Thyroid Removal Long-Term Side Effects

The thyroid gland is a butterfly-shaped organ located in the front of the neck in humans. It has many functions throughout the body, including metabolism, energy regulation, development, and mood.

In healthy individuals, the function of the thyroid gland helps them survive each and every day. However, its dysfunction can cause significant detriment to physical and psychological health. 

Thyroid removal or thyroidectomy may be required in some cases. This process involves the surgical removal of either a portion or the entirety of the thyroid gland.¹

Thyroidectomies are quite serious and may be required in cases of thyroid cancer, thyroid nodules, and other conditions that are severely detrimental to one's health. Surgery can occur either through the mouth or, most commonly, through an incision in the neck. 

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Main indications

There are a few reasons one might receive a thyroidectomy. The most prevalent of which is the presence or growth of nodules on the thyroid gland.

These nodules or tumors are often benign but can still cause many issues. Often, these include stimulation of the thyroid gland, causing hyperthyroidism. If nodules continue to grow, they can cause eventual obstruction of breathing.

Such conditions may need the removal of the thyroid gland. In benign nodules, the thyroidectomy process can be either complete or partial, though complete thyroidectomy tends to be the most effective. 

In cases where these tumors are cancerous, thyroid removal can be a key treatment to prevent cancer from spreading throughout the body.

Individuals who experience a goiter may also need a thyroidectomy. A goiter occurs with irregular swelling/growth of the thyroid gland, appearing as a protrusion on the front of the neck.

This can obstruct the windpipe and cause trouble with eating and breathing. It may also cause many of the issues associated with hyperthyroidism. Goiters are one of the more common thyroid conditions that need surgical intervention.

Other symptoms indicative of hyperthyroidism or other thyroid conditions that may warrant surgery include:²

  • Sensitivity to heat

  • Fatigue

  • Nervousness and irritability

  • Thirst

  • Frequent urination

  • Hyperactivity

  • Unintentional weight loss

Side effects of thyroid removal (thyroidectomy)

As with any surgery, thyroid removal has some possible side effects. While some can be troubling, they are often better than the alternative of leaving the thyroid gland as is and letting thyroid-associated problems persist.

Post-thyroidectomy complications

After the thyroid removal surgery, you may notice some complications such as increased bleeding from the throat, lower levels of thyroid hormone (hypothyroidism), a laryngeal nerve injury or wound, and lower levels of parathyroid hormones in circulation. 

The more obvious complications, such as bleeding, tend to occur a few hours after the surgery and typically stop after a short period.

Some people who undergo thyroidectomy can also experience numbness in their extremities, lips, and the surrounding areas post-operation. Sometimes, this is referred to as Hashimoto’s tingling or numbness. 

Seromas can also occur after surgery. Seromas present as a collection of fluid that spreads under the skin. Individuals with seromas experience fevers, confusion, and changes in heart rate and blood pressure.

Thyroid removal long-term side effects

There are some possible long-term side effects of thyroid removal. As with any surgery, there is a risk of infection. But if the incision is properly sanitized and looked after post-operation, this can reduce the risk of infection occurring. 

It is also important to ensure the healthcare professional undertaking your surgery uses proper hygienic practices.

Scarring can be another long-term side effect that some individuals may be concerned about. This is especially likely if the incision occurs in the front of the neck. However, the incision is often small, so the scar is not largely noticeable.

Individuals undergoing thyroidectomy may experience mild weight gain. This is due to the reduction of thyroid hormone being produced by the thyroid gland, which can slow the metabolism down.

The risk for weight gain is higher in those that received the surgery for hyperthyroidism and in younger individuals.

Hoarse voice/laryngeal nerve damage

A common postoperative issue of thyroidectomy is hoarseness of the voice, sometimes referred to as post-thyroidectomy dysphonia. This complication can include not only difficulty speaking but also difficulty with eating and, in some cases, the noisiness of breath.³

This is often due to damage to the laryngeal nerve, a nerve associated with the voice box. Such damage can occur due to error by the surgeon or intubation (tube insertion through the mouth into the windpipe). 

Research has found that presurgery identification of the superior laryngeal nerve by the surgeon can prevent post-thyroidectomy voice hoarseness.⁴

Hypoparathyroidism

Hypoparathyroidism is a condition where levels of parathyroid hormone (PTH) are low. This condition is associated with hypocalcemia, a condition with lowered calcium levels in the blood.⁵

Parathyroid hormone and calcium are closely linked, so lower levels of PTH can cause lowered calcium levels in the blood, which greatly impairs quality of life. 

This condition is most often caused by damage to the parathyroid glands during thyroidectomy. In fact, hypoparathyroidism is the most common long-term complication of this surgery.

However, this condition can be transient, and research has indicated that those with low postoperative PTH tend to recover fairly quickly. Despite this, the return to normal calcium/PTH can take up to a year.⁶

It is important to note that, in some cases, hypoparathyroidism manifests as seizures after the operation.

Risks

Thyroidectomy comes with general risks. These include infection and allergic or adverse reactions to general anesthetics. 

As mentioned above, specific risks associated with thyroidectomy, as mentioned above, include laryngeal nerve damage, hypoparathyroidism, bleeding, tingling, and seromas.

A less commonly considered risk of thyroidectomy is its possible effect on the brain. A 2016 study indicated that individuals with acute hypothyroidism after thyroidectomy experience increases in local functional brain connectivity. In simpler terms, this means how connected certain areas of the brain are.⁷

In this case, increases in functional connectivity are associated with increased depressive symptoms and reductions in quality of life. 

How to prepare for the surgery

If a thyroidectomy is required, your doctor should give you specific information about how you should prepare for the surgery. However, in general, pretesting of the thyroid occurs alongside blood tests and general screening tests to ensure general overall health and recovery are possible. 

Individuals are advised not to eat or drink anything past midnight the day before the surgery. Often, medications can be taken with a small amount of water. 

On the day of the surgery, it is important to wear comfortable clothing and inform your doctor of any recent changes in your health status.

Life after thyroid surgery: thyroid conditions

While individuals can experience some complications after thyroid surgery, it is completely possible to experience a normal life without your thyroid gland. Research even indicates that thyroid removal surgery tends to increase the quality of life in individuals compared to pre-surgery.⁸

Complications such as swelling, bleeding, and changes in voice are often temporary, and individuals can live a relatively normal life without a thyroid gland. 

The only noticeable change is likely to be the addition of levothyroxine to your medicine regime after surgery. This medication increases the amount of thyroid hormone circulating in the body.

It allows an individual to have functional levels of thyroid hormone where the thyroid gland has been removed or partially removed and can no longer produce thyroid hormone to natural levels. Generally, this medication is quite effective.

Recovery from surgery

Thyroidectomies are generally considered to be safe. However, the need for follow-up checkups with the doctor is crucial to minimize postoperative complications. Such visits can involve blood tests, consideration of symptoms, and ultrasounds.

Immediately after the surgery, it is recommended that individuals try to leave the wound alone, take a shower instead of a bath, and refrain from smoking cigarettes or vaporizers. Intense physical activity and lifting heavy items are not recommended in the first-week post-surgery.

To ensure the best wound healing, it is important to avoid trauma to the area, keep it out of the sunlight, and take all prescribed medications.

You should contact your doctor immediately if you experience profuse bleeding, temperatures, intense pain, or an adverse medication reaction.

The lowdown

Thyroidectomy is a surgical process where the entire or part of the thyroid gland is removed. Such removal may be warranted in cases of thyroid nodules, thyroid cancer, hyperthyroidism, and goiters.

While these surgeries are generally successful, they have some possible postoperative complications, including hoarseness of voice, hypoparathyroidism, infection, bleeding, depression, weight gain, and hypothyroidism.

  1. Thyroidectomy | Johns Hopkins Medicine

  2. Symptoms: Overactive thyroid (hyperthyroidism) | NHS

  3. Speech therapy after thyroidectomy (2017)

  4. Post-thyroidectomy dysphonia in patients with bilateral resection of the superior laryngeal nerve: a comparative spectrographic study (2011)

  5. Thyroid cancer | American Thyroid Association

  6. Hypoparathyroidism after total thyroidectomy: Incidence and resolution (2016)

  7. Diminished quality of life and increased brain functional connectivity in patients with hypothyroidism after total thyroidectomy (2016)

  8. Quality of life after thyroid surgery (2017)

Other sources:

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