Hi, I have two questions, and hopefully I can get some help.
1. Does somebody whose thyroid glands were completely removed can have Hashimoto?
2. What does it mean, where is the problem if the TSH is very high 8.61( 0.39-4.00), FT3 2.1 (2.3-4.2), FT4 0.8 (0.8-1.5)
many thanks in advance
I believe that if your thyroid is completely removed you will not have the possibility of antibodies to the thyroid gland so logically Hashimotos cannot be present.
If TSH is elevated above the lab range when taking thyroid hormone, it means thyroid hormone medication needs to be increased.
Re-Hashimoto's, I also think so, but not sure.What happens if you had Hashimoto, autoimmune disease, before Thyroidectomy?
Re-TSH, even if both FT3 and FT4 are low? thank you
Low, or below lab range FT3 and Ft4 confirm you need an increase in thyroid hormone if you are taking thyroid medication.
If you had Hashimotos before total thyroidectomy then you will no longer have TPO antibodies after thyroidectomy as there is no thyroid tissue to activate the antibodies.
I agree with what the others have said. When you are on replacement hormones your tsh should be 1 or under with ft4 and Ft3 well up in there ranges. If your thyroid was removed due to cancer I believe it Is important to keep your tsh suppressed to reduce possibility of a return of the cancer.
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range
How much Levothyroxine are you currently taking?
If you had Hashimoto's before thyroidectomy then it's likely to have low vitamin levels.
Important to regularly test vitamin D, folate, ferritin and B12
When were these last tested?
What vitamin supplements do you currently take
As you had Hashimoto's, you may find benefit fro. Strictly gluten free diet too
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
Thank you. It's actually not for me. I have Hashimoto's years and I am fine (mostly) and doing everything that should be done.
Can you explain re-Gluten free? As Nanaedake wrote, if there is no thyroid, there are no antibodies, so no problem to eat gluten, no?
RE- medicine, she is on 100mcg a day. Taking D as well. I know what the ranks of thyroid hormones should be, but thought it's strange that both T4 and T3were so low. I guess needs to increase the Levo, as Nanaedake wrote. Any other thoughts on that?
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Gut damage doesn't always heal so there might be an absorption problem. Check that levo is being taken at least an hour away from food, tea, coffee or milk and not with any other vitamins or minerals. 100mcg isn't a high dose.
Gluten is an individual thing. If going gluten free makes you feel healthier and your digestion more balanced, stick with it. It may or may not affect absorption, of digestion is better it may affect a range of metabolic processes including thyroid hormones.
Gluten is not an issue for me at all; some types of meat and too much of some fibres such as wheat definitely is.
I have to be careful not to drink too much milk as I then don’t absorb iron!
No, you can't have Hashis with no thyroid as there is nothing for the antibodies to clean up but you can still have Graves. Your results just suggest serious undermedication. You need an increase in meds urgently.
I have to disagree with some of the replies.
If, by "Hashimoto" you mean TPO antibodies above range, yes this is seen folowing total thyroidectomy. Very often, even with a highly skilled surgeon, a thyroid tissue remnant remains because it adheres to a critical structure. When RAI follows surgery, it doesn't always totally obliterate all existing tissue. If the sugery was done for cancer, there may be thyroid cancer cells which have spread to other parts of the body which antibodies may react to.
In addition there have been reports of Graves eye disease relapsing at a later time if there was sufficient tissue left behind in the thyroid bed and new nodules arise (especially if TSH was not adequately suppressed).
If the surgery was for thyroid cancer, then detectable TPO antibodies should be an indication to closely follow thyroglobulin (Tg) and thyroglobulin antibodies (TgAb) and TSH should be suppressed (< 0.2).
Patti in AZ
Thank you for the information
OK Thanks a lot
AZ is Arizona - in the Southwest US.
I would go with your oncologist - if I had any lymph node involvement I would want to stay pretty suppressed for at least a couple of years. We occasionally have someone on the ThyCa forum report a reoccurence popping up after several years.
What is addressed by only some is that problems from suppression are usually related to excessive doses of T4 and that adding T3 to achieve suppression can eliminate most potential problems.
Patti in AZ
My idiot endo told me after full thyroidectomy I no longer had hashi's. Wrong...still got it. You need a good natural with both t3 & t4. Also, a thyroid supplement. Plus there is a supplement called Cortisol management to help sleep, and cortisol level that will only help the come down.
Armour is not a good med, but if a compounding pharmacy can make equivalent to WP...get it.
As I understand resaults if thyroid hormone tests, your FT3 is low. But I you feel good it is OK. Symptoms are important to put levels on the best place within normal range. As your T4 is good and FT3 low it could be bad conversation of T4 in FT3. Some people use some NDT like Armour with T4 supplement and they feel good. Some people take T3 twice a day and feel good. If it is taken too late it is hard to get asleep.
THS is not thyroid hormone. It doesn't mean Hashimoto. It means low level of thyroid hormone. Antybodies show Hashimoto. It is up to doctor to do radioactive test to see if some thyroid cells are someware. They are good in that field. If you are not satisfied with your doctor find another one. But chack for opinion before. Good are rare. Ask, even on this group.
To the first question. You would still technically have hashis but if you have no thyroid gland your immune system would have nothing to react against.
That's why innoculation against disease works. The next time that particular virus or whatever tries to invade, even years later, your body will be ready for it and go straight into the attack. With Hashis your immune system makes a mistake and attacks your thyroid gland the same way
Skin after thyroidectomy 
1 year after thyroidectomy
Recovery after partial thyroidectomy 
Medication after thyroidectomy
Fasting a Year After Thyroidectomy 
