چاقی بعد از عمل تیروئید

جراحی تیروئید (تیروئیدکتومی) به عمل جراحی گفته می‌شود که در طی آن بخشی از غده تیروئید یا تمام آن برداشته می‌شود. Patients with an overactive thyroid (hyperthyroidism) usually gain weight after thyroid surgery. This weight gain is also seen in those who have undergone surgery for a nodular goiter (a type of lump in the thyroid) or thyroid cancer. You may imagine that the temporary hypothyroidism after thyroid surgery is the cause of this obesity; But you should know that even taking levothyroxine tablets (to replace thyroid hormone) also affects the body's metabolism; Even if the blood TSH level is normal. Obesity after thyroid surgery has various causes, which we will discuss below.

In fact, after thyroid surgery, along with thyroid surgery side effects, patients often complain of weight gain; Even when blood tests show that their thyroid hormone levels are normal. In some cases, severe weight changes do not occur in patients. But often those who have had a thyroidectomy (especially in patients with hyperthyroidism or thyroid cancer) experience sudden changes in weight.

Cause Obesity after thyroid surgery

Weight gain after thyroid surgery happens for various reasons. In most cases, a combination of the following factors is involved in obesity after thyroidectomy.

Metabolism slows down due to the reduction of thyroid hormones

The thyroid gland plays a key role in regulating the body's metabolism. Removing all or part of the thyroid gland leads to a decrease in the production of thyroid hormones such as T4 and T3. This hormone deficiency lowers your basal metabolic rate, or BMR (the amount of calories your body burns at rest). Weight gain occurs when the body consumes fewer calories. Also, in people who had lost weight due to Hyperthyroidism, the surgery causes the metabolism to return to normal, and this also leads to weight gain.

Hormone replacement therapy with levothyroxine

Almost all patients after thyroid surgery have to use Levothyroxine for life to compensate for the lack of hormones. This drug is a type of hormone replacement therapy and its purpose is to restore the level of thyroid hormones to normal. But the way of this hormone replacement is slightly different from the normal functioning of the thyroid gland.

A normal thyroid gland produces both T3 and T4 hormones; While levothyroxine is simply T4. Sometimes, even though the TSH level is normal in the blood test, the ratio of T3 to T4 in the body may not be ideal or the conversion process of T4 to T3 may not be done correctly. This imbalance is another reason for obesity after thyroid surgery, which has a negative effect on the body's metabolism and leads to weight gain.

Read more:

Should you take levothyroxine after thyroid surgery?

Insulin resistance after thyroid surgery

One of the problems that occurs after thyroid surgery (despite hormone regulation) is insulin resistance. This condition is defined as a decrease in the sensitivity of body cells to insulin. This means that body cells do not respond well to insulin and sugar cannot enter cells easily. Therefore, instead of consuming sugar as energy, the body stores it in the form of fat, which leads to weight gain, especially in the abdominal area. This insulin resistance can result directly from metabolic changes after surgery or be exacerbated by initial weight gain (which occurs after surgery for whatever reason).

Water retention

One of the reasons that can contribute to weight gain after thyroid surgery is water and sodium retention in the body. In this situation, instead of excreting excess fluids, the body keeps them in tissues and intercellular spaces. This issue is more common especially in the early stages after surgery; This is because the body is adjusting itself to sudden changes in thyroid hormone levels. If the levothyroxine dose is not adjusted and temporary hypothyroidism occurs, fluid retention will intensify. In this way, even though the actual body fat did not increase; But the weight increases and the patient suffers from puffiness and swelling.

Decreasing physical activity

After any surgery, including thyroidectomy, it is normal for patients to have less physical activity for a while. The reason for this decrease in activity is pain in the surgical area, feeling tired and general weakness caused by the operation and the recovery process or the doctor's recommendations to avoid putting pressure on the stitches and the operation area. By reducing the activity level, the body burns fewer calories throughout the day. This process gradually leads to obesity after thyroid surgery and real weight gain (fat tissue increase).

Change in appetite

Some patients experience changes in their appetite pattern after thyroid surgery. Thyroid hormones play an important role in regulating metabolism as well as hunger and satiety signals in the brain. After the removal of the thyroid gland and the start of alternative medicine, this delicate hormonal balance that affects appetite may not completely return to its original state. This appetite stimulation leads to overeating and increased caloric intake, and combined with reduced physical activity, complicates weight management after thyroid surgery.

Anxiety and stress after thyroid surgery

Anxiety and stress after thyroid surgery play an important role in weight gain. Stress causes the release of the hormone cortisol, which can increase appetite, especially for high-calorie and sweet foods, and lead to the storage of abdominal fat. Many people turn to emotional eating in response to stress and discomfort, which leads to excessive calorie intake.

Also, anxiety reduces the desire for physical activity by causing fatigue and lethargy, and by disrupting sleep, it has a negative effect on appetite regulating hormones (ghrelin and leptin). As a result, it increases the desire to eat and causes obesity after thyroid surgery. Therefore, the correct management of anxiety and stress after surgery is vital not only for mental health, but also for weight control and maintaining physical balance.

scale Weight gain after thyroid surgery

The amount of weight gain after thyroidectomy depends on several factors such as the amount of thyroid tissue removed (type of thyroidectomy), the dose of replacement hormone and the individual's lifestyle. Due to the decrease in metabolism caused by the lack of thyroid hormone, about 2 to 5 kg of extra weight is usually observed after thyroid surgery, which can be prevented to a large extent by following a few simple tips.

In cases where the excess weight is more than 6 kg, usually other factors such as underlying diseases or the use of other drugs are involved in this, and it is necessary to determine the main causes by a detailed examination by an endocrinologist. The severity of the primary thyroid disorder and the skill of the thyroid surgeon will also affect the final amount of weight change. Also, strict adherence to medical recommendations can minimize obesity after thyroid surgery.

Effect Type of thyroid surgery on weight gain

The degree of obesity after thyroidectomy is directly related to the type of thyroid surgery (complete or partial). In general, total thyroidectomy (the entire thyroid gland is removed) results in more weight gain than partial thyroidectomy. Because in complete thyroid surgery, no thyroid hormone is produced naturally and the body is completely dependent on hormone replacement therapy (levothyroxine pill).

So regulating hormone levels and metabolic balance will be more complicated than when only a small part of the thyroid is removed and the body is able to produce some natural thyroid hormone. The remaining thyroid tissue in partial thyroidectomy helps stabilize metabolism and regulate hormones more easily, making weight gain less and more manageable after thyroid surgery.

Remember that your weight changes after thyroid surgery are mainly due to a malfunction of the body's metabolism. Therefore, you must control all the factors involved in the body's metabolism.

Correct and regular use of medicine

Levothyroxine tablets are prescribed for most patients after thyroid surgery. This drug is a synthetic hormone replacement and you must take it for the rest of your life. Over time and with regular tests, your doctor can determine the best dose for your body. If you do not take levothyroxine or use it in an inappropriate dose, you will suffer from hypothyroidism, in which the body does not produce enough thyroid hormone; Therefore, you will be more prone to gain weight.

For better absorption of levothyroxine, take it on an empty stomach and avoid simultaneous consumption of this drug with walnuts, soy products and iron or calcium supplements. Also, some antacids and stomach ulcer medicines interfere with this pill; So be sure to talk to your doctor about this.

Follow a balanced diet

Follow a balanced diet rich in whole foods. Minimize the consumption of simple carbohydrates and refined sugars to provide your body with better energy. Dark green leafy vegetables, lean meats, fresh seafood, low-sugar fruits, and dairy alternatives are good options. This type of nutrition plays a significant role in balancing blood sugar levels and preventing insulin resistance.

Get enough iodine

Iodine plays a role in regulating the body's metabolism as well as the function of the thyroid gland (remaining tissue from the thyroid after surgery). Even with levothyroxine, the body still needs a certain amount of iodine to function optimally. Therefore, adequate consumption of iodine is necessary to maintain thyroid health and prevent disorders such as goiter. Iodine deficiency leads to goiter disease (enlargement of the thyroid gland) followed by hypothyroidism, which is accompanied by symptoms such as fatigue, weight gain, and slow metabolism.

To ensure that you get enough iodine, it is recommended to use iodized salts available in the market. In addition to helping maintain hormonal balance and preventing hypothyroidism, the balanced consumption of this type of salt prevents unwanted problems such as weight gain and obesity.

Avoid foods rich in goitrogens

If you are suffering from thyroid diseases or have recently had thyroid surgery, it is better to be careful in consuming foods containing goitrogens. These compounds can cause enlargement of the thyroid gland (goiter). Food sources rich in goitrogens include soybeans, types of cabbage (such as broccoli, cauliflower, Brussels sprouts), millet, horseradish, radishes, and peanuts. Especially in the post-surgery period when the body's hormonal balance is being restored, paying attention to the diet containing these substances becomes more important.

Regular exercise

Exercise plays a very important role in regulating metabolism. Try to get enough physical activity every day and exercise regularly. There is no need to follow difficult and complicated exercise programs. Choose a physical activity that fits easily into your daily routine and that you enjoy! Yoga, outdoor walking, jumping rope and cycling are good options to start physical activity. Gradually, you can start more intense exercises such as jogging, spinning classes, weight lifting or even boxing.

Stress Management

Chronic stress affects metabolism and weight gain by increasing cortisol hormone secretion. Cortisol increases appetite and helps store fat, especially in the abdominal area. Therefore, the use of stress reduction techniques such as meditation, yoga, deep breathing exercises, or even relaxing activities for weight control after thyroid surgery is particularly important.

Adequate and quality sleep

Sufficient and quality sleep is essential for metabolic health; Especially after thyroidectomy. Lack of sleep or irregular sleep disrupts the balance of appetite regulating hormones such as ghrelin (hunger hormone) and leptin (satiety hormone). This leads to appetite stimulation, increased calorie intake and eventually weight gain.

Concluding remarks

Thyroidectomy leads to weight gain by disrupting the body's metabolism in different ways. To manage and minimize weight gain after thyroid surgery, regular use of hormone replacement medications, following a balanced diet with an emphasis on whole foods and low sugar, and incorporating regular exercise into the daily routine are essential.