Hello All, I had a partial (just over half) thyroidectomy on June 1st 2018. I had stage 1 papillary carcinoma on my right lobe. I currently have a colloid (benign) nodule on my left remaining lobe. My ENT surgeon is not interested in thyroid function testing until I show symptoms of hypothyroidism, which I am not happy about. I am currently 8 weeks 3 days post op and awaiting a GP appointment to request blood tests. I will ask for TSH, FT4, TT4, FT3, vitD, folate, ferritin and B12. Is this correct and is there anything else I should request please? Thank you very much for reading this post. I appreciate any advice that can be offered.
Thyroid testing post partial thyroidectomy - Thyroid UK
Definitely ask for all these, but sadly unlikely that they will do them all.
But Ask GP. Often lab refuses even when GP requests
private testing is available for any that aren't done
All thyroid tests should be done as early as possible in morning and fasting . This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)
For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies
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.
So, your tumor was almost 2cm...
Here are the official guidlines:
For TSH suppression recommendations see page 50.
For no recommendation of RRA from page 38:
ALL CRITERIA BELOW SHOULD BE MET
• Tumour <1cm unifocal or multifocal
• Histology classical papillary or follicular variant of papillary
carcinoma, or follicular carcinoma
• Minimally invasive without angioinvasion
• No invasion of thyroid capsule (extra thyroidal extension)
Even the no RRA group still needs TSH in the low range, which is going to be difficult if it isn't monitored!
From the guidelines for papillary thyroid cancer page 50:
Patients who have not received radioiodine remnant ablation
(RRA) because they fall in the ‘no indication for RRA’ group
(Chapter 9.1), do not require TSH suppression and the serum
TSH should be maintained in the low-normal range between
0.3 and 2.0 mU/l (4, D)
Looking at the info for my condition, it would appear that the there is no conclusive evidence for or against RRA in my case. I understand why the MDT made the decisions they did. However, I still think my dr hasn’t given me the info I require going forward (nor did he when I was going through the diagnosis etc). Thank you very much for your help.
I think you will have to be strong and demand TSH T4 T3 testing as I was left for 20 years after only with a TSH test and that was showing signs it was struggling, They never once took into consideration my symptoms and was left quite unwell for years and when i did get treated I was left for a further 14 yrs with a Tsh of 4.5 which is too high when on Levo,, If you feel symptomatic at anytime ask for a full thyroid panal to be done and get blood results post on here and many will help you on them'
Do not trust you GP as they in my case have proved to be useless, ..
If you are still with The Endo Get the Endo to put it in writing at what level will they treat you if you go Hypo and symptoms to look out for , and ask him to answer within 14 days of getting letter for him to reply with all this info before he lets you back into care GP who may be clueless like many on the thyroid
I was not told of symptoms to look out for and no internet back then,, but I think after destroying part of your thyroid they should have the decency to tell you what to look out for !
I would hate for anyone to struggle as i have after sub Thyroidectomy
you will go probably go Hypo thyroid later on in Life, Im not sure how much you have had taken out, it was 20 years before i got treated but i look back and was definitly hypo not long after surgery.....
Their is very little anywhere to read on part or sub thyroidectomys, I cant find anything at all about treatment after
So insist your Endo puts it in writing so if you get put in care of GP a letter confirming what should be tested from Endo could make sure they test thyroid properly TSH T4 at least and T3 if he can put that , you are living with a bit of Thyroid missing so it is the least they can do,, I think they will test you yearly once stabilised after op..
By getting all this in place you will not be left to struggle as I did
you get full Thyroid panal done else like me you will only get TSH tested which is wrong and your symptoms ignored
Learn everything you can about thyroid disease and you can be in control of it all then an arm yourself with as much info as you can..
Good luck for good health in the future x