Meds after Hemithyroidectomy?: Hi all, I just got... - Thyroid UK

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Meds after Hemithyroidectomy?

benmertus profile image
10 Replies

Hi all,

I just got a Hemithyroidectomy done in Mid December and am feeling fine so far but am scared that I may need meds later. The Surgeon told me that it was unlikely that I’d need meds, however, I see so many posts of under treated individuals. Anyone out there have a Hemithyroidectomy and been fine without medication?

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benmertus
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10 Replies
jimh111 profile image
jimh111

A work colleague of mine had a hemithyrodectomy many years ago and she is fine. You could end up needing thyroid hormone, it depends on how much thyroid is removed and how well the remaining tissue performs. Go by how you feel. If your thyroid secretes less hormone your TSH rises in an attempt to stimulate more secretion. This also increases the rate of conversion of T4 to T3 (the active hormone) and this can compensate for the loss of some secretion. If you start to exhibit hypothyroid signs or symptoms, or your TSH goes above 10 I would request some levothyroxine. Also, keep an eye on your cholesterol level, if it starts to go high consider some levothyroxine if your fT3, fT4 are below mid-interval. Sometimes you can feel well but have harmful effects such as high cholesterol if you produce lower levels of thyroid hormone.

Your user name suggests you might be male, but in general women who are or are planning to get pregnant should keep their TSH below 3.0.

benmertus profile image
benmertus in reply to jimh111

This is really helpful, thank you so much!

Astridnova profile image
Astridnova in reply to jimh111

I would not let my TSH go much above 2, let alone 10! Are you going by UK guidelines for doctors or something?

jimh111 profile image
jimh111 in reply to Astridnova

No. TSH is a poor marker for thyroid hormone activity. Some people are fine with a TSH moderately above the upper limit of it's reference interval and some are dreadful with a 'perfect' TSH. An elevated TSH is a sign that the thyroid is working harder, and clearly half a thyroid will have to work harder. However, if the patient is feeling fine with a mildly elevated TSH (<10) then taking levothyroxine could make them a little worse. If TSH is at higher levels then it makes sense to supplement even if the patient is feeling OK as a high TSH is associated with increased risks of cardiovascular problems (as is a low TSH).

SlowDragon's suggestion of a full thyroid blood test as a baseline is a good idea, it may be very useful in the future. I'm not in favour of excessive testing but one test now is a good idea.

Nanaedake profile image
Nanaedake

You don't say why you had a hemithyroidectomy, however, the newest thinking seems to be to wait and see if you need thyroid hormone replacement. I think it's a good idea as I was put straight onto thyroid hormone right away and then had a lot of trouble with it. I never knew if I actually needed any or if I was over or under replaced as I could not recognise the symptoms of being hypothyroid (underactive thyroid).

10 years (or more) later I am trying to find out exactly how much I actually need to replace adequately and feel well. The idea is to take just as much as you need to feel well if you find your thyroid is not performing well enough. Blood tests will help to ensure you do not go over or under range which could cause problems even if you have no symptoms. You could ask for a thyroid blood test every 6 months for the next couple of years to put your mind at rest and If you feel unwell for any reason then ask to include blood tests to rule out thyroid dysfunction.

Thyroid changes generally happen quite slowly over a period of weeks and months. If you start feeling very tired, gain a lot of weight quickly with no change in diet or exercise, find your bowels slow down remarkably and feel unusually cold, colder than other people when in a warm room and experience an unusual loss in motivation with low mood, then you might suspect a problem developing and ask for blood tests.

pudules profile image
pudules

Hi, I had half my thyroid removed mid September. By the end of November I was feeling very tired, brain fog, constipated, freezing, muscle and joint aches etc etc.

I was lucky my GP and I have a good relationship and after 2 tests and seeing my TSH go from 0.9 to 6.2 ref range (.35-4.94) with the symptoms I was getting started me straight on 100mg thyroxine, I’m totally back to normal now and within optimal range TSH around .9 and F4 at the higher end of the range. You should have a blood test around 6 months post surgery to check how the remaining gland is coping but if you start to have symptoms I’d go and have a blood test.

SlowDragon profile image
SlowDragonAdministrator

Suggest you get full private testing now as a baseline

Then retest in few months

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised or if become hypothyroid

All thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies 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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

Keep record of results and any symptoms that may develop

Fruitandnutcase profile image
Fruitandnutcase

Had a friend who had a hemithyoidectomy and when I last came across him he wasn’t taking any thyroid meds. thyroid replacement hadn't been mentioned and he was fine and that was a few years after his op.

That was a couple of years ago and the couple moved away so I don’t know how things are now.

Good advice from the others about testing and levels and definitely keep records of how you feel etc. I did that and it was a really useful thing to have when discussing treatment with your doctors.

Starlet97 profile image
Starlet97

Hi there, I had a hemithyroidectomy in 2011 because of goiter/nodules and also a parathyroid gland with an adenoma on it. I had an underactive thyroid as well as Hashimoto's thyroiditis which of course I still have. As far as I understand if you have half your thyroid removed and do not have other problems with the rest, then the dr told me the other half would compensate. However, because I had other problems I had to increase my thyroxine. I do not know the reason for your hemithyroidectomy but I would urge you to keep having blood tests at your doctor's recommendations as I am sad to say I felt horrid at the time and have not felt right since. I do however have sjogrens syndrome and fibromyalgia and other conditions so cannot be sure what is causing this. Good luck and I hope you continue to feel fine xx

Poppi4 profile image
Poppi4

Hi I had a hemi thyroidectomy 7 weeks ago. Had a blood test last week and it has come back as normal. I feel absolutely fine in fact better than I did before. Good luck x

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