In 2003, at the age of 36, I had a serious scare as I was putting on makeup one morning. I noticed a knot in the right side of my neck and immediately called my family doctor to set up an appointment for the next day.
After numerous doctor visits, blood tests, biopsy, and ultrasound, it was determined that the knot–a thyroid nodule–should be surgically removed. I had no previous thyroid issues, and problems don’t run in my family. At that time, I had no other medical conditions that I was aware of, but later developed quite a few.
A general surgeon performed the operation which ended up taking over three hours. He removed the nodule, as well as half of my thyroid, and I was told medication would be required for the rest of my life. I would also need regular blood tests to determine my thyroid function. Over the years, the expenses would add up quickly.
After the surgery, it was necessary for me to go to my family doctor for blood work every 6-12 months to make sure my TSH levels were normal and adjust medication as necessary. When I changed to a plant-based diet in 2013, my levothyroxine was reduced from 100 mcg to 88 mcg daily.
A few months ago, I came across an article that said it was possible for people who have had a thyroid lobectomy to come off medications. I had never heard that before and was very surprised that my family doctor had not mentioned it to me. I scheduled an appointment with an endocrinologist in my area of Western North Carolina, Dr. Kathya Rivera.
Come to find out, research has shown that only 1 in 7 patients (or 14.3%) experience hypothyroidism, requiring thyroid medication following a thyroid lobectomy, if their TSH levels were normal prior to surgery. I had no idea and became interested in finding out if this was a possibility for me. Had I been going through the motions and expense unnecessarily for over a decade?
When I went for my appointment and told the endocrinologist about the article I had read, she said that it was indeed possible for me to get off medication, if I wanted to give it a try.
“Hypothyroidism is a common complication of thyroid surgery. However, after partial thyroid resection it is possible that the remaining thyroid tissue will be able to function and produce the amount of thyroid hormone that the patient requires. As long as the patient is aware of all the potential symptoms of low thyroid hormone, it is reasonable to monitor thyroid hormone levels closely after surgery to determine whether the patient will truly need to start thyroid hormone replacement therapy.”--Dr Kathya Rivera
I was told that some people who have only a small portion of their thyroid left after surgery are able to come off medication completely, and I still had half of mine. According to Dr. Rivera, from my history, it looked like my thyroid had never been asked to work and do its job since the surgery. All those years, it had been sensing the medicine in my system and, knowing it didn’t need to do anything, had just been kind of dormant.
Dr. Rivera said she was optimistic and cut my medication in half immediately. She said that she preferred to reduce medications aggressively, when possible.
Within days, I noticed that I wasn’t having the heart flutters I had grown used to over the years. In the past, when I went in for a regular recheck, TSH levels in my blood would always come back normal, even though I experienced palpitations occasionally.
Some of the symptoms of hypothyroidism the doctor told me to watch for were fatigue, weakness, constipation, mood swings, and weight gain. I told her that many of those symptoms were similar to perimenopause, so it might be difficult to distinguish but, since my diet is strictly plant-based with over 40 grams of fiber daily, suddenly developing constipation would be a big red flag.
Menopause for women in my family tends to come at an early age–my grandmother was 45, and my sister was only around 43. I had been going through a lot of the very painful and unpleasant perimenopause symptoms before switching my diet, nearly 4 years earlier, but those symptoms had subsided since then. With the medication change, I wasn’t sure if the symptoms would return, at least temporarily.
Thankfully, I did not experience the hypothyroid symptoms the doctor cautioned me to watch for, so shortly my medication was reduced to one-forth of a pill (22 mcg). If symptoms became a problem, my doctor said we would simply reduce my medication in smaller amounts.
For a short period of time, I did have a number of hot flashes (or power surges, as I called them), but they quickly subsided. I haven’t had any further problems with those and seem to be sliding smoothly into menopause with very minor symptoms.
After 6 weeks, I went to a lab for blood tests to check my TSH and T4 Free levels, and both were straight down the middle within normal range (TSH 2.233 and T4 Free 1.17). My thyroid was waking up and doing the job it was designed to do after all these years. I was beyond excited!
I was able to completely come off of my levothyroxine and am now medication-free! We will recheck with blood work periodically to make sure my TSH and T4 levels stay in healthy ranges, and I will continue to watch for any symptoms of hypothyroidism. However, I am feeling great and don’t anticipate problems.
Because I don’t have insurance, but am part of a healthcare sharing ministry called Samaritans Ministries where members share needs (a Biblical, non-insurance approach to health care needs), I was considered cash-pay. This allowed me to receive 40%-85% discounts for doctor visits and blood tests.
My endocrinologist was wonderful and did not require me to keep coming in for visits with each medication adjustment, as long as I was not experiencing any negative symptoms. She simply reviewed my blood test results and advised me by phone. This also saved money.
NOTE: I am including information about the company and lab I used for blood work. I was able to obtain an 85% discount–$40 at the lab instead of $268 at my family doctor’s office for the two tests (TSH & T4 Free). Yes, I am quite happily serious! I receive no compensation from these companies but want to share that there are affordable options available in many areas. Check their website for service in your area.
Below, I have included links to research papers and articles that I hope will be helpful.
Inexpensive Lab Testing:
- Medical Screening Services (Ray Fritsch) firstname.lastname@example.org 919/ 452-5404. Serving NC, SC, VA, GA. Ray is also available for group event and conference lab testing.
- PDF File of Lab Prices
- Quest Diagnostics Check their website for services in your area.
Research on Thyroid Replacement after Surgery:
- Thyroid Hormone Replacement After Thyroid Lobectomy –National Institutes of Health
- Risk of Hypothyroidism Following Hemithyroidectomy –Endocrine Society Journal
- Hypothyroidism After Hemithyroidectomy -Jandee Lee and Woong Youn Chung, Department of Surgery,Yonsei Univeristy College of Medicine, South Korea
Thyroid and Diet:
- How Your Thyroid Works –Endocrine Web
- Vegan Diets and Hypothyroidism –National Institutes of Health
- “With the exception of the lacto-ovo vegetarian diet findings in the prevalence study, vegetarian diets were not associated with increased risk of hypothyroidism. Vegan diets which may be expected to lack iodine due to complete exclusion of animal products tended to be protective..”
- Dr. Joel Fuhrman “The fear of eating cruciferous vegetables or that people with hypothyroidism should reduce or avoid the consumption of kale or other cruciferous vegetables (circulating the internet) is unfounded and does a disservice to the community. Whether you have normal thyroid function or hypothyroidism, there is no benefit for you to avoid or restrict your intake of cruciferous vegetables.
- “Eating cruciferous vegetables is not optional; it is a necessity for optimal health. They have numerous anti-cancer benefits, a high micronutrient to calorie ratio and an association with reduced risk of premature death.1 An effectively functioning immune system is dependent on their consumption2 and these benefits clearly outweigh the risk of a modest decrease in thyroid function, which could only occur if the amount of raw cruciferous intake was at an insanely high level or a person was significantly iodine deficient.”
- How to Take Care of Your Thyroid on a Plant Based Diet –One Green Planet
- Dr. Kathya Rivera (my endocrinologist) in Hendersonville, NC
Non-Insurance Share Program:
- Samaritan Ministries is the program I have been a part of for a number of years. What I love about their approach to healthcare is that, 9 months out of the year, I send my monthly shares directly to the person/family in need, along with a card of encouragement. This coincides with my personal Christian beliefs and principles. “Today more than 64,000 households (more than 210,000 people) from all 50 states and several foreign countries, are actively sharing health care needs of more than $23 million each month. In a time of rapidly increasing health care costs, we continue to be amazed at how low the monthly share has been, and realize that it is not because of our wisdom, but God’s blessing.”
I am not a doctor or nutritionist. This website provides general information and discussion about medicine, health, and nutrition. The words and other content on this website, and in any linked material, are not intended and should not be construed as medical advice. If the reader, or any other person, has a medical concern, he or she should consult with an appropriately licensed physician or other healthcare worker.
Never disregard professional medical advice or delay seeking it because of something you have read on this website or in any linked material. If you think you may have a medical emergency, call your doctor immediately.
The views expressed on this website and blog have no relation to those of any academic, hospital, practice, or other institutions with which the author is affiliated.