I had surgery with a suppressed TSH, despite what the pre-assessment clinic said.This is an update on my progress since then.

[JANJAN2]

I was a regular user of this wonderful site (Jan Jan),but disappeared for a while as I was very low and quite frankly, rather fed up with myself! I desperately needed a second knee replacement, but couldn't get past the pre-op assessment stage because I always have a suppressed TSH, having been on armour thyroid since 1998.I have hashimotos.I also had a fast heart-due to terrible nerves, plus as I later found out, a urine infection. I was told that I could not have surgery with a suppressed TSH and that the anaesthetist would not put me out because of it. I had had six knee ops in the past with a suppressed TSH and nobody queried it then.

I took Shaws' advice and emailed Louise Warville who sent me a Pulse article by Dr Toft, explaining why some people have a suppressed TSH in order to feel well-which does not mean the patient has an overactive thyroid. My GP who is amazingly supportive and knew all this anyway, sent a letter to the hospital explaining all this. The hospital promptly lost this letter! My GP faxed it again and again it got lost I emailed it and it got corrupted in the process.I then sent it through the post and they got it!

So after several months, the pre assessment clinic gave me the go ahead and I had my knee replacement in February.I climbed on the operating table with great trepidation, expecting the anaesthetist to read my notes and tell me to get down and send me on my way! But he was fine and didn't even mention my TSH.My recovery was tough going as I was on morphine tablets for a month and I have poor tolerance of morphine.Also,this time the hospital did not give me Diclofenac for inflammation, which I now know is a thyroid antagonist!

I am glad to say that I am now feeling better than I was, but still pretty exhausted....but I can walk a lot better already.So I am now looking forward to leading a brand new life!!!

When Dr Skinner so very sadly passed away ( I will always remember him as he was also really good to my late Dad and he was such good fun!), my GP agreed to me having Armour thyroid on the NHS...at last!!!!! The health trust has agreed and I now have my first NHS prescription for it.

I have returned to tell my tale, hoping it will be of some help to anyone else about to embark upon surgery.My GP said she knows that with hypothyroidism, patients take longer to heal and recover, but we get there in the end.

[shaws Administrator]

That's great news and I am sure you will be well soon. I have just been reading about suppressed TSH, funnily enough:- Excerpt

Let me emphasize another important point: Some conventional endocrinologists have grossly exaggerated the cardiac risks of TSH-suppressive doses of thyroid hormone. When compared to replacement doses of thyroid hormone, TSH-suppressive doses are not associated with an increased incidence of ischemic heart disease. In fact, TSH-suppressive doses of thyroid hormone protect the heart. TSH-suppressive dosages lower the levels of blood fats more than replacement doses do. And higher-end doses of thyroid hormone can halt the progression of coronary artery disease. In patients who don’t have coronary artery disease, myocardial ischemia and/or infarction are rare even in those who are thyrotoxic. Moreover, restricting many patients to replacement doses predisposes them to cardiovascular disease and premature death. With these patients, erring on the side of safety means one thing—allowing them to use higher-end rather than lower-end doses of thyroid hormone.

In most patients, then, TSH-suppressive doses of thyroid hormone don’t harm the heart. This justifies Dr. L.E. Shapiro writing in 1997, "In the absence of symptoms of thyrotoxicosis, patients treated with TSH-suppressive doses of L-T4 may be followed clinically without specific cardiac laboratory studies."[2].

web.archive.org/web/2010103...

The next sentence goes on to say that Dr S said that people with clinical symptoms should be given a trial of levothyroxine - that's also the reason the Powers that be pursued him.

[JANJAN2 in reply to shaws]

Thanks for your reply, Shaws.

That is very interesting reading indeed! When I was in hospital, fortunately all my post op observations were normal-that was the big test for me.