Advice

[Mands74]

Hi. I could do with a bit of help . I had half my thyroid removed last April due to s large growth they thought could be cancerous but luckily not. Tsh went up to 3.9 very symptomatic. GP wanted to get levels as close to 1 as we could get . 6 weeks ago TSH 1.7 on 75mcg if levothyroxine. Still felt not my best so GP suggest trying 100mcg . Results from last weeks test below . Do you think I am over medicated . For the first time in a while I don’t feel as tired . Actually feel like my old self .

[SeasideSusie Remembering]

No, you're not overmedicated, your FT4 is in range.

[Mands74 in reply to SeasideSusie]

What about my tsh . Sorry to sound thick but that all my gp looks at normally. I can not get to speak to her till 5 April as no surgery appoints or telephone appointments.

[SeasideSusie Remembering in reply to Mands74]

Most GPs tend to only look at TSH and that is so wrong. Your TSH is low because you are taking Levo, therefore your pituitary is detecting that there is enough thyroid hormone and doesn't need to send a signal (TSH) to your thyroid to produce any.

The aim of a treated hypo patient generally is for TSH to be 1 or lower or wherever it is needed for FT4 and FT3 to be in the upper part of their ranges if that is where you feel well.

See thyroiduk.org.uk/tuk/about_... > Treatment Options

"Dr Toft 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)."

Dr Toft is past president of the British Thyroid Association and leading endocrinologist. If you would like a copy of the article then email Dionne at [e-mail] and highlight question 6 to show your GP.

[Nanaedake]

Have you also asked your GP to check vitamin D levels and other vitamins? As you've had half your thyroid removed, also keep an eye on calcium intake and ensure a good balanced diet. When menopausal, ensure you eat enough calcium rich foods and keep an eye on vitamin D levels. Ask your GP if it is advisable to have a DEXA scan in the future. I don't know if you lost parathyroid glands with the partial thyroidectomy but trouble utilising calcium can emerge at a later date so just ask GP to monitor it.

[Mands74 in reply to Nanaedake]

Thank parathyroid not effected . I have had low vit d . I drink loads of milk . They have question early menopause as they though my tiredness was due to that

[Nanaedake in reply to Mands74]

I think simple blood tests can monitor menopause progress. Has your GP given you supplements for low vit D?

[Mands74 in reply to Nanaedake]

No but suggested talk it to have started

[Nanaedake in reply to Mands74]

Ummm, not quite sure what you meant to say??

[Mands74 in reply to Nanaedake]

Sorry auto correct . Not prescription vit d but she suggested I have some as at the time I had to pay for prescription so bought over the counter what the gp recommended

[Inseeing7 in reply to Mands74]

Consider avoiding dairy give it a try.

[shaws Administrator]

I would go along with your GP as not many will increase dose. Between 100mcg to 200mcg can be 'normal' doses. Don't be nervous of the starred TSH result and that is only because it is low. Once we take thyroid hormone replacements many of us feel better when it is very low or suppressed. Members who've had thyroid cancer take suppressive doses of hormones and come to no harm.

If we find, when we increase dose, that we our heart beats too fast it is easy just to reduce dose slightly and in a number of days you should feel fine. The aim is relief of all clinical symptoms.

[Mands74 in reply to shaws]

Thank . I have had heart issue before . Had an op in 1999 for svt. All ok now . Heart has not run fast at all

[shaws Administrator in reply to Mands74]

Did you have a heart problem before your were diagnosed? I am not medically qualified but I believe that we can develop problems if undiagnosed. For instance cholesterol increasing is also a clinical symptom but most doctors would provide statins instead of making sure we are on an optimum of hormones.

This link may interest you:-

hypothyroidmom.com/is-your-...

i.e. T4 is inactive. It has to convert to T3. T3 is active and the only hormone required in our millions of T3 receptor cells.

[Mands74 in reply to shaws]

supraventricular tachycardia was diagnosed in 1995 had an operation in 1999 to burn away the faults . Only had thyroid issues sense last jan

[Hidden]

No you are not over medicated everything is fine and you are feeling better again.

[Mands74 in reply to Hidden]

Thanks fingers crossed my go does lot reduce it then as I feel so much better

[kluang]

I wonder why they removed half your thyroid when they were not sure if it was cancer or not

[Mands74 in reply to kluang]

They did a biopsy and it came back inconclusive . Was large and growing back in my neck not sticking out . They had to remove to do full tests to confirm if it was cancer or not

[kluang]

It must have been very frightening to go through all that, and thank goodness it was not malignant. I hope they will get you feeling ok soon as possible. You seem to be responding to the levo which is a good sign. How did they find it ? I have had trouble swallowing and sometimes wonder if there is something in the way.

[Mands74 in reply to kluang]

It was all in the space of 2 months . I feel so good now fingers crossed I can stay on that level . I had that too and a cough and losing my voice

[JOLLYDOLLY]

Hi Mands74,

I was born with a partial non working gland and would say that at the moment, your T4 levels although near the top of the range, are about right, especially if you are feeling good. My level in range normally sits around the 19 mark.

As Shaws said, the usual "normal" dose is around 100 to 200 mcg of T4. Most of my life I have been on 200 mcg which is what I call my "normal" but they did mess me around in my 30's which lead to all sorts of problems. (long long story) but I am now back on 200 mcg T4 and 20 mcg of T3.

The brand of medication can make a difference too, but if you are feeling good, then carry on.

Sometimes, not always you can get other symptoms which would suggest that you might have B12 deficiency, anaemic and/or have a vitamin D deficiency. These conditions do walk hand in hand with thyroid problems but not always. Unfortunately for me, I have the lot and also sleep apnoea too However since my diagnosis, it appears that all my conditions run in the family, which is another possibility

A lot of GP's and Endo's tend to treat everyone the same - one pill for all, but everyone should be treated as an individual. As someone without complete thyroid function, is different then someone who needs a "top up" to help their thyroids. At the end of the day, we can live without our thyroid glands, BUT NOT the hormones that the thyroid produces.

When they removed part of your thyroid, did they ever mention a possibility of a goitre? Which is a growth in the throat associated with underactive thyroid? As far as I know It is not the "C" word but benign. My parents were told that I was at high risk of developing one, but it is has never happened to me (yet). I just wondered, in case that was why they removed some of your thyroid to stop it happening and as your results were inconclusive.

Hope all goes well and you continue to stay well on your current medication, but if unsure, go back to your GP for advice or get a second opinion.

Take care