There could be a most surprising reason for a patient’s non-compliance and memory problems after hip or other surgery…

—and it’s not the anesthesia or painkiller drug side effects.

An elderly person has hip replacement surgery (or any operation for that matter), and after the postoperative delirium wears off, you find that he or she has short term memory issues and is non-compliant with orders from medical staff.

  • Could this still be the anesthesia?
  • Could it be just an exacerbation “from all the drugs” of the patient’s pre-surgical personality?

Could it be that the patient’s thyroid levels were knocked out of whack from the physical stress of the surgery?


My mother had already been diagnosed with hypothyroidism about six years prior to her total hip replacement surgery.

Back then, the symptoms blew in like a tropical storm immediately following minor knee surgery, and in retrospect, I realized that before that knee surgery, low thyroid symptoms were barely bubbling on the surface but not enough to grab anyone’s attention.

So now she has a hip replacement, and right away, I’m thinking that this assault on her body threw her thyroid out of whack—even though she’s already been taking Synthroid (her daily thyroid pill).

My thinking is that the physical stress of the hip replacement “desensitized” (for lack of a better term) her body to the effects of her usual Synthroid dose.

Well, I’m not a doctor or nurse, but several years ago I interviewed Dr. Ken Holtorf, a thyroidologist, about this very topic: that the stress of surgery could stress the thyroid and cause noticeable symptoms. He explains that yes, indeed, this CAN happen!

Non-Compliance, Short-Term Memory Loss After Hip Replacement

My mother’s non-compliance was alarming. I won’t go into detail, but suffice it to say, it had the family very worried.

The short-term memory loss was aggravating, and there was also impaired judgment.

Nurses and a doctor kept telling me this was the result of the general anesthesia (she suffered postoperative delirium).

We also attributed the issues to age related cognitive decline, and in fact, prior to surgery, this age related decline was already evident — there had been memory lapses and irrational thinking, but she was still functional.

At the rehab center, the memory problems and non-compliance were very obvious, and she was also sleeping too much and popping in and out of a depressed or easily anguished state. At least on one occasion my mother complained of being cold.

None of the nurses suspected her thyroid. This should have jumped out at them because they were giving her the Synthroid every morning.

But very few people, even medical personnel, realize that the stress of surgery could upset thyroid levels even in someone who’s already taking a thyroxin pill.

I was the only person who suspected this. In fact, prior to the hip replacement, I wondered about it, and planned on pushing for a thyroid blood test at some point after the surgery.

I spoke to the rehab center’s doctor about ordering this simple blood test, and he put the order in.

Two days later the results came back: My mother’s result was 10! It should not have been higher than 5.5.

(Low thyroid causes a high score, by the way; that’s just the way the labs do it). So 10 is high, when you consider that the value should not exceed 5.5.

Her Synthroid dose was immediately increased! This should improve her state of mind and reduce the desire to sleep so much.

Memory problems, non-compliance, irrational thinking, impaired judgement—and especially if combined with feeling cold and excessive sleep — these issues following a surgery could be, at least in part, explained by a stressed thyroid.

Push for the blood test! Don’t just attribute all of these problems to age related cognitive decline.

Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer. 
Top image: Shutterstock/ By pathdoc