Thyroid surgery is the first line of treatment for papillary thyroid cancer (also known as papillary thyroid carcinoma). Thyroid hormones are essential because they control your body's metabolism. In most cases, you will need to take thyroid hormone replacement therapy to manage hypothyroidism after surgery. Before we dive into hormone replacement options, let’s first define hypothyroidism and its effects on the body.
Thyroid Surgery's Impact on Hormone Production
There are two main types of thyroid surgery — partial thyroidectomy (partial thyroid removal) and total thyroidectomy. If you require a total thyroidectomy, your body will no longer be able to produce thyroid hormones, and you will become hypothyroid. The thyroid gland produces two hormones—T3 and T4. You will most likely take a daily dose of T4 via an oral pill.
Synthetic forms of T4 hormone are the most common hypothyroidism treatment — you may know them as Levothyroxine (generic) or Synthroid. You likely will need regular bloodwork and checkups to ensure your dosage is correct. However, even if you’re diligent about taking your thyroid hormones, you can still suffer from uncomfortable flare-ups of these symptoms. For instance, you might feel unusual fatigue, aches, sensitivity to cold, or memory problems.
There are some common lifestyle factors that may precede a flare. While your doctor can alert you to any medical abnormalities in your bloodwork, there are some factors that you can begin paying more attention to when you start to suffer from a flare-up:
1. Your diet: Many people find that grains (specifically gluten-containing grains), high sodium and high iodine intake as common triggers for a flare-up. Table salt is traditionally iodized, so if you’re eating a lot of high-salt foods you’re also likely consuming too much iodine.
2. Your lifestyle: Lack of sleep or insomnia, high levels of stress, as well as being too sedentary—or exercising too much with high intensity workouts (think fast runs, HIIT workouts or sprints) can be triggers for flare-ups.
Tips for dealing with hypothyroid flare-ups:
1. Address your stress.
We all have stress, but when you’ve undergone a thyroidectomy, it’s important to guard your time, give yourself some grace on your to-dos, and relax when you need it. It’s also important to realize that an overload of mental stress isn’t just a trigger for a flare itself, but can also impact your ability to care for yourself as you otherwise would. For instance, if you’re under stress, you might reach for less healthy foods or might be going to bed later or staying up late with worry and anxiety. Now is the time to go full-stop with self-care: unplugging when you need to, whatever that means for you. Temporarily deleting social media apps, going to bed early, calling a friend to vent, and taking walks outside are all ways to lower your cortisol levels naturally.
2. Check your supplements.
You want to make sure that you’re supplemented enough with selenium and vitamin D in particular, since these are the building blocks of thyroid hormones. And when selecting vitamin D supplements, go for D3 rather than D2 — it’s naturally produced in your body (and not having a thyroid may make it more difficult for your body to produce). Plus, it’s more effective at improving your overall vitamin D status. But check with your doctor before taking any supplements to ensure it doesn’t impact other aspects of your treatment.
3. Eat fresh, whole foods.
You’ve heard this all before, but it’s especially crucial now: focus on non-processed foods, lots of vegetables and greens, organic meats, and reduce sugar intake. Processed foods are tough for anyone to metabolize, and you don’t want to put the added stress on your body when your T3 levels are already low.
4. Ditch sugar and gluten.
Cookies and ice cream may be comforting in times of stress, but they’ll only exacerbate your symptoms now. Loading up your diet with sugar will lead to spikes and dips in blood sugar, something that activates your immune and metabolic system. Since gluten is a trigger for many people, consider avoiding gluten-containing foods (many packaged snacks, wheat pastas, bread, cereal, and junk foods).
5. Eat more fiber — just wait until two hours after you take your thyroid hormones.
A common symptom of hypothyroidism is constipation. It makes sense — as your metabolism slows down, so do your bodily processes. Take a fiber supplement, probiotics, or increase your fiber intake in your diet. However, be careful not to eat too much fiber right after you take your thyroid hormones; doing so can mean that less is absorbed into your bloodstream.
Many people take synthetic thyroid hormones on a daily basis, and most therapies are effective. Even flare-ups tend to only last 2 - 3 weeks on average. While uncomfortable, rest assured that a combination of medical and holistic therapies will likely alleviate your symptoms.
