How to Support Your Thyroid Before and After a Thyroid Lobectomy

Lobectomy Is a Common Procedure Used to Normalize Thyroid Hormone Production

• What Is a Thyroid Lobectomy?|
• Natural Alternatives to Thyroid Lobectomy|
• Support for Thyroid Lobectomy|
• Maintain Healthy Hormone Levels Post-Surgery|
• Thyroid Lobectomy Is a Low-Risk Procedure|

If you’ve been told you need a thyroid lobectomy, don’t worry — this type of surgery is a very routine and low-risk procedure. However, there are still things you can do to support your body before and after surgery to ensure you have the best possible outcome and maintain your thyroid health moving forward.

In this article, we’ll discuss what a thyroid lobectomy is, why you might need one, what other options you may have, whether there are natural alternatives to a lobectomy, natural support before the surgery, and maintaining healthy thyroid hormone levels after the procedure.

What Is a Thyroid Lobectomy? 

A thyroid lobectomy is a thyroid surgery that removes one half, or one lobe, of the thyroid. You may also hear a thyroid lobectomy referred to as a partial thyroidectomy. 

Although it’s typically an outpatient procedure with a pretty low risk of complications, it may still be considered a “major surgery.” However, it’s a candidate for robotic surgery, which uses a very small incision, reducing scarring. You can also expect to go back to your normal activities after 24 hours — just no heavy lifting. 

During a thyroid lobectomy, you’ll be placed under general anesthesia. If a surgeon is performing the procedure, they’ll make a small horizontal incision as close to a skin crease as possible to reduce the appearance of scarring. Then they’ll remove the affected part of the thyroid and close the incision. During the procedure, they may also take a small biopsy of the remaining thyroid tissue to check for any abnormalities.

Why You May Need a Thyroid Lobectomy

A thyroid lobectomy is typically recommended for [1]:

• Thyroid cancer in which only part of the thyroid is affected and there’s no lymph node involvement; typically this is papillary thyroid cancer, which is an abnormal growth or nodule on one side of the thyroid
• Noncancerous thyroid nodules on one lobe of the thyroid
• Thyroid goiter (abnormal growth of the thyroid gland itself)
• Hyperthyroidism (an overactive thyroid gland)
• Autoimmune thyroid disease (Graves’ disease that has been unresponsive to treatment)

Keep in mind that not all cases of these conditions will require a lobectomy. Especially in the case of autoimmune thyroid disease, such as Hashimoto’s or Graves’ disease, there’s almost always a non-surgical solution involving diet and lifestyle changes and supplementation.

Is Thyroid Surgery My Only Option?

Of course, this depends on your situation. But you always have multiple treatment options, and you may want to get a second opinion before agreeing to surgery. In our clinic, we have helped many patients recover from thyroid issues like Hashimoto’s disease, Graves’ disease, hyperthyroidism, hypothyroidism, and many other endocrine conditions.

Are There Natural Alternatives to Thyroid Lobectomy?

There are some cases where thyroid surgery is necessary and unavoidable. But in general, improving thyroid health and function is possible through natural therapies like diet, targeted supplementation, and light therapy.

Dietary interventions like removing gluten or dairy may help reduce thyroid antibodies in Hashimoto’s thyroiditis and improve overall thyroid function [2, 3, 4]. One small study also showed reduced thyroid symptoms and improvement in inflammatory markers on the Autoimmune Paleo Diet (AIP) [5]. Improving blood sugar balance can also help to improve thyroid peroxidase antibody levels for those with Hashimoto’s thyroiditis [6].

Supplements that may support the thyroid include:

• Vitamin D
• Selenium
• Zinc
• Magnesium
• CoQ10
• L-Carnitine (for hyperthyroid symptoms)
• Bugleweed and lemon balm (for hyperthyroid symptoms)

Multiple systematic reviews and meta-analyses have shown a large beneficial effect of vitamin D for reducing thyroid antibodies (TPO and Tg antibodies) [7, 8]. Vitamin D needs time to build up in the body, so at least three months of treatment may be required to see a notable effect [7].

A systematic review and meta-analysis (the highest quality research) showed that selenium supplementation for three, six, nine, and 12 months reduced thyroid antibodies for patients who were being treated with prescription thyroid hormone replacement (like Synthroid). Selenium supplementation also reduced thyroid antibodies after three months in hypothyroid people who weren’t previously being treated with medication [9].

This research, and other research on hypothyroidism, is often relevant to hyperthyroidism too, as autoimmunity is the primary cause of both conditions.

Thyroid autoimmunity seems to improve even more when vitamin D and selenium are taken simultaneously [10].

In hyperthyroidism (an overactive thyroid that produces too much thyroid hormone), L-Carnitine is an amino acid that can both help prevent and reverse hyperthyroid symptoms. It has no known toxicity or drug interactions, and causes minimal side effects [11, 12].

Apart from diet and supplements, there’s some encouraging data showing that low-level laser therapy can improve thyroid function and decrease TPO antibodies. The therapy also reduced the amount of levothyroxine medication the patients needed, even after nine months of follow-up [13, 14].

Natural Support for Thyroid Lobectomy

If you do need to have a thyroid lobectomy, there are several things you can do to support your body before and after surgery. 

For pre-surgery recommendations, research shows that optimizing your calcium levels, magnesium, and vitamin D levels is highly supportive of good surgical outcomes and lowers the risk of complications [15]. Addressing any metabolic health conditions like type 2 diabetes, high blood pressure, and overall systemic inflammation also leads to better outcomes and fewer complications [16, 17, 18].

Post-surgery, there are a few physical exercises like neck stretches, neck massage, and voice therapy that can reduce pain, improve surgical adhesions, and support full recovery [19, 20, 21].

One randomized controlled trial wanted to see if performing neck stretching exercises after thyroidectomy could improve neck pain. A total of 80 patients who had undergone thyroidectomy were randomly assigned either to perform neck stretches for four weeks or to a control group. The results showed that patients in the stretching group experienced significantly less neck pain and disability than the control group after one week and one month following thyroidectomy [19].

The stretching exercises consisted of the following eight steps:

1. Relax shoulders and neck sufficiently
2. Look down
3. Turn face to the right
4. Turn face to the left
5. Incline head to the right
6. Incline head to the left
7. Rotate shoulders 
8. Slowly raise hands fully then lower them

Participants were asked to perform five repetitions of the stretches, three times per day.

A self wound massage was another technique used to improve post-surgical neck and voice symptoms after thyroidectomy. Four weeks after surgery, 45 female patients who underwent thyroidectomy were randomly assigned to perform wound massages for four to 12 weeks or to a control group.

The results showed that the massage group had significantly greater improvement in wound adhesions, neck discomfort, swallowing discomfort, and voice discomfort compared to the control group. Objective voice analysis also showed that the massage group had significantly greater improvement in several measures that are associated with proper laryngeal (voice box) movement [20].

Note: Participants were trained on how to safely perform the massage, and massages lasted 10 minutes, performed three times a day.

Lastly, voice therapy — consisting of activities like relaxation and breathing exercises, laryngeal massage, and resonance therapy — may help the healing process and improve objective measures of voice quality. 

A nonrandomized/noncontrolled clinical trial attempted to see if voice therapy could improve measures of voice quality after thyroid surgery. Thirty-five patients who had undergone total thyroidectomy or lobectomy were given voice therapy three times a week for up to six months. The results showed that voice therapy improved objective measures of voice quality compared to before therapy, and that patients perceived that their voice quality improved after voice therapy compared to before therapy [21].

It’s important to note that this study had no control group, so it isn’t clear how much voice therapy improved the participants’ voice quality. However, the perception of improved voice quality could be particularly helpful for patients who have significant voice issues after surgery.

How to Maintain Healthy Hormone Levels After a Thyroid Lobectomy 

Patients who undergo thyroid lobectomy have a distinct advantage over those who undergo a total thyroidectomy (removal of the entire thyroid gland). Thyroid lobectomy patients still have part of their thyroid, so they may not need supplemental thyroid medication like levothyroxine.

They also have a lower risk of complications like hypoparathyroidism (when the parathyroid glands underproduce parathyroid hormones) and hypocalcemia (low blood calcium​ levels) [15, 22].

But, with only 50% of a functioning thyroid gland, these complications are still possible. Other more subtle side effects include possible weight gain, increased risk of osteoporosis, and hypothyroidism (underproducing thyroid hormones), which may show up as fatigue, feeling cold, constipation, muscle weakness, and weight gain, among other symptoms [16, 23, 24].

Whether you’re taking supplemental thyroid hormones or not, supporting your thyroid after surgery looks like:

• Prioritizing key nutrients that support thyroid health
• Improving and supporting gut health
• Making sure to get plenty of rest and take time to destress each day
• Follow up with your endocrinologist for regular lab testing to check on your thyroid hormone levels (TSH, T3, and T4).

Key nutrients are the same ones we mentioned earlier for natural thyroid support: vitamin D, calcium, selenium, and magnesium, among others. You should make sure to eat foods that carry these nutrients regularly, but you can also work with a healthcare provider to determine which ones you may need to supplement. 

Gut Health and Your Thyroid

Because of the gut-thyroid connection, improving your gut health can also support your thyroid health (and vice versa). Research shows that gut conditions and poor thyroid health tend to occur alongside each other [25, 26, 27, 28, 29], and treating gut conditions may support thyroid health [30, 31, 32, 33].

We have a research-packed article on all the ways you can befriend your gut to keep your thyroid healthy too, but after addressing your nutrition and managing stress, probiotics are a great starting point. Research shows that probiotics may help those who are taking thyroid medication reduce their dosage, because they’re able to absorb it better through the gut lining [34, 35, 36, 37, 38].

At our clinic, we’ve been able to help many patients like Monica, a 36-year-old woman who came to us with hypothyroid symptoms that didn’t respond to conventional thyroid medication. We were able to get her feeling much better using dietary changes (a low FODMAP diet to start), probiotics, a multivitamin, fish oil, vitamin D, and some supplemental fiber. This significantly improved her symptoms where thyroid medication did not. The root issue was actually a gut problem, not a thyroid problem first.

Listen to the full podcast on Monica’s recovery journey here.

Thyroid Lobectomy Is a Low-Risk Procedure

If you need a thyroid lobectomy, there’s no need to panic. This procedure has a very low risk of complications and typically improves a patient’s quality of life significantly post-surgery [39]. The best thing you can do to support your body’s ability to recover is to maintain a thyroid-supportive and anti-inflammatory diet and lifestyle, as well as potentially incorporate some extra physical support, like gentle stretching exercises and neck massage.

If you want to consult with one of our clinicians at the Ruscio Institute for Functional Health and put a plan together to support your thyroid health, reach out to us today.

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