Symptoms

[Jake123-]

Do u think if ur mess aren't rite that ur symptoms will be worse hyper or hypo if u have had thyroidectomy

[Jazzw]

Er... Sorry? It's probably just me, but I don't understand the question. Though my meds have made me a mess in the past...

[shaws Administrator]

I am sure that many people who were hyperthyroid and had a thyroidectomy would wish they had been well informed before the procedure and were promised effective thyroid hormones that made them well again. If there is cancer on the thyroid gland, it has to be removed. No doubt of that.

If you have Graves disease, hyperthyroidism, it can be controlled and calmed down. This is an excerpt from an article by the ex President of the British Thyroid Association:

5 Patients with hyperthyroidism often ask for advice on drug treatment versus radioiodine therapy. Can you summarise the pros and cons of each?

The three treatments for hyperthyroidism of Graves’ disease – antithyroid drugs, iodine-131 and surgery – are effective but none is perfect.4

Iodine-131 will almost certainly cause hypothyroidism, usually within the first year of treatment, as will surgery, given the move towards total rather than subtotal thyroidectomy.

There is no consensus among endocrinologists about the correct dose of thyroid hormone replacement so patients may prefer to opt for long-term treatment with carbimazole. Standard practice is that carbimazole is given for 18 months in those destined to have just one episode of hyperthyroidism lasting a few months.

But there’s no reason why carbimazole shouldn’t be used for many years in those who do relapse. Any adverse effects such as urticarial rash or agranulocytosis will have occurred within a few weeks of starting the first course.

Iodine-131 treatment for toxic multinodular goitre is the most appropriate choice as hypothyroidism is uncommon. Surgery would be reserved for those with very large goitres and mediastinal compression.

Once hyperthyroidism has developed in a patient with a multinodular goitre, it will not remit and any antithyroid therapy would have to be lifelong.

[Jake123- in reply to shaws]

I just had to have a thyroidectomy cause it was so large couldn't swallow they said there was lots of scar tissue during op I justometimes wonder if it's worse getting it removed and if symptoms are worse when it's not stable

[Jazzw in reply to Jake123-]

Ah right, sorry if I was being dense. My brain just doesn't work at all well anymore.

I've certainly read that the thyroidless, like you, are probably in greater need of T3 than those who still have thyroids. Not sure why that should be?

[shaws Administrator in reply to Jazzw]

Usually, I think, it is if we have a failing thyroid gland it might still be producing some hormones. If we have it removed there is none, so T3 is necessary as it is the Active hormone that drives our metabolism. T4 doesn't. T4 (levothyroxine) is a storage hormone which should convert to sufficient T3 to enter our Receptor Cells and makes us feel well and normal with no pain, sore muscles etc.

Unfortunately, we are restricted by some doctors keeping our TSH in the 'normal' range but if we have a dysfunction of the thyroid gland our TSH should be low, very low or suppressed. We are not 'normal'. People who have a healthy thyroid gland are 'normal'.

[shaws Administrator in reply to Jake123-]

Yes, there are obviously times when it has to be removed. I just hope they give you the option of medication if levothyroxine alone doesn't suit. Even the addition of T3 to your T4 could be very helpful. Also they shouldn't adjust your medication according to your TSH result. They are treating you, the patient, not a blood test.