Life after cancer

[Littlebowpeep]

Hi everyone, its my first post. I had total thyroidectomy done August of last year. I had micropapillary thyroid cancer, plus hyperparathyroidism. God was so good and answered my prayers for a successful operation. Now, getting my thyroid level right with Synthroid is the next challenge. My t4 is at 0.19, and I have been having hand tremors, heart palpitations , leg sweats at night, and insomnia. I am nervious and get upset easily. My question is, now that my Endo has reduced my dose of Synthroid to 88, how long should it take till I feel better. I have a re check of bloods in March, is there an easier and faster way to find in right dose than waiting two months between every dose change? Thank you very much if you took the time to read this all through, you all seem so wise, I look forward to hearing what you have to say, thank you so much, at least I dont feel alone with this problem, littlebowpeep

[SlowDragon Administrator]

For full evaluation you ideally need TSH, FT4, FT3, TT4, TPO and TG antibodies, plus vitamin D, folate, ferritin and B12 tested

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

Low vitamins are common

As is low FT3, even if FT4 is high

You may need addition of small dose of T3

[Littlebowpeep in reply to SlowDragon]

Thank you so much for your help SlowDragon, my Endo. is only testing the T4. Should I ask her to also test for the others you mentioned? She isent that approachable when I want something differant, but I will ask if I get the courage. I really appreciate your input, thank you again, littlebowpeep

[Clutter]

Littlebowpeep,

Can you post your thyroid results TSH, FT4 and FT3 if you have them, with the lab ref ranges? The ranges vary across the world so T4 0.19 tells me nothing. If you are overmedicated symptoms should start improving on the reduced dose in around a week. 88mcg is a low dose for someone without a thyroid though so it seems unlikely you are overmedicated.

It takes 6-8 weeks to metabolise dose adjustments so you do need to wait a few weeks in between dose changes. Have a look at the explanation in this link thyrophoenix.com/adjusting_...

[Littlebowpeep in reply to Clutter]

Clutter, thank you so much for answering me. I wish I had more information for you, but my Endo. only tests me for T4. She said I was getting too much Synthroid, my level was at that point 10 mcg, and my TSH later read 0.19. So now I am on 88 mcg. I am now wondering why Iam having all these symptoms of hyperthyroidism on just 88mcg? Thank you so much for the link, it really helped me to understand why things cant be any faster, Im still frustrated, but at least now I understand, thank you again, really appreciate it, littlebowpeep

[Clutter in reply to Littlebowpeep]

Littlebowpeep,

TSH 0.19 is a little below range and doesn't mean you are overmedicated. What is T4 level and range? 10mcg is a dose not a thyroid level.

Sometimes symptoms cross over. Breathlessness, racing heart, palpitations, tremors and sweating are more commonly overmedication symptoms but can also be due to undermedication.

[Littlebowpeep in reply to Clutter]

Clutter, whoops, type o, I ment to say my level of Synthroid was 100mcg, then she switched me to 88 mcgs because she said I was getting too much thyroid med., my T4 level at that time was 0.19. Is the TSH level the same as T4?, because all they test me for is TSH, and it dosent say anything else is tested. I assumed that it was my T4. that was being tested. I have a walk in apt to get my blood tested again in March, then I will see what my thyroid level looks like then. I hope they test me for reacurring cancer then, it will have been 7 months since the surgery. Thank you so much for helping me, it is so nice of you, littlebowpeep

[Clutter in reply to Littlebowpeep]

Littlebowpeep,

If they only test TSH then 0.19 must be TSH. My oncologist and endo want TSH <0.10 to avoid recurrence after thyCa. It is in fact <0.01 but I'm not overmedicated because FT4 and FT3 are within range. Ask your doctor to test FT4 and FT3 as well as TSH.

They will probably test thyroglobulin which is used as a cancer marker post thyroidectomy.

[Littlebowpeep]

Clutter, thank you so much for this information, I will ask my Endo. for the other tests. If I may, could I ask you what type of cancer you had? I have asked my Endo. if I was going to get an oncologist, she said no. I guess my cancer type, micropapillary, didnt warrent an oncologist. One worry I have is, I havent been checked for thyroid globulin, am I being paranoid? My TT surgery for cancer and hyperparathyroidisim was done in Augest, 25th, 2017. This is all new to me so forgive me if I know so little. Iam so blessed to have such a fine resource as yourself to kindly help me out, thank you, littlebowpeep