Special Considerations When You Do Not Have a Thyroid Gland

If you don't have a thyroid gland, you can expect to have many of the same symptoms as the more common types of hypothyroidism that occur due to an underactive thyroid gland. You may also require similar medical treatment, but there are unique considerations to keep in mind in terms of diet, thyroid hormone levels, and medication doses.

While most of the instructions and information about hypothyroidism apply to you if you do not have a thyroid gland, you also need to pay attention to several special concerns. Interestingly, some issues are a bit easier and more straightforward if you do not have a thyroid gland.

Diet

If you do not have a thyroid gland, you don't need to be concerned about goitrogenic foods, such as brussels sprouts, broccoli, and kale. These foods can interfere with the body's ability to make active thyroid hormones. But, if you do not naturally make these hormones at all, goitrogenic foods that interfere with their normal production should not pose a problem for you.

You should, however, still be careful about overconsuming soy-based foods, as excessive soy intake may affect your ability to properly absorb your thyroid hormone replacement medication, reducing the intended effects.

TSH Level Maintenance

If you have had an underactive thyroid gland in the past, you may recall that an underactive thyroid gland can occasionally produce thyroid hormone. The gland can erratically increase or decrease functioning thyroid hormones, making it harder to regulate thyroid levels with medication.

Medications After Thyroid Cancer Removal

If you had your thyroid gland removed due to cancer, you are in a unique situation in that you may be given thyroid hormone replacement medications at "suppressive" levels. Suppression means taking a sufficient level of medication to keep your thyroid stimulating hormone (TSH) level very low or even undetectable. You would then be considered "hyperthyroid" by most lab standards, but this degree of suppression may be necessary to prevent cancer recurrence.

In the end, while you may refer to yourself as "hyperthyroid," much of the advice about hypothyroidism may still apply to you because you do not have a thyroid gland.

There are a number of reasons that you could be missing your thyroid gland, and your symptoms may change if you had your thyroid gland in the past, but do not have it now.

The most common reasons for an absent thyroid gland include:

• The treatment of thyroid cancer is usually surgical removal of all or part of the thyroid gland.
• Sometimes thyroid nodules, a goiter, or an enlarged thyroid need to be surgically removed if the growth affects breathing or swallowing. Rarely, an enlarged thyroid may be removed if it is cosmetically undesirable. 
• Some people with a toxic nodule, a goiter, or Grave's disease, have hyperthyroidism when too much thyroid hormone is produced and released. One of the treatment options considered for this type of hyperthyroidism includes surgical removal of the thyroid gland.
• A small percentage of people are born without a thyroid gland or with a malformed thyroid, a condition known as congenital hypothyroidism.

There are other situations in which the thyroid gland is not completely absent, but the function is so severely diminished that the under activity is below the levels expected from standard hypothyroidism.

These conditions include: 

• Radioactive iodine (RAI) treatment for hypothyroidism or Grave's disease is known as ablation therapy. RAI greatly impairs, and may completely destroy your gland's ability to produce thyroid hormone, leaving you hypothyroid.
• Hashimoto's disease is an autoimmune condition in which antibodies gradually destroy your thyroid's ability to produce hormones. 
• Medications, such as lithium, can damage your thyroid's ability to produce thyroid hormone.

A Word From Verywell

If you do not have a thyroid gland, most of the information about hypothyroidism generally still applies to you. With that, if you are still experiencing thyroid symptoms after removal of your thyroid gland, you may need an adjustment of your thyroid hormone replacement medication.

Be sure to follow up with your doctor as advised and proactively work together to optimize your treatment and symptoms.