Refused knee op because of Thyroid reusults - help please

[ck7156]

First post for me and am asking for help as I have been refused a knee operation because of my thyroid results and i have no idea why or what to do. I am waiting to see my GP but thats weeks away and was hoping that someone on here could review them and tell me what they mean.

I am taking 175 levothyroxine and my latest blooded results are: TSH level is 0.01 and my T4 level is 17.7.

Thanks in advance

[helvella Administrator Thyroid UK]

I suspect the anaesthetist is concerned that you appeared over-medicated based on the TSH being so low.

What is the reference range for FT4 at your lab?

[ck7156 in reply to helvella]

It’s 7.9 - 16

[MissGrace in reply to ck7156]

This is an issue people with low or suppressed TSH on here have come up against before. I have specifically asked my endo to tell my doctor to put on my notes that my TSH is below the normal range but this is okay and I am not over-medicated. He expressed it as ‘runs a low TSH’.

We constantly come up against this brick wall of ignorance. I hope you are able to get this sorted without having to make yourself ill by reducing your dose. 🤸🏿‍♀️

[helvella Administrator Thyroid UK in reply to ck7156]

How long did you leave between your last dose and the blood draw?

[ck7156 in reply to helvella]

About 6 hours

[helvella Administrator Thyroid UK in reply to ck7156]

The FT4 might still have been elevated from your tablets.

We usually suggest at least 12 and up to 24 hours between levothyroxine and blood draw.

Obviously depends on whether they are refusing due to low TSH or high FT4 - or both. Definitely worth trying to discuss.

[LowB12]

Can they do it using an epidural and sedative if required, if they are worried about general?

I don’t know or know if it is something you would consider if an option??!

[Fruitandnutcase in reply to LowB12]

I’d say if you get the option when they finally decide to do it definitely go for epidural and sedation. My husband had that for his hip replacement and he felt terrific - well as terrific as was possible under the circumstances but he made an amazing recovery - when he woke up.

Hope you get it done soon.

[ck7156 in reply to Fruitandnutcase]

Thanks for reply - am def going to ask for epidural as it worked really well last time

[SeasideSusie Remembering in reply to LowB12]

My cousin has had a knee replacement and a hip replacement with epidural.

[Emyloulou]

I am having a total hysterectomy including both ovaries next week and like you have a suppressed tsh as I take t3. Following my pre-op I got the call I was expecting to go and see the anaesthetist but once she’d seen me and we’d had a long conversation regarding my results and other medical conditions(I have a few!) she was more than happy. My ft4 and ft3 are both well in range and I had a completely normal ecg which is what she based her decision on, quite rightly.

Did they test your ft3 and ft4? Could you request to see the anaesthetist and discuss it with them?

[MMaud]

Are you certain it was on the basis of the thyroid results? There a re several elements to the pre-op blood panels that can be stumbling blocks between pre-op and the op.

[Hidden]

I had knee surgery in June 2018 and my TSH is below range my orthopedic surgeon never said anything about my needing thyroid blood results prior to surgery..