TSH levels 6 weeks post hemi-thyroidectomy

[HannahS]

Hi everyone, this is my first post, so I hope i'm doing this right!

I'm a 35 year old female and I had a hemi-thyroidectomy in Feb due to a Thy3F nodule which fortunately turned out to be benign.  I had blood tests yesterday and my TSH has come back at 8.5 mlU/L and my Vitamin D as 29.9 nmol/L.  I just wondered why the Vit D was tested, is this a normal test after a hemi?

I'm also undergoing seperate investigations for Cushings disease, but these bloods have been taken at a seperate appointment.

[Clutter]

Welcome to the forum, HannahS.

You must be relieved that histopathology of the nodule was benign.

Your remaining thyroid lobe isn't producing sufficient thyroid hormone as TSH 8.5 is high.  Your doctor should start you on Levothyroxine replacement.  Most people will be comfortable when TSH is 1.0 or lower.  You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine as dose will probably need increasing.  Arrange an early morning and fasting test (water only) as TSH is highest early and drops after eating and drinking.  Take Levothyroxine after the blood draw.

For maximum absorption Levothyroxine should be taken with water 1 hour before or 2 hours after food and drink, 2 hours away from other medication and supplements, and 4 hours away from iron, calcium, vitamin D supplements and oestrogen.

thyroiduk.org.uk/tuk/diagno...

thyroiduk.org.uk/tuk/about_...

VitD wasn't tested after my hemi or completion thyroidectomy.  When it was tested 18 months later I was severely deficient.  VitD 29 isn't deficient but it is very low.  Most people are comfortable with it around 100.  If your doctor doesn't prescribe I recommend you supplement D3 5,000iu and retest in 6 months.  Take vitD 4 hours away from Levothyroxine.

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I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[HannahS in reply to Clutter]

Thank you for taking time to reply. It makes things a bit clearer when someone reaffirms what is running around my mind!

I have a follow-up on 19th April so hopefully should make some progress!

Thanks again,

Hannah

[Clutter in reply to HannahS]

HannahS,

I would contact your endo or GP to see whether you can be started on Levothyroxine as soon as possible.  3 weeks is a long time to wait if you are feeling very unwell.

[HannahS in reply to Clutter]

Hi Clutter, thanks for your reply. Unfortunately my endo is on annual leave and no one can discuss my results. Hopefully he'll be back Monday!

[SilverAvocado]

Hi Hannah! I was in quite a similar position. Same age, and I originally had a hemi and a high TSH. 

You don't mention whether you're feeling bad, or how your doctors have responded. For me, I found those first few months after the partial thyroidectomy very hard, don't know if it's because of how much fatigue there was, or because I was having to adjust my expectations from previously being very mobile and fit. 

I also found it hard to get through to doctors, as they insisted most people could manage fine. I was eventually given thyroid replacement very dismissively, as if I didn't strictly need it, but they were humouring me because I was going in for the completion operation, so it was only very temporary anyway. 

I only recently saw my blood test for that time, and saw my TSH was 12, and rising very rapidly, which is not a low number. I don't know if you've had an explanation that 8.5 is quite high, people can feel absolutely terrible with much lower numbers. Although doctors can still be very dismissive. 

[HannahS in reply to SilverAvocado]

Hi, no wonder you felt dreadful!! What has surprised me most about this whole thyroid malarkey is lack of professionals being supportive and patients having to be so persistent. 

Hope you feel much better now you've had your completion thyroid tony. Thanks for your advice, it's much appreciated!

[SilverAvocado in reply to HannahS]

Yes, there's a steep learning curve. Originally I really thought the doctors would aim to get me back on my feet, able to return to work, etc. But in fact it's only been through my own research that I started to see improvement. Doctors are very keen to operate, very keen to deal with my cancer as it turned out to be. But after that they run out of steam, and really do seem to be on a different planet. 

I hope you're not having too hard a time of it, and you end up in the 80% who do well on Levothyroxine (the first form of thyroid replacement you will be offered). If not, this forum is great Clutter is a lifesaver