have Free T-3 and Free T-4 tests run post op. These 2 tests tll the active thyroid hormone in your blood. A TSH test lags up to 6 weeks, yet many doctors rely heavily on this test only.

If you hang around - we can help you dial in your replacement doses.

It is not the endo of life without a thyroid. Many many people live completely normal lifes without a thyroid. I am sure you must be petrified.


----------



## jade

I had a thyroidectomy in early August and haven't gained a pound. I haven't had to change my diet either. I'm a vegetarian and usually eat a healthy diet, so nothing has changed. As far as recovery time, I felt pretty good by day 3 or 4 and close to normal within a week or so. I was driving (carefully) by day 5 post-op. I'm still working on getting my medication dose right, but I'm doing really well overall. I'm sure you'll do fine. The surgery and recovery were much easier than I expected. As long as your levels are good, you should feel fine and not worry about weight gain.


----------



## thegriz445

Thank you so much for your responses thus far. Being a student with limited time to spare for exercise, I am particularly concerned about potential weight gain. As I personally don't know anybody who has gone through this, I am even happy to hear from just one person (Jade) that has had this surgery without the weight gain.

Thank you Lovlkn for your response as well--I will definitely stick around and I will greatly appreciate any advice on medication dosage post-op. It seems that the most important thing will be to make sure that I am properly medicated after the surgery. I guess I'm just so frustrated because as of now, my TSH test and T-3 and T-4 levels are absolutely perfect, and I know that once my thyroid is gone they will be all out of whack.

I just spoke to my doctor again and he said that we will schedule the surgery for this December during my winter break so that I do not have to miss any school. I have about 2 weeks off from school so I am hoping that I will be able to go back for second semester on time. The surgery will be at Johns Hopkins so I trust that I will be in good hands. But my major worry is more about figuring out and managing the medication dose post-op, as I actually live and go to school in the midwest (Chicago). With the TSH test lagging up to 6 weeks, I am very anxious about having to fly back to school without yet having stabilized my replacement dosage. So, here is perhaps my most important question:

*Can figuring out/managing replacement dosage be effectively managed from afar? Or should I consider trying to find another endocrinologist locally?* I'd be hesitant to have the surgery done locally, because my doctor from Johns Hopkins has been following me for a while now and I do trust him. But on the other hand, I know that I will probably be sent back to school before my proper dose is figured out. Any advice? Thank you all again, your comments are greatly appreciated.


----------



## joplin1975

Yes to everything above. You are going to be ok...that's #1.

Your meds can be managed from afar, but you do need to have good communication with your doctor. And you need a doctor who tests TSH, free t4 *and* free t3.

I wanted to add that RAI, according to new standards/guidelines, should never be assumed, particularly without seeing the pathology report first. RAI is being used much more conservatively - a trend that's developed in the past ~2 years or so. You might want to get some clarification from your doctor.


----------



## jenny v

I had a total thyroidectomy 1 year ago (my surgery anniversary was Friday!) and I've lost over 20 pounds in the last few months. Just make sure whoever is managing your thyroid meds doesn't just run and dose by TSH alone--you want Free T3 and Free T4 run every single time. Good luck! It's a relatively easy surgery.


----------



## Lovlkn

thegriz,



> my TSH test and T-3 and T-4 levels are absolutely perfect, and I know that once my thyroid is gone they will be all out of whack


Can you post these with ranges please?

The tests need to be "free" in order to be the correct tests for post op dosing.

I would suggest you find a General practitioner in the Chicago area to write your prescriptions as an out of state prescription will likely not be filled.. That doctor and the endo at Johns Hopkins should manage your care together.


----------



## chicknshrimp

I had your same issue...healthy 20 something and nodule found on another exam. Biopsy showed hurtle cells, everything else was normal and I felt great (ran a trail marathon the month before my surgery).

I had a TT/neck dissection in 2011... began as PT then cancer was found under frozen section in the OR and surgery was converted to TT. I had the RAI and Ive been cancer free since. I continue seeing an endo and get ultrasounds every 6 months, bloodwork every 3.

My opinion isn't everyones but its what I wish someone had told me....

You have options, and waiting, monitoring, and watching is one of them, even with a suspicious biopsy. So is a TT. It all depends on your comfort level knowing there "may" be a problem. If there is cancer it is one of the most treatable, unless you get hurthle cell, then its not as good.

If I could do it again I would have waited and done more monitoring. Western medicine is really big on taking thyroids out just to avoid a future problem. Surgeons will say you need a TT and will offer that as your only option when there are other ways to manage it... bottom line is nobody wants to get sued for not acting on it, and thats where the decision making comes from. I say this as someone who works in healthcare...not just a patient.

I feel like I rushed into it but I do say that as someone who is cancer-free... so theres that. I had a fantastic surgeon, just wish I hadn't had the surgery.

I did gain weight, can't take it off, and I've had a ton of trouble regulating my meds. I always feel fatigued and if I increase my dose to the therapeutic levels to prevent cancer recurrance then I get all of the hyper symptoms...not fun. I had a fast surgical recovery, I went back to work full-time in less than a week, but I've never felt the same. You shouldn't have a problem with having children, I've seen fertility specialists (for hubby's stuff) and they aren't concerned with my thyroid as long as my labs look good, you will have to have more frequent blood work though.

Like I said, this isn't everyones experience and some are more sensitive to the change than others... I happen to be super sensitive, you may not be. Just do all of your research, you're really young and this is a decision you have to live with forever. Whatever you decide, make sure you're comfortable with it, and it will be the right one.

Best of luck


----------

