Best tests post thyroid removal

[Bamboo36]

Hi, I’m due to have my remaining half thyroid removed on 3 January due to thyroid cancer. I’m incredibly nervous about being on medication and getting the balance right so I want to make sure I understand the testing properly to know what to make sure is assessed. I’m someone who likes to be prepared and have knowledge! From my reading I’ll need to make sure that TSH, FT4 AND FT3 are tested. Sometimes the doctors don’t do FT3 but I need to push for that one to make sure I am converting T4 to T3. Is this correct?

I’m assuming that I wouldn’t need tests for various antibodies as I won’t have a thyroid anymore. Is this right?

Is it worth having any vitamins / iron tested at all? I’m prepared to pay for private tests if required and not provided on NHS. I just want to make sure I have everything needed to get to optimal health.

I am getting my half thyroid results tested next week so that I have a base line to understand my ‘normal’. Unfortunately I didn’t know enough to do this before the first half was removed in September. However, I’ve felt good (in fact more energy than before) since the operation so I think the cancer may have affected me without knowing. I thought it may be useful to have results for when I felt good so we have a baseline. I know it’s not ideal only on half thyroid but at least I’ll have something if ever needed. The test is Monday morning. I’m going to not eat after dinner the night before prior to test plus I haven’t been taking my normal pregnacare vitamins for 10 days prior to the test to try and make sure that doesn’t skew. Anything else I should consider?

I should also mention that once stable I want to get pregnant. I understand I’d need TSH to be at 2 or under to conceive. Is this right. And then once pregnant (fingers crossed, the last 6 months has been a long journey of tough health news) is need TSH to be monitored and stay under 2. Is there anything else to be aware of?

Thank you so much god helping me to understand it all. I’m finding this forum is helping me grow my knowledge so thank you all.

[MaisieGray]

Knowing what your thyroid hormones are with a thyroid & unmedicated, is unlikely to have any/much relevance to what they will be without a thyroid and medicated. With a thyroid your body is producing the hormones T1,2,3,4, & calcitonin in a cyclical process, and everything is being constantly checked and self-regulated in minute degree. Once you take exogenous hormones such as mono-T4, that is no longer the case; and especially if we take either T3 or an NDT, that creates an entirely different set of results whereby the TSH is very low or suppressed and the FT4 proportionately low, for instance. It is the very insistence of many Drs that we try and fit into the same numbers exhibited by euthyroid people once we have no, or only a poorly functioning thyroid, that often prevents us from being optimally well.

[shaws Administrator]

You state " I’m incredibly nervous about being on medication ". I just want to point out that when our thyroid gland fails, or is removed, that it is replacement hormones we take rather than 'medication' as our body is no longer able to produce the life-giving hormones.

I do hope that your doctor/endo prescribes a combination of T4/T3 and not T4 (levothyroxine) alone.

I have my thyroid gland and know how bad I felt on levothyroxine - that's not to say you will also - but be prepared.

Levothyroxine is inactive - it has to convert to T3 (liothyronine) and it is T3 that is required in our millions of T3 receptor cells in order for our body to function as normal, i.e. the brain and heart need the most T3.

If you're in the UK, there is a Petition before the House of Lords as T3 was withdrawn without any notice (due to it rise in cost) and left many desperate and searching for T3 from anywhere in the world. The cost had risen in the UK by 6,000% but should not have been withdrawn, especially to patients who could not recover on levothyroxine.

I wish you well on your next op and a speedy recovery.

Always get your blood tests at the very earliest, fasting (you can drink water) and allow a gap of 24 hours between your last dose and the test as that method keeps the TSH at its highest as doctors appear to only look at the TSH and they're happy if it is somewhere in the range, when we need it 1 or lower but as you've had thyroid cancer it has to be suppressed.