It’s almost 3 months since my partial thyroidectomy due to thyroid cancer and it’s been a roller coaster ride of emotions and recovery. I have hypothyroidism. I went back to work on phased return ( I’m a teacher) and find that after talking a lot my voice becomes hoarse and I’m forever clearing my throat and feeling like there’s something stuck in it. Apart from feeling exhausted and not with it. I’m finding it hard to teach. In a weeks time I go back full time - I’m 58 years old btw. ( this also happens every morning) . It feels like there’s a mucus build up that I can’t clear, throat clearing and a feeling of a foreign body. In addition I can’t sleep, Ive started suffering with carpal tunnel syndrome and severe tinnitus. I don’t know if any of these are linked. My last TSH was 8.5, GP is trialling me on Levothyroxine for a month . Is anyone out there feeling the same? I just want to feel like me again.
Post hemithyroidectomy op: It’s almost 3 months... - Thyroid UK
Post hemithyroidectomy op
Your high TSH confirms you are hypothyroid
Standard starter dose of levothyroxine is 50mcg
Bloods should be retested 6-8 weeks after each dose change
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 is in top third of range and FT3 at least half way through range
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
nhs.uk/medicines/levothyrox...
Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)
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 you are very hypothyroid (as you are ) or if have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Ask GP to test vitamin levels NOW
Improving low vitamin levels helps reduce symptoms and helps thyroid hormones work better
Have you ever had thyroid antibodies tested?
You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
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
thyroiduk.org.uk/tuk/testin...
For thyroid including antibodies and vitamins
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
If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )
monitormyhealth.org.uk/thyr...
If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all primary hypothyroidism in Uk is due to Hashimoto's.
Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten.
So it's important to get TPO and TG thyroid antibodies tested at least once .
Link about thyroid blood tests
thyroiduk.org/tuk/testing/t...
Link about antibodies and Hashimoto's
thyroiduk.org.uk/tuk/about_...
thyroiduk.org.uk/tuk/about_...
List of hypothyroid symptoms
thyroiduk.org.uk/tuk/about_...
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
Add vitamin results if you have them, or come back with new post once you get results
You are very knowledgeable, would you know if reflux is also connected to hypothyroidism. Since having surgery I have had this feeling that food is stuck in my throat and it makes me want to force burps out. I have no acid feeling though , it’s very uncomfortable- I have given up gluten and dairy hoping that might help.
Acid reflux is very common hypothyroid symptom due to LOW stomach acid
articles.mercola.com/sites/...
thyroidpharmacist.com/artic...
stopthethyroidmadness.com/s...
healthygut.com/articles/3-t...
naturalendocrinesolutions.c...
There are thousands of posts on here about low stomach acid
healthunlocked.com/search/p...
Frequently misdiagnosed as high stomach acid. Similar symptoms, very different treatment
Also
Levothyroxine should always be taken empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more effective or more convenient taken at bedtime
verywellhealth.com/best-tim...
Many people find Levothyroxine brands are not interchangeable.
Once you find a brand that suits you, best to make sure to only get that one at each prescription.
Watch out for brand change when dose is increased or at repeat prescription.
Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients. Teva is the only brand that makes 75mcg tablet, so when dose is increased use 50mcg plus 25mcg or cut second 50mcg in half when get 75mcg if avoiding Teva.
healthunlocked.com/thyroidu...
Thank you so much for all that fantastic information. No I’ve never had anything except TSH tested as my GP and consultant say it’s not necessary. The GP has started me off on 25mcg of Tevo Levothyroxine . I’ll try taking the tablet at bedtime instead .
If you find you don’t get on with Teva (high percentage don’t)
List of different brands available here in UK
thyroiduk.org/tuk/treatment...
Get vitamins tested by GP now
Should have been started on 50mcg.....starting on too low a dose can make symptoms worse
NICE guidelines
cks.nice.org.uk/hypothyroid...
The initial recommended dose is:
For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.
This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response. The usual maintenance dose is 100–200 micrograms once daily.
Current UK understanding and treatment of thyroid disease is woefully inadequate, hence over 105,000 members on here
3% of population take levothyroxine.....yet many GP’s are clueless
Although the TUK list has more detail, it has not yet been updated so could be misleading:
UK Levothyroxine Tablets
Last updated 05/02/2020.
This is a list of currently marketed levothyroxine tablets in the UK.
🔹 Accord – formerly Actavis (manufacturer)
50
100
🔸 Almus (brand owned by Walgreen Boots Alliance – Boots and Alliance distributor)
50 – This is repackaged Accord – formerly Actavis.
100 – This is repackaged Accord – formerly Actavis.
🔹 Mercury Pharma (manufacturer – part of Advanz) includes both “Levothyroxine” and “Eltroxin” which are identical.
25
50
100
🔹 Teva (manufacturer)
12.5
25
50
75
100
🔸 Northstar (brand owned by McKesson – Lloyds pharmacy and AAH distributor)
25 – This is repackaged Teva. ❗
50 – This is repackaged Accord - formerly Actavis. ❗
100 – This is repackaged Accord - formerly Actavis. ❗
🔹 Wockhardt (manufacturer)
25
🔹 – identifies manufacturers.
🔸 – identifies repackaged products.
❗ – Take particular note of the actual product which varies by dosage.
Numbers refer to tablet dosages in micrograms.
Carpal Tunnell and Tinnitus can be linked to low B12 as well as low thyroid ... Hope you feel stronger soon.
Do you always obtain copies of your results with ranges ? - so you can monitor your own progress and check what has been missed ! They are legally yours.
Thank you, I had my b12 checked and it was fine but I guess there’s no harm in getting it done again.
Sadly fine/normal/OK means you are in range - but it is where you are in the range that is the key ! B12 is good st 500+ ...
I also have the tinnitus and carpal tunnel and I was told low b12 I was given injections but I had my vitamin levels done in March and they were normal and November when I had them done again my b12 was 111..... I would go back and get them checked again to be sure..... I hope your feeling better soon xxxxx
Thank you I will,did you feel better after the injections?
Iv not really felt a difference in energy and fatigue but the carpal tunnel and tinnitus have got better.... iv just had a hemithyroidectomy 1 week ago though so my body is still adjusting and my b12 is most likely low again due to the anaesthetic I also had low folate and vitamin d not sure if this is linked to anything but I have my check up in 5 weeks time soil see what they say then xxxx
As Marz says ..
Always get actual results and ranges on all tests
Keep good records of how feel at each dose and which brand levothyroxine suits you best
You are legally entitled to printed copies of your blood test results and ranges.
The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results
UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.
In reality many GP surgeries do not have blood test results online yet
Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.
Thank you so much for all the information and advice. It’s greatly appreciated.
I had it done before I had surgery but the surgeon said that the vocal chords were fine post surgery but I can ask at my next 3 month check up. Thank you.
Yeah the surgeon said I might need speech therapy especially as I’m a teacher. No mention of Hashimotos , I don’t know how they tell if you have it. Thank you so much for all your advice and support. It’s been almost 3 months now since my op and everyday I wake up thinking today I’m going to feel ‘normal’ again but not happened yet. I know it takes time I guess but some days are just miserable .#stayingpositive
Getting full thyroid and vitamin testing is first step
Vitamin levels need to be optimal
Which vitamins tests should I ask for? Do you know what optimal levels should be?
See my first reply above.
Many UK patients forced to get private testing.
Important to do all thyroid tests as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
Thank you I’ll look into a private test .
Always keep good records of how you feel alongside each blood test results
Just testing TSH and Ft4 is completely inadequate
All four vitamins need to be optimal
Very important to know if you have Hashimoto’s
Thank you I will raise all these issues at my 3 month check up 👍
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