Comments please on my friend’s TSH and T4 results following a surgical removal of thyroid gland.

[Jollypolly]

Can anyone help please...I know someone who recently had her thyroid surgically removed as I believe it was pressing on her oesophagus ..

She was , of course , put into Levothyroxine...

Her recent blood test from mid December showed a tsh of 39.83...

And a free t4 of 11.8

This seems like a totally unacceptable result, yet she’s had her thyroxine put DOWN to 50 mcg !

I don’t yet know what her symptoms are...I only know she’s not feeling at all well.

I have Hashimotos but don’t understand too much of the science in cases of removal of thyroid gland.

..can anyone offer any lucid comments....I can only think she needs far more thyroxine..

Any thoughts anyone?

[SlowDragon Administrator]

She needs a new GP/endo

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

please email Dionne:
[e-mail]

Also ask for list of recommended thyroid specialists

Prof Toft - article just published now saying T3 is likely essential for many especially if had thyroidectomy

rcpe.ac.uk/sites/default/fi...

[Jollypolly in reply to SlowDragon]

Thanks Slowdragon..

Do you mean likely to need t3 itself..or the test result..?

[SlowDragon Administrator in reply to Jollypolly]

Well NHS have cunning plan .....they don't test FT3 ...... therefore no one would know they need it .....but many do

We have to test privately

Private tests are available

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results

[Jollypolly]

Thanks..helpful...but did you mean she may need to take t3?

[greygoose in reply to Jollypolly]

Yes, she may need to take T3, but one won't know until she gets her TSH down to around one and has her FT3 tested.