Book Your Consultation
- Specialist consultation
- Personalized Coaching
- Body Composition Analysis
After a total thyroidectomy, the American Thyroid Association (ATA) states that thyroid hormone supplementation is needed for life. After a lobectomy, blood tests show whether the remaining half of the gland produces enough hormone. Endocare’s endocrinologists in Dubai manage the medical care that follows thyroid surgery. The operation itself takes place elsewhere. We help with thyroid hormone replacement, calcium checks when needed and longer-term monitoring after surgery.
- Endocare’s endocrinologists manage the thyroid hormone replacement and the monitoring that follow thyroid surgery, at our Dubai clinic in Dubai Healthcare City.
- The ATA describes lifelong thyroid hormone supplementation as necessary after complete removal of the thyroid gland.
- After a lobectomy, the remaining half of the gland may produce enough thyroid hormone on its own. The UK National Institute for Health and Care Excellence (NICE) recommends considering blood tests at 2 and 6 months after the operation.
- The parathyroid glands sit next to the thyroid and control calcium. The American Thyroid Association puts the chance that all four are damaged or removed during a total thyroidectomy at 1% to 3%, and that low calcium is much less likely after a lobectomy.
- The ATA puts the risk of temporary hoarseness after thyroid surgery at 5% to 7%, and the risk of permanent nerve injury at 0.5%.
- Your thyroid-stimulating hormone (TSH) target after surgery depends on why your thyroid was removed. After surgery for thyroid cancer, it depends on the risk of the cancer returning.
01 Introduction
After thyroid surgery, your care continues with medical treatment and monitoring. Your thyroid hormone level may need replacing. Your calcium may also need checking, and this care can continue long after the surgical follow-up ends. This page covers what each operation means for hormone replacement, how your dose is set, what your thyroid-stimulating hormone (TSH) target depends on, why calcium matters, and which doctor to contact for what.
02 What Endocare does after thyroid surgery
Endocare does not perform thyroid surgery. Our endocrinologists manage the care that follows the operation, regardless of where it took place. This includes starting and adjusting your thyroid hormone replacement and setting the target for your dose. It also includes monitoring your calcium where your parathyroid glands were affected. Your endocrinologist will continue to review you for as long as that care is needed.
03 What was removed, and what that means for you
The extent of the operation shapes the care that follows. Your endocrinologist will first establish which operation you had.
After a total thyroidectomy
A total thyroidectomy removes the whole gland. The American Thyroid Association states that patients who undergo complete removal will require lifelong supplementation with thyroid hormone after surgery. The US National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) states that removing the entire thyroid always results in hypothyroidism. Your thyroid hormone then comes from your daily medication.
After a thyroid lobectomy
A lobectomy, also called a hemithyroidectomy, removes one half of the gland. The ATA states that, depending on your current level of thyroid function, there is a possibility the remaining half can produce all the hormone your body needs. If it does not, you may still need to take thyroid hormone supplements life-long. NICE recommends considering TSH and free thyroxine (FT4) tests at 2 and 6 months after a hemithyroidectomy, and then a TSH test once a year.
04 What treatment is needed after thyroid removal?
Thyroid hormone replacement with levothyroxine is the standard treatment. NIDDK lists surgical removal of part or all of the thyroid among the causes of hypothyroidism. NICE recommends offering levothyroxine after a total thyroidectomy, with the dosing and monitoring it recommends for primary hypothyroidism. Where low calcium develops, the ATA lists oral calcium and vitamin D as the treatment. We manage both treatments together.
05 How your replacement dose is set and re-checked
Your endocrinologist will set your starting dose based on your weight, your age, your heart health and the reason your thyroid was removed. NIDDK describes a blood test around 6 to 8 weeks after you begin taking the medication, and another after each change in dose. Our page on treatment for an underactive thyroid covers how levothyroxine is taken and what can reduce how much of it you absorb.
After a total thyroidectomy, NICE recommends following its monitoring recommendations for hypothyroidism. These advise considering a TSH test every 3 months until the level has stabilised, and then once a year. NICE describes a stable level as two similar measurements within the reference range, 3 months apart.
06 What should my TSH be if I had my thyroid removed?
Your TSH target depends on why your thyroid was removed. After a total thyroidectomy for a benign condition, NICE points to its recommendation for primary hypothyroidism, which aims to keep TSH within the reference range. After surgery for thyroid cancer, Recommendation 59 of the 2015 American Thyroid Association guidelines bases the initial TSH target on the risk of the cancer returning. For patients at higher risk, the guidelines recommend an initial TSH that is lower than the reference range.
Your endocrinologist will explain your target and what it is based on. We recommend keeping a note of it with your results, as it affects how each result is interpreted.
07 What happens if you stop taking levothyroxine after a thyroidectomy
After a total thyroidectomy, your thyroid hormone level can fall without the medication, as no gland remains to produce it. The symptoms of an underactive thyroid can then develop. NIDDK lists fatigue, weight gain, trouble tolerating cold, joint and muscle pain, and dry skin or thinning hair among them. It also lists a slowed heart rate and depression, and states that hypothyroidism can contribute to high cholesterol. If you have missed doses or run out of your medication, we recommend contacting your endocrinologist rather than taking a double dose.
08 Calcium and the parathyroid glands
Why calcium is checked after thyroid surgery
The ATA describes the parathyroid glands as four tiny glands that sit next to the thyroid and control the body’s calcium levels. Because they sit so close to the thyroid, thyroid surgery can affect them. The ATA states that when patients undergo a total thyroidectomy, there is a 1% to 3% chance that all four glands can be damaged or accidentally removed. It adds that there is also a risk that one or two of the glands are affected. Low calcium is much less likely after a thyroid lobectomy.
The symptoms of low calcium
The ATA states that the main symptom of low calcium is typically numbness and tingling in the fingers and toes and around the lips. In severe cases, low calcium can cause muscle cramps. MedlinePlus, from the US National Library of Medicine, states that injury to the parathyroid glands during thyroid or neck surgery is the most common cause of low parathyroid hormone (hypoparathyroidism).
We recommend contacting your treating team promptly if you develop any of these symptoms after thyroid surgery. Your endocrinologist can check your calcium with a blood test and adjust your treatment.
When low calcium needs urgent attention
Call an ambulance on 998 if you have a seizure or difficulty breathing after thyroid surgery. MedlinePlus states that seizures or breathing problems are an emergency in hypoparathyroidism. It also states that muscle spasms caused by low calcium can affect the voice box and cause breathing difficulties.
09 Voice changes after thyroid surgery
The recurrent laryngeal nerves control the vocal cords and run close to the thyroid. The ATA states that there is a 5% to 7% risk of temporary hoarseness, which gets better on its own as the nerve recovers. It puts the risk of permanent nerve injury at 0.5%. We recommend contacting the surgical team who performed your operation if your voice has not settled.
10 Which doctor to go back to, and for what
Different teams typically handle different parts of your care after thyroid surgery:
| What you need | Who handles it |
|---|---|
| The wound, the scar, and any swelling or bleeding at the site | The surgical team who performed your operation |
| A hoarse voice that has not settled | Your surgical team |
| Your thyroid hormone replacement dose, and the target it aims at | Your endocrinologist |
| Calcium and parathyroid function, and any supplementation | Your endocrinologist |
| Radioactive iodine after surgery for thyroid cancer | A nuclear medicine service, arranged by your specialist team |
| Long-term monitoring and annual review | Your endocrinologist |
Where something falls between two services, your endocrinologist will tell you which to contact.
11 Long-term follow-up after thyroid surgery
Once your dose is stable, NICE advises considering a TSH test once a year. Where your calcium is affected, your endocrinologist will monitor it alongside your thyroid hormone. A new symptom, pregnancy, a new medication or a significant change in weight can each change the dose you need. We recommend telling your endocrinologist about any of these.
12 After surgery for thyroid cancer
After surgery for thyroid cancer, monitoring continues alongside hormone replacement. The 2015 ATA guidelines include measuring thyroglobulin, a protein made by thyroid tissue, during follow-up. Some patients also receive radioactive iodine after surgery. NIDDK states that radioiodine therapy slowly destroys the cells of the thyroid gland that produce thyroid hormone. A nuclear medicine service delivers this treatment.
Surveillance after thyroid cancer is often shared between an endocrinologist and the specialist cancer team. Your endocrinologist will explain which parts of your follow-up take place at Endocare.
13 Pregnancy after thyroid surgery
NIDDK states that many women taking thyroid hormone medication need a higher dose during pregnancy. After a total thyroidectomy, your body cannot increase its own thyroid hormone production to meet that need. The American Thyroid Association publishes guidelines for thyroid disease during pregnancy and the postpartum period. We recommend telling your endocrinologist as soon as you are pregnant or planning a pregnancy. Your endocrinologist may need to change both your dose and how often you have blood tests.
14 What your care at Endocare involves
Specialist thyroid care at Endocare begins with a full medical assessment. Your endocrinologist will assess your symptoms alongside the appropriate thyroid tests to understand what is actually driving them and determine the right treatment. We review your surgery report, tissue test results and blood tests to plan the right follow-up. Where possible, your first appointment takes place in person at Endocare’s Dubai clinic, as the physical examination and body composition analysis cannot be completed remotely.
Your thyroid hormone level affects how quickly your body uses energy. Changes in your dose can affect your weight and your body composition. At Endocare, body composition analysis is included free of charge at every consultation. Body composition analysis estimates body fat, muscle mass and body water. Repeated measurements help your endocrinologist understand how your body is changing beyond the number on the scale.
Monthly follow-up appointments can be held in person at the clinic or online. Our blood test panels cover the markers involved. Your endocrinologist will arrange any further test your assessment calls for.
15 FAQ
What is the best thyroid medication to take after total thyroidectomy?
Levothyroxine is the standard replacement after a total thyroidectomy. NIDDK describes it as a thyroid hormone medication identical to a hormone a healthy thyroid makes. Your endocrinologist will adjust the dose to your weight, age and heart health, and to your TSH target.
What happens if I do not take levothyroxine after thyroidectomy?
Without the medication, your thyroid hormone level can fall, as no thyroid gland remains after a total thyroidectomy. Symptoms of an underactive thyroid, such as fatigue, weight gain and feeling cold, can develop. We recommend contacting your endocrinologist about any missed doses.
Will my voice come back?
Hoarseness after thyroid surgery is often temporary. The ATA describes temporary hoarseness as getting better on its own as the nerve has time to recover. It states that if permanent nerve injury occurs, the voice can still be brought back to normal with additional procedures.
Do I need calcium tablets after thyroid surgery?
Calcium tablets are typically needed only where the operation has affected your parathyroid glands. Low calcium is much less likely after a lobectomy. After a total thyroidectomy, your endocrinologist will base the decision on your calcium results.
Our Dubai clinic is located in Building 27, Block B, Unit 504 B, Dubai Healthcare City. Opening hours are Sunday 10:00-20:00, Monday 08:30-18:30, and Tuesday to Thursday 10:00-20:00. The clinic is closed on Fridays. Free parking is available in the building and on the surrounding streets. For patients using public transport, Dubai Healthcare City Metro Station on the Green Line is the nearest stop.
In the UAE, you can see an endocrinologist directly, with no GP referral needed, for concerns related to hormones, weight, metabolism or blood sugar. If you plan to use health insurance, we recommend checking your policy before you book, because some insurers require a referral or pre-approval. To book a consultation with our endocrinologists in Dubai, call +971 4 285 3885 or email contact@endocare-clinic.com. We recommend bringing your operation record, the tissue test (histology) report where you have one, and your most recent thyroid function and calcium results to your appointment.
Book Your Consultation
- Specialist consultation
- Personalized Coaching
- Body Composition Analysis