My medications after surgery
After your surgery, you may be required to take some of these medications:
1. Levothyroxine (e.g. Synthroid, L-thyroxine)
- If your whole thyroid gland is removed (total thyroidectomy), you will need to take a small pill to replace the thyroid hormone once a day for the rest of your life.
- Your endocrinologist or family doctor can reassess the amount you are taking regularly based on blood work and symptoms.
- If only a portion of the thyroid gland is removed, you may not need to take any medication. However, some patients may need thyroid hormone pills if the remaining gland is not producing enough thyroid hormone on its own.
2. Calcium supplements:
- Most patients will not require calcium supplementation.
- If your whole thyroid gland is removed, there is usually a 30% risk of needing temporary oral calcium +/- vitamin D. supplements at home. These medications can usually be stopped once your parathyroid glands recover and begin working again.
- In 4% of the time, you may need to take the oral calcium and vitamin D supplements permanently if the parathyroid glands do not recover their function after surgery.
3. Tapazole/ Methimazole
- If you were taking these medications before surgery to treat hyperthyroidism, you will no longer require them once the whole thyroid, or the hyperactive part of the thyroid has been removed. Sometimes, you surgical team may keep you on these medications for several weeks after surgery until the excess thyroid hormone in your body washes out.
4. Radioactive iodine treatment for cancer
- In many cases, the cancer is localized in the thyroid gland and can be entirely removed by surgery. In these cases, you may not need any further treatment.
- If the disease cannot be removed completely or your surgeon suspects that there is residual disease after the surgery, an aggressive disease or that many lymph nodes are affected by the cancer, you may require radioactive iodine treatment to destroy the remaining thyroid cells.
- This treatment is usually managed by your endocrinologist several weeks after your surgery and consists of a liquid or a pill containing radioactive iodine. Since thyroid tissue has the capacity of absorbing iodine, the radioactive effect of the substance will kill the remaining thyroid cells.
- The number and duration of treatments will depend on the extent of the disease and follow-up blood tests and ultrasound exams.
- If your surgeon thinks you may require radioactive iodine, you should discuss the risks and benefits with your endocrinologist at your follow-up appointment after the surgery.
When should I restart my blood thinners?
- Talk to your surgeon about when it is appropriate to restart your blood thinners. It will depend on the reason you are taking them and the risk of bleeding from your surgery.