The thyroid gland plays an important role in regulating metabolism, growth, and development. Its hormones, triiodothyronine (T3) and thyroxine (T4), affect every cell and system in the body. So it’s understandable that removing the thyroid through surgery (thyroidectomy) could potentially lead to changes beyond just metabolism.
In particular, some patients report alterations in mood, energy, memory, and overall personality after having their thyroid removed. But why might this happen and how significant are these changes for most people?
Quick answers on thyroid removal and personality changes
Here are quick answers to common questions on whether thyroid removal impacts personality:
- Thyroid removal leads to hypothyroidism, which can cause fatigue, depression, and memory issues that may be perceived as personality changes.
- Most personality changes are subtle and often improve with thyroid hormone replacement medication after surgery.
- Some patients, especially those with no underlying thyroid disease, may experience more significant effects on mood and cognition.
- Personality changes likely depend on individual factors like reason for surgery, mental health history, dose of replacement hormones, and adjustment challenges.
- Patients should communicate with their doctor if they experience concerning personality changes after thyroidectomy.
How does thyroid removal affect thyroid hormone levels?
The thyroid gland produces thyroid hormone, which regulates many body functions and even brain development. When the thyroid is surgically removed, whether partially (lobectomy) or totally (total thyroidectomy), this eliminates the gland’s ability to produce T3 and T4 hormones.
Without sufficient thyroid hormone levels, the condition hypothyroidism results. In adults, hypothyroidism symptoms may include:
- Fatigue
- Depression
- Memory and concentration problems
- Muscle weakness
- Weight gain
- Constipation
- Dry skin and hair
- Sensitivity to cold
In infants and children, hypothyroidism can impair growth and brain development. The lack of thyroid hormone commonly slows metabolism, though it affects far more than just weight.
Does hypothyroidism after thyroid removal cause personality changes?
For most patients who have their thyroid removed, personality changes are usually subtle if present at all. But some individuals do experience more noticeable differences in their mood, cognitive skills, and overall temperament after surgery.
This is likely because hypothyroidism affects more than the body – it influences brain function as well. Even mild thyroid hormone deficiency can lead to symptoms like:
- Depressed mood
- Impaired memory
- Mental fogginess
- Fatigue and lethargy
- Slowed thinking
On the surface, these effects may be perceived as personality changes. Someone who was previously upbeat and social may become withdrawn and sad. An individual with a sharp mind for details might start feeling perpetually forgetful.
Fortunately, while personality alterations can occur with hypothyroidism, they are usually subtle. With proper thyroid hormone replacement medication, these changes often improve or resolve.
What factors influence personality changes after thyroidectomy?
Somethyroidectomy patients notice significant mood, memory, or temperament changes, while others feel like their personality stays mostly intact. Why the discrepancy?
Several factors likely influence an individual’s risk of personality changes after thyroid removal surgery:
- Reason for thyroidectomy – Patients with Graves’ disease (hyperthyroidism) may notice improvement in mood symptoms like anxiety or irritability after surgery. Those with thyroid cancer are more prone to depression and cognition issues from hypothyroidism.
- Mental health history – Individuals with a prior history of depression, anxiety, bipolar disorder, or other mental health conditions may be more vulnerable to personality changes.
- Thyroid hormone levels – The correct dosing of thyroid medication is crucial. Too high or too low can worsen mood, energy, and cognition.
- Adjustment challenges – Stress from surgery recovery, cancer treatment, or the need for lifelong medication can impact quality of life and personality.
Overall, those with well-managed hypothyroidism, social support, and no major mental illness tend to have minimal personality changes from thyroid removal alone. But this varies between individuals based on health history and life circumstances.
Are significant personality changes common after thyroidectomy?
For the majority of thyroidectomy patients, noticeable changes in personality, mood, motivation, and cognition are uncommon when hypothyroidism is properly treated. One study on over 2,000 patients found:
- Less than 3% had significant alterations in memory after 5 years.
- Less than 4% experienced a worsened sense of well-being after 5 years.
- Less than 6% reported worsening depression after 5 years.
However, up to 20% of patients do experience some subjective decline in cognitive function and mood, even with thyroid hormone therapy. The risk may be higher for certain groups, like those with no underlying thyroid disease prior to surgery.
A study on thyroidectomy patients with healthy thyroids found:
- 40% had worse concentration ability after 18 months.
- 25% self-reported impaired memory after 18 months.
For these patients undergoing surgery for benign nodules or goiter rather than Graves’ disease or thyroid cancer, an intact thyroid gland is removed. This sudden shift in thyroid status could play a role in increased personality changes compared to those with prior thyroid dysfunction.
Can changes in personality be permanent after thyroidectomy?
For the majority of patients on proper thyroid hormone therapy, personality changes are minor or temporary. But a subset of individuals can experience lasting effects even with adequate treatment. These long-term side effects may include:
- Depression or anxiety
- Fatigue
- Subtle memory deficits
- Introversion
- Lack of motivation
One study found that compared to controls, thyroidectomy patients had sustained differences in temperament an average of 7 years after surgery, including increased harm avoidance and decreased reward dependence. However, personality scores remained within normal ranges.
While full recovery is possible, some patients may notice subtle personality traits like increased caution, introversion, or seriousness long after surgery. Supportive care from mental health providers can aid adaptation.
Which patients are at highest risk of significant personality changes?
Most thyroidectomy patients see only minor personality effects, if any. But the following groups have an increased risk of experiencing significant, lasting mood and cognition changes after surgery:
- Patients with no prior thyroid disease – Those with healthy thyroids removed may struggle more with the sudden hormone deficiency.
- Patients with mental health conditions – Pre-existing depression, anxiety, bipolar disorder, etc can worsen after hypothyroidism develops.
- Patients with low thyroid hormone levels – Inadequate thyroid replacement medication increases risk.
- Patients with severe hypothyroid symptoms – Those with fatigue, weight gain, and very high TSH are more prone to personality changes.
- Patients with stressful circumstances – Life stresses like cancer treatment, surgery recovery, family demands, or work struggles can contribute.
Personality changes are not inevitable and can improve over time. But higher risk patients would benefit from more vigilant therapy monitoring and mental health support.
Can personality return after thyroid levels stabilize?
In many cases, significant personality changes after thyroidectomy are temporary and improve or resolve with proper thyroid hormone therapy and time. Restoring thyroid levels to the optimal range allows brain function and mood to return toward normal.
For example, the characteristic personality differences seen with hyperthyroidism (anxiety, irritability) and hypothyroidism (fatigue, depression) tend to resolve when the thyroid imbalance is corrected. Even long term, subtle effects on temperament often lessen over months to years.
However, a subset of patients can experience lasting personality changes even once their thyroid levels stabilize after surgery. This may be due to variations in individual brain sensitivity to hormone fluctuations. Supportive care focuses on helping adaptation.
How are personality changes after thyroidectomy treated?
If significant personality changes emerge after thyroid removal, the first step is checking for appropriate thyroid hormone levels. The TSH should not be too high or too low. Adjusting the dose of levothyroxine may improve mood and cognition in some cases.
Beyond optimizing the thyroid medication dose, the following interventions may be helpful:
- Counseling – Talk therapy can aid coping with any surgical aftereffects.
- Support groups – Connecting with other thyroidectomy patients can provide support.
- Antidepressants or anxiety medication – If indicated for mood symptoms.
- Cognitive behavioral therapy (CBT) – CBT is effective for memory and concentration impairment.
- Stress management – Relaxation, adequate sleep, and socializing may lessen mood effects.
While some patients may see their personality fully revert to “normal,” others may need support in adapting to subtle longer term changes in their temperament.
How should patients communicate personality changes to their doctor?
If significant personality changes emerge after thyroid removal, it’s important for patients to share this with their doctor.
To best communicate concerns, patients can:
- Keep notes tracking when changes began and how they specifically impact mood, relationships, work/school ability, etc.
- Bring a close friend or family member who can corroborate observed changes.
- Request screening for depression, anxiety, or other mental health disorders.
- Ask about cognitive testing to evaluate memory and concentration difficulties.
- Discuss optimization of thyroid hormone therapy – the TSH level and dosage of levothyroxine.
- Inquire about referrals to therapy or support groups.
Personality alterations will likely resolve faster when caught and addressed early. Ongoing communication with the treatment team is key.
When do personality changes warrant medical attention?
Minor mood or cognition changes are common with thyroid surgery. But more concerning alterations in personality require prompt medical evaluation, including if the patient experiences:
- Depression – Loss of interest, sadness, hopelessness, suicidal thoughts
- Mania – Extreme irritability, less need for sleep, risky behavior
- Psychosis – Hallucinations, delusions, paranoia
- Cognitive decline – Worsening confusion, memory loss, dementia symptoms
- Changes causing life disruption – Inability to work, go to school, care for family, or function
Severe personality changes always warrant medical assessment to identify underlying causes and provide proper treatment. Thyroid levels should be verified alongside a mental health evaluation.
Conclusion
Thyroid removal surgery is lifesaving when needed, but may increase the risk of subsequent personality changes to some degree. However, most patients have only subtle effects on mood, energy, and cognition – if any.
Significant personality changes are more likely in vulnerable groups and when thyroid levels are not properly managed. But even high risk patients often improve with supplemental thyroid hormone, mental health support, and time.
Ongoing communication with the healthcare team is important to optimize thyroid therapy and address any mental health concerns. While personality may not return to exactly how it was pre-surgery, most patients can adapt and regain a good quality of life.