The hormone needs in persons with Hashimoto's vs person who have had a thyroidectomy?

The other day, a friend of mine saw this hormone expert in Belgium. Unlike most other hormone experts there, this doctor prescribes synthetic combo drug Novothyral only.

My friend was told that since she still has a thyroid (she has Hashimoto's), she'd most likely only need one pill a day (100 mcg T4, 20 mcg T3), possibly one and a quarter or one a half but no more, whereas patients having had a total thyroidectomy often require at least two pills a day for complete symptom-relief (so, 200 mcg T4 and 40 mcg of T3).

Quite frankly, I fail to see the difference between someone who's had Hashimoto's for years and then been on TSH-suppressive doses of T4, and someone who's had her thyroid gland removed. It's not like people with advanced Hashi's produce that much more hormone than someone having had a TT, or am I completely wrong...? Would appreciate some input on this. Anyway, I told my friend not to obsess too much with numbers, but to aim for symptom-relief.

[Hidden]

I reckon the "hormone expert" is completely wrong. The aim for everybody is to become symptom free. Without a thyroid since 2005 and tried taking more and taking less of both Levothyroxine and NDT and cannot take any more than 150 of levo or 2 NDT per day without it being an obvious overdose for me. Any less than that is an obvious underdose for me.

These seem normal dosages to me, not excessive.

What is different is that I retain significany hypo symptoms with levo whatever dose I take, even with the appropriate dosage. Even with NDT I never feel as good as before my TT and RAI treatment.

No idea about Hashi, thank goodness!

[Nanaedake]

Having Hashimotos and reduced thyroid function and having a thyroidectomy is different. For one thing, thyroidectomy sometimes removes or damages parathyroid glands and disrupts calcium levels. It removes the follicles that produce calcitonin. There is no capacity for thyroid tissue to release more hormone through TSH stimulation and no T3 being released at all directly from the thyroid gland. Even partial thyroidectomy may disrupt parathyroid function and release of calcitonin.