Life After Thyroid Surgery: Thyroid Tablets, Calcium and Follow-up

Once the operation is over, most patients want to know how life will be afterwards. For the large majority, life returns to normal. A few simple things need attention, mainly thyroid hormone tablets, calcium and regular follow-up.

Do I need thyroid tablets?

• If the whole thyroid is removed, you need a thyroid hormone tablet (levothyroxine) every day for life, because your body can no longer make the hormone.
• If only half of the thyroid is removed, the remaining half often makes enough hormone, but some patients still need tablets. Blood tests will show.

Tips for taking the tablet

1. Take it once a day on an empty stomach, usually in the morning, and wait about 30 to 60 minutes before breakfast or tea.
2. Keep a gap of a few hours from calcium and iron tablets, which reduce its absorption.
3. Do not stop or change the dose by yourself, and do not skip tablets.
4. Tell your doctor if you become pregnant, because the dose often needs a change.

Blood tests

The dose is adjusted with a TSH blood test, usually repeated a few weeks after the operation or after any change in dose, and then regularly, as your doctor advises.

Calcium and the parathyroid glands

Four tiny parathyroid glands lie next to the thyroid and control the calcium in your blood. After surgery they can be sluggish for a short time. Low calcium may cause:

• Tingling or numbness around the mouth, or in the fingers and toes
• Muscle cramps or twitching

Please tell your doctor or the hospital at once if you notice these symptoms. Calcium and vitamin D tablets, taken as prescribed, treat this quickly. In most patients the glands recover and the supplements can be stopped.

Follow-up after thyroid cancer surgery

If the operation was for thyroid cancer, your surgeon will explain the biopsy report and any further treatment, such as radioactive iodine. Regular blood tests and an ultrasound of the neck are part of the follow-up for several years.

Getting back to routine

• Light daily activity can be resumed gradually. Avoid heavy lifting and strenuous exercise until your surgeon allows it.
• Take care of the wound as advised, and look after the scar.
• Eat a balanced diet. There is no special diet needed after most thyroid operations unless your doctor advises one.
• If your voice is rough for a while, see voice changes after thyroid surgery.

For questions before or after an operation, you can meet Dr. Om Prakash Prajapati at Delta Clinic & Hospital, Varanasi, or start with a video consultation. Read about endoscopic thyroid surgery or our thyroid department.