Thyroidectomy

[DeniseA]

I am new here and am a little confused to say the least. Following routine thyroid test and ultrasound, I will have an operation in two weeks. Multiple benign nodules and one large one (29x31x59 MM.). My FT3 on bloods is 3.59 (range 2.3 - 3.9) and FT4 is 0.96 (range 0.61 - 1.25). My TSH is the bad one at 0.06 (0.34 - 5.6 range) and the Doctor says my hormone levels are way to high and causing the growths so I need gland removal as soon as he gets my levels down with Propycil over the next two weeks. Does this all mean I have Hyperthyroidism? It just doesn't make proper sense, as I have always struggled with weight gain and I thought people who were Hyper had weight loss. Can anyone explain it in simple terms please?

[Clutter]

Welcome to the forum, DeniseA.

I can see your doctor would want to remove the large thyroid nodule. Was a fine needle aspiration biopsy done to check whether the nodule is benign or malignant?

Your FT4 and FT3 levels are within range, they are not high. TSH is low but as FT4 and FT3 are within range I don't think you are hyperthyroid.

[DeniseA in reply to Clutter]

Thank you for replying Clutter. The Doctor did an ultrasound and he said the calcifications he saw lead him to believe it was benign not cancerous but he will still have the growths analysed when he removes the Thyroid, and samples of lymph nodes too, just to make sure it is not malignant. Then onto HRT 3 weeks after surgery. I am presuming I will become hypo before HRT is stabilised. Any idea what dose they will start me on and how it would normally progress before stabilisation. I am worried about weight gain and fatigue as I lead a very full life ! Thanks again

[Clutter in reply to DeniseA]

DeniseA,

I believe the usual replacement dose is 125-200mcg Levothyroxine. As far as I'm aware replacement should be started the morning after thyroidectomy.

Because I'd had thyroid cancer I was prescribed 60mcg Liothyronine the day after thyroidectomy to suppress TSH while I awaited radioactive iodine ablatement (RAI). After RAI I was switched to 200mcg Levothyroxine which over replaced me.

[DeniseA in reply to Clutter]

Thanks Clutter. I will ask the Surgeon again, but he (and the GP) said I would need to wait 3 weeks - maybe they want the see the biopsy results first, to know which type of drug to give me? Of course, idiot that I am, I forgot to ask how soon they would know whether benign or malignant.

[Clutter in reply to DeniseA]

DeniseA,

It took 4-5 weeks for my pathology result to be returned but Christmas and New Year holidays will have delayed them perhaps by a couple of weeks.

[jimh111]

Your blood test results suggest you are a little hyperthyroid, perhaps not enough to affect your weight. Often when there is thyroid disease the thyroid spontaneous produces hormone, particularly T3. This would explain your highish fT3, normally this would be lower with a low TSH and middling fT4. It's an exaggeration to say your hormone levels are way too high. However, it seems that when patients get to the stage where their hormone levels are high and their TSH has been suppressed for some time their pituitary tends to become down-regulated, it underperforms. So, perhaps it is good that you are having it sorted now, although you are not really very hyper at the moment.