Post-Thyroid Surgery: Recent Health Issues and Symptoms - Internal Medicine

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6.7 years post-thyroidectomy, experiencing some recent health issues?


I previously had hyperthyroidism and underwent surgery six to seven years ago.
I have been taking Antithyroid medication regularly, and recently I have been taking two 50 mg tablets a day.
However, I have been experiencing chest tightness and mild pain near my heart at night while sleeping.
Additionally, my legs feel fatigued, but it's not a painful sensation.
My weight was over 48 kg six months ago, but now it fluctuates between 43 and 44 kg.
I haven't been doing any specific exercise.
Could you please advise on the possible reasons for these symptoms?

xxx, 20~29 year old female. Ask Date: 2018/08/02

Dr. Hong Yuanbin reply Internal Medicine


Hello, I'm not sure if you have been continuously monitoring your thyroid function.
If you are on medication, you should be regularly tracking it.
If your thyroid function is normal, based on your described symptoms, the most likely cause is a strain.
I wonder if you have recently lifted heavy objects, engaged in any special exercises, or adopted unusual postures that could have led to the strain.
If so, I recommend resting, which should help improve your condition.
If not, I suggest visiting a family medicine or cardiology clinic for an X-ray and an electrocardiogram to check for any abnormalities in your cardiopulmonary function.
Thank you for your question.

Reply Date: 2018/08/02

More Info


Post-thyroid surgery symptoms can be multifaceted, especially in individuals who have undergone treatment for conditions like hyperthyroidism. Given your history of thyroid surgery and ongoing medication, it’s essential to consider several factors that could contribute to your recent health issues, including chest discomfort, fatigue, and weight loss.

Firstly, the symptoms you describe, such as chest tightness and discomfort near the heart, can be concerning. While these symptoms may be related to anxiety or stress, they could also indicate potential cardiovascular issues, especially if they are new or have changed in intensity. It’s crucial to consult with a healthcare provider to rule out any serious conditions, including heart-related issues, particularly since you have a history of thyroid disease, which can sometimes affect heart function.

The sensation of heaviness or fatigue in your legs, along with weight loss, could be attributed to several factors. One possibility is that your thyroid medication, such as the one you mentioned (likely levothyroxine), may need adjustment. Overmedication can lead to symptoms of hyperthyroidism, including anxiety, palpitations, and weight loss. Conversely, under-medication can lead to hypothyroid symptoms, such as fatigue and weight gain. Regular monitoring of thyroid hormone levels (TSH, Free T4) is essential to ensure that your medication dosage is appropriate.

Additionally, lifestyle factors play a significant role in your overall health. A lack of physical activity can contribute to feelings of fatigue and muscle weakness. Incorporating light exercise, such as walking or stretching, can improve circulation and energy levels. Furthermore, dietary habits should be evaluated; a balanced diet rich in nutrients is vital for recovery and maintaining a healthy weight.

Stress and anxiety can also manifest physically, leading to symptoms such as chest discomfort and fatigue. If you have been experiencing increased stress or anxiety, it may be beneficial to explore relaxation techniques, such as mindfulness, yoga, or counseling, to help manage these feelings.

Lastly, consider the possibility of other underlying health conditions that may not be directly related to your thyroid status. Conditions such as anemia, vitamin deficiencies (like vitamin D or B12), or even chronic fatigue syndrome could contribute to your symptoms. A comprehensive evaluation by your healthcare provider, including blood tests and possibly imaging studies, may be warranted to identify any other potential issues.

In summary, while your symptoms may be related to your thyroid condition and medication, it is essential to approach this holistically. Regular follow-ups with your healthcare provider, monitoring of thyroid levels, lifestyle modifications, and addressing any psychological stressors are crucial steps in managing your health post-thyroid surgery. Always prioritize open communication with your healthcare team to ensure that any changes in your health are appropriately addressed.

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