How To Optimize Thyroid Hormones After Thyroid Removal Surgery

There are a lot of folks out there who have had their thyroid gland removed. And, now they need medication long term (because it is medically necessary). But sadly, there’s a lot of situations where people don’t feel as well as they did beforehand.

This is where thyroidectomy hormone optimization can play a key role.

In this article, I want to help you with balancing hormones post-thyroid surgery, and tell you a bit more about how that can help you in your overall health with some simple, quick steps.

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Table of Contents

The Role of Medications
Are You On the Right Dosage?
The Role of Medication Types
The Role of Diet
The Role of Nutraceuticals
The Role of Comorbidities
Thyrogastric Syndrome
Balancing Hormones Post Thyroid Surgery

The Role of Medications

While these are not the most important step you can take, they are essentially (and, you’re likely going to be on them anyway). So, let’s talk a bit about medications.

The wrong medications can prevent you from feeling well, and the right ones can be a big part of your recovery.

But, there is one big paradox at play that I want to bring to your attention.

You will need medication for a long time. However, when things stabilize, you shouldn’t need to have your meds up and down all of the time.

There are those who are on medication and do need a lot of dose adjustments. By and large, though, that is more common if they have a thyroid. When you don’t have a thyroid, you will need a great amount – and the amount you need will stay rather steady.

Are You On the Right Dosage?

This is one of the first things we need to think about when it comes to medications.
Are you on the right amount for you?

The rule of thumb is somewhere around three quarters of a microgram of T4 per pound of bodyweight.

So, if you weigh a hundred pounds you’re going to need 75 micrograms (if it were in T4, but we’ll talk a bit more about other types of thyroid medication later on). That’s about the same as three quarters of a grain of natural thyroid.

What If Your Dose is Too High?

But, what if the dose you take is a lot higher than that? The first scenario, and the most typical, is that your current dose is simply too high. You know that when the TSH is below range.

There are many doctors and advocates who say that you need to dose based on T3. I get all of that and totally understand it, but I don’t find the arguments convincing.

These levels are important, but they are not the first to show one of those is elevated, they are the last. Once the TSH heads below range, the dose is just too high.

What If Your Dose is Too Low?

If your dose is dramatically lower than you would expect, this is worth knowing. This is especially true if it was stable and then it dropped off – that could mean that you have regrown some thyroid tissue in your body.

Now, in a lot of cases that would be totally fine. But if you had thyroid cancer, we wouldn’t do that because it could qualify as cancerous tissue. So definitely be aware if your dose is way less than you would need, especially if it becomes that way over time.

The Role of Medication Types

Beyond dosage, now we need to think about whether you are on the best type of medication for your needs. There are a couple options here, but the ones I tend to recommend the most include:

• T4 by itself
• Natural desiccated thyroid (NDT)
• Or a combination of the two

T4 Medications

The most commonly prescribed category of medication contains T4. This is also commonly known as thyroxine. Brands of this medication include Synthroid, Levothyroxine, and Tirosint.

This is a really close approximation to what your body naturally does. The drawbacks is that it may be harder for your body to make T3 or T2 out of it.

I would argue, though, that before you feel the need to switch types, think about why your body isn’t converting T4 to T3 or T2. You may be able to work around it, but healing is likely better.

Natural Desiccated Thyroid (NDT)

This is also a good option. The top brands include Armour Thyroid, Adthyza, and NP Thyroid.

These are particularly good because they include T4, T3, and T2. The drawbacks are that some feel stimulated while on them. They can feel that their heart is racing, or feel themselves getting anxious, even when the dose is reasonable.

Not-Recommended Medications

Amongst all of the options, there are some that I do not recommend for those following thyroid removal surgery or trying to optimize for that. These include compounded synthetic thyroid, like T4/T3, T3 only, or over the counter.

The drawback surrounding compounded thyroid is that you don’t always know what you’re going to get. The cool thing is that they could select any potency, but what is meant to go in is not the same as what goes out (and, ultimately, what goes into your body).

There are some who advocate for T3-only medications. If you really get deep into how thyroid hormones work, you’d know that T3 is not the only thing that matters. Your body needs T4, T3, and T2 in complementary ways, so you really want to mimic what the body does when healthy.

The Role of Diet

Especially if you are managing a hormone imbalance after thyroid surgery, how can you ensure that your medications are doing the best job possible? The biggest single factor is your diet.

I have talked a lot about the Thyroid Reset Diet helping your thyroid work better, but that’s not really our goal here because your thyroid is gone (and it won’t change that).

But, medications contain iodine. So when you’re already at your body’s upper limit of iodine, and now you add thyroid medication into it – your body may resist the medication because of iodine.

The big perk of the Thyroid Reset Diet is that it gives you a solid balance of macronutrients. These include your proteins, fats, and carbohydrates.

These are all good things. And, while you can have too much of any of these, you can also definitely have too little (and that’s something you definitely want to avoid for optimal health).

In terms of practicalities, the most common way I see people go “off the path” is when it comes to getting too little carbohydrates. That is a very simple way to shut down your body’s ability to activate T4 – that’s all it takes.

Another common is that people get too little protein for maintaining their lean body mass. Over time, this can make them unable to manage their weight quite as effectively.

The Role of Nutraceuticals

Nutraceuticals are relevant because they affect the enzymes that convert your thyroid hormones, helping your body take them up effectively.

There are a handful of key nutrients that can play a big role here, including:

• Selenocysteine (Selenium)
• Vitamin E
• Zinc
• D-Limonene and Calcium-D-Glucarate
• Ellagic Acid
• Turmeric Root
• Grape Seed Extract

These are all things that help your body utilize, convert, and absorb thyroid hormones more effectively. As it happens, I have combined these into the T2/T3 Converter supplement which is super helpful for helping your body work with T4 only.

This can be paired with Hypothyroid Support, which helps your body utilize the hormones after you have converted them.

The Role of Comorbidities

One of the last things I want us to think through today include comorbidities. There are ways you can develop problems following thyroid disease, or have had problems all along, but they are often overlooked or underdiagnosed.

Calcium Metabolism

The first two I want to mention relate to calcium metabolism (either too low or too high). It is not simply a matter of consuming the wrong amounts, rather it’s a matter of your body not being able to regulate calcium at all.

These can both be consequences of thyroid surgery (due to inadvertent damage or disruption to the parathyroid glands). The common symptoms include muscle cramps, tingling sensations around the lips and extremities, muscle spasms, and potentially seizures.

Adrenal Stress

The next big comorbidity can be adrenal stress. This is how your body regulates your entire stress response, and there are a lot of ways in which this aligns with changes in overall thyroid hormone production.

If your thyroid has been off, you can have a lot of issues with your adrenal slope. We typically think about this when there are symptoms that are persistent, troublesome, and recurrent (this is the key term, in that they come back during certain points of the day repeatedly).

This is best screened for with salivary cortisol tests within the context of blood cortisol tests. The good thing, though, is that this is entirely treatable. It typically requires simple uses of light and food timing which can help your body regain its rhythm.

Latent Iron Depletion

Basically, latent iron depletion is an early stage of anemia. It is also super common and includes the vast majority of folks with thyroid disease. This can often be the cause of so many symptoms, including fatigue, hair loss, joint pain, sleep issues, cognitive decline, and more.

Learning more includes working with someone who can rate your iron scores, knowing between normal and optimal, and knowing safe ways to build that up. In this case, oral iron is the mainstay and is also why I created the supplement Easy Iron.

Thyrogastric Syndrome

This is an autoimmune disease that 30-40% of people with thyroid disease also suffer from. It causes them to not absorb iron or B12, have low levels of zinc, as well as suffer from a range of gastrointestinal symptoms.

It is good to be aware of thyrogastric syndrome, because it is a risk factor for esophageal and stomach cancer. The treatments include watching for the risks and helping your nutrient levels stay in place with more targeted measures.

Balancing Hormones Post Thyroid Surgery

Taken together, being aware of steps like these can help you feel fine again. If your thyroid was taken out, you may feel poorly at first. But, I hope I was able to effectively outline some action steps you can take to get back to your best self.

As a quick refresher, here are those action steps worth considering:

• Get on the right dose of the right medication
• Embrace a diet that helps your body use thyroid hormone
• Take nutraceuticals to support your body’s ability to convert thyroid hormone
• Screen for and manage any potential comorbidities

I hope all of that is super helpful for you. If you want to learn more, I’d love for you to start today by taking the Thyroid Quiz. It can help you learn more about where you stand and some additional steps you can take to feel good and stay healthy.

P.S. Whenever you are ready, here is how I can help you now:

1. Schedule a Thyroid Second Opinion with me, Dr. C, Click Here for Details
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3. Need a Personalized Supplement? Check out My Thyroid Specific Formulations
4. Download and use my Favorite Recipes Cookbook Here
5. Check out my podcast Medical Myths, Legends, and Fairytales Here

Dr. Alan Glen Christianson (Dr. C) is a board-certified Naturopathic Endocrinologist, and the author of The NY Times bestselling Adrenal Reset Diet, Metabolism Reset Diet, Thyroid Reset Diet, and the Healing Hormone Cookbook.

Dr. C’s gift for figuring out what really works has helped hundreds of thousands of people reverse thyroid disease, lose weight, diabetes, and regain energy. Learn more about the surprising story that started his quest.