Thyroid Hormone Replacement Therapy for Papillary Thyroid Cancer

Managing Hormone Changes after Surgery

Thyroid surgery is the first-line of treatment for papillary thyroid cancer (also known as papillary thyroid carcinoma). In most cases, you will need to take thyroid hormone replacement therapy to manage hypothyroidism after surgery. This article describes how and why thyroid hormone replacement therapy belongs in many papillary thyroid cancer treatment plans.

Thyroid Surgery's Impact on Hormone Production

There are 2 main types of thyroid surgery—partial thyroidectomy and total thyroidectomy. If you require a total thyroidectomy, you body will no longer be able to produce thyroid hormones, and you will become hypothyroid. Thyroid hormone replacement therapy is the standard treatment for hypothyroidism.

Most papillary thyroid cancer patients will undergo a total thyroidectomy. With the total removal of the thyroid gland, your body can no longer naturally produce thyroid hormones. Thyroid hormones are essential because they control your body's metabolism. In other words, they dictate how your body uses energy—from how you process food to how fast you think.

After a total thyroidectomy, you will become hypothyroid. This condition is characterized by too little thyroid hormone. Fortunately, thyroid hormone replacement therapy effectively manages the symptoms of hypothyroidism.

A partial thyroidectomy may be done, instead of total, if you have a small (<1 cm) papillary thyroid cancer (microscopic) without evidence of spread outside the thyroid, and if the other lobe is normal without any nodules. In these cases, you might still be placed on thyroid hormone medication by your doctor. This depends on your thyroid function tests (TSH) and the pathology, although the dose will be frequently lower than if you had a total thyroidectomy.

Thyroid Hormone Replacement Therapy Options

The thyroid gland produces two hormones—T3 and T4. You will most likely take a daily dose of T4 via an oral pill. The reason only T4 is taken is because most T3 hormones were once T4. When T4 hormones come into contact with other cells, they lose an iodine atom in order to interact with those cells. After losing this atom, T4 becomes T3.

Synthetic forms of T4 hormone are the most common hypothyroidism treatment. There are a number of approved synthetic T4 supplements available. And you may read more about them in our article about synthetic T4 supplements for hypothyroidism.

Though synthetic thyroid hormones are the most popular thyroid hormone replacement options, animal thyroid medications are also available. Animal thyroid medications are made from dried out pig thyroid glands. Some patients prefer these natural alternatives to their synthetic counterparts because they assume these drugs are the safest treatment. However, many doctors believe that synthetic thyroid hormones are the best—and safest—option. This is because the blood levels of the hormone are more predictable with the synthetic forms than the animal source pills.

If you'd like to get more details about these medications, please read our article about animal thyroid supplements for hypothyroidism.

Thyroid surgery is an essential treatment for papillary thyroid cancer. If you require a total thyroidectomy, then thyroid hormone replacement therapy will eliminate the effects of hypothyroidism after surgery. EndocrineWeb has many resources to help you learn about this treatment. If you'd like more information, please read our article about thyroid hormone replacement therapy for hypothyroidism.

View Sources
  • Skugor M. Treating Hypothyroidism. In: The Cleveland Clinic Guide to Thyroid Disorders. New York: Kaplan Publishing; 2009: 29-31.