Throat problems after complete thyroidectomy

[Pickles3]

I'm new here and just wondering if anyone has experienced the same throat problems as me..? Over 10 years ago I had a thyroidectomy and so was put on levothyroxine. After the operation I started experiencing horrible coughing fits - something would catch the back of my throat and the next minute I'd be gasping for air while trying to cough to clear whatever it was that had irritated my throat. My GP told me that my throat would just take time to settle and not to worry about it. Then about 6 months later my throat began to feel dry, tickly and sore as if I was starting with a cold. Ten years down the line and my throat feels worse than ever and I'm still having the gasping for air/coughing fits. Is there anyone who has similar problems?

[SlowDragon Administrator]

Perhaps you are not on high enough dose of Levothyroxine

For full Thyroid evaluation you need TSH, FT4, FT3 and also very important to test vitamin D, folate, ferritin and B12

First thing is, do you have any actual blood test results? if not will need to get hold of copies. You are legally entitled to printed copies of your blood test results and ranges.

UK GP practices are supposed to offer online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need enhanced access to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up. They can no longer charge for printing out, rules changed after May 25th 2018

How much Levothyroxine are you taking ?

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or vitamins

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 ideally be done as early as possible in morning and fasting. When on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

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 at

[e-mail]

Professor Toft recent article saying, T3 may be necessary for many. Note especially his comments on current inadequate treatment following thyroidectomy

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

[Pickles3 in reply to SlowDragon]

Thanks for your email SlowDragon. There's a lot to take in. I must admit it had crossed my mind that perhaps my dossage was wrong, but I don't experience any of the usual symptoms that most people seem to suffer. Both my energy levels and my weight have remained constant throughout and I have been on 75 mcg ever since I began taking the Levothyroxine. I have tried various things like giving up dairy, going gluten free and more recently have been on the acid watcher diet, all to no avail. I am starting to wonder if there is just something in the medication that irritates my throat..? The only other thing I occasionally suffer from (which may have nothing to do with the Levothyroxine) is aching pains in my legs, which get worse at night when in bed - these episodes usually last no more than 3-5 days.

[SlowDragon Administrator in reply to Pickles3]

Aching legs is often due to low vitamin D. A very common problem with thyroid patients

Suggest you get full Thyroid and vitamin testing privately and bring results and ranges on new post. Members can advise

Always do tests as early as possible in morning, fasting and last dose vitamin f Levothyroxine 24 hours before test