Post thyroidectomy blood results

Hi, my 16 year old daughter had a full thyroidectomy last month following diagnosis of Hashimotos.  Her thyroid was so full of cysts that she struggled to swallow, couldn't turn her head properly so couldn't get comfortable to sleep and she got short of breath easily (not to mention it made her feel self conscious as it was very visible!).  Those symptoms are now gone but she's still feeling a bit rubbish, really tired, so I thought I'd post her results from last week (6 weeks post op):

Free T4 19.38 (range 12-22)

TSH 4.410 (range 0.270-4.200)

Albumin 46 (range 35-50)

Serum calcium 2.48 (range 2.2-2.6)

Adjusted calcium 2.44 (range 2.20-2.60)

The consultant increased her thyroxine from 100 to 150 on this basis, should she feel better soon??  Is there anything else to consider?

Thanks all, Dawn

3 Replies

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  • Hashimam1,

    Your daughter should start feeling improvement in a couple of weeks when the dose increase kicks it.  It will take up to six weeks to feel the full impact of the dose increase.  Most people feel well when TSH is 1.0 or lower.

    Ask your daughter's GP to test ferritin, vitamin D, B12 and folate which are often low/deficient in hypothyroid patients and cause fatigue, musculoskeletal pain and low mood similar to hypothyroid symptoms.

    _________________________________________________________________________________________________

    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.

  • Thanks Clutter, that's reassuring.  The consultant (surgeon) did say her Vit D was the best he had seen although the result of that wasn't on the printout.  We are lucky that I get healthcare through work and the consultant is a specialist in our region.  Funny (not haha) that you mentioned musculoskeletal pain as she has been complaining of aches in her collar bones.  She is being re tested in 5 weeks then we see the consultant again the following week so fingers crossed.

  • Hashimam1,

    The pain in her collar bones is probably due to high TSH.  It should start improving now her dose has been increased to 150mcg.

    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 calcium, iron, vitamin D supplements and oestrogen.

    Arrange an early morning and fasting (water only) blood draw for your daughter when TSH is highest, and tell her to take Levothyroxine after her blood draw.

    Most people will find symptoms resolve after their TSH drops to around 1.0 with FT4 in the upper range but symptoms can lag a couple of months behind good biochemistry.

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

    ______________________________________________________________________

    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.

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