Blood tests after total thyroidectomy

[Occamoo]

Hello

I wonder if anyone could help clarify which blood tests you should have after a tt? I'm only ever tested for TSH, which seems odd when there is no thyroid to stimulate anymore. Should a tt patient be routinely tested for T3 and T4 to make sure they are converting correctly??

Thanks

[helvella Administrator]

If the logic of the TSH test for everyone else held water, then it would also work after total thyroidectomy. It is the pituitary responding to the amount of thyroid hormone on the blood wherever it came from (and to the TRH from the hypothalamus).

The fact that there is no thyroid to stimulate is not really an issue.

However, I absolutely agree that thyroid patients of all types should have FT4 and FT3 tests as well because any imperfection in the response of the pituitary makes TSH unreliable - you simply do not have to go any further to explain why it is inadequate.

Rod

[Jackie]

Yes, you are quite right. all the normal thyroid tests, especially TSH, T4 and Free T3. Also the other common autoimmune hormonal tests, Diabetes, B12 and Folic acid and lightly to be low, vit D ( hormonal), if low corrected caclcum before treatment, must be in range, D tends to push it up a little and lastly definitely ferritin/iron.

Best wishes,

Jackie

[marram]

If only! It is 32 years since my TT and I have had my T3 tested just once, 3 months ago, which I paid for to be done privately.

This revealed that my T4:T3 ratio is no better than 6:1 rather than the commonly assumed 4:1. In my case even testing the T4 as well as the TSH would not reveal my true status because while my T4 is above the laboratory range, the T3 is low in the range. Testing the T3 is essential in my case.

To sum this up, it would be very useful to know your T4 and T3 levels regardless of the TSH so any conversion problem could be identified. If that is the case, then test the vitamins and minerals essential for conversion to see if this might be the cause.

What was the reason for your TT? this could also affect your TSH levels and make it even more important to test the actual thyroid hormones.

[Occamoo]

Thank you all for your responses. Marram it is 11 years since my tt. It was only discovered that I was over active during some routine blood tests for infertility. I was put directly on carbimazole and within a matter of weeks my thyroid removed. I was not offered any alternatives and I have to say I wish I was more informed as it is the biggest regret of my life as never felt 100% like the 'old me' since having it done. I've always been a scary-cat at the doctors but know feel I have to fight my corner and make sure they do the tests which give a full picture as I feel I may be under prescribed.

[Heloise in reply to Occamoo]

Better late than never. This is a list of optimal labs from SSTM

stopthethyroidmadness.com/l...

[Occamoo in reply to Heloise]

Thank you Heloise the link is really useful and made interesting reading.