Questions around thyroxine/life after total thyroidectomy, 4 days post-op !

Hello everyone! I put a post up here not long ago and received so, so many wonderful, kindhearted replies that I haven't had the chance to respond to because I am very tired. From the bottom of my heart, you have my sincerest apologies and I will reply as soon as I can, I promise. Words are not nearly enough to express just how much each and every one means to me, I genuinely cried in relief upon reading some of them. But at the moment, I have some more questions and won't be able to reach my endocrinologist for a few days, if that's okay. :')

I am a 17 year old girl who is 4 days post-op after a total thyroidectomy and I have been on thyroxine for two of those four days. I stop eating at 8pm and have been taking it at 10pm every night. I am incredibly constipated and it is impacting my sleep because I cannot pass any stool at all - whether this is a result of anything I don't know, but I'd very much like to take a laxative. My problem is it is a night laxative (do you think taking it during the day would really matter or would that be unsafe?) and I understand you are not supposed to take other medications around the same time as thyroxine. So my question is: am I able to safely take my laxative (bisacodyl) after taking my thyroxine and if so, how many hours after? I'd also like to know this for food, if I take my thyroxine at 10pm, how many hours after am I allowed to eat? Also, I am aware I need to take it on an empty stomach, but does this include drinks? Can I drink water between 8pm and 10pm and thereafter without impacting the thyroxine?

How long do you think I should take laxatives for my constipation before I seek out other methods with my doctor? I do not want to become dependent on them but I don't know what else to do at the moment and my doctor's are very hard to reach.

Another question I have is now that I've already started taking it at night, how can I switch to taking my thyroxine during the day? Do I double dose (one at 10pm like usual and then one in the morning) or skip a dose (miss the usual 10pm one and just take it in the morning)? I do not yet know if I will or not, but it would bring me comfort to know the safe method in case I ever need to. People who take their thyroxine in the morning, at what time do you take it?

Does anyone know if taking thyroxine at night can cause insomnia? My endo mentioned it in passing, but then dropped it as a possible cause for mine when she found out I hadn't started it yet, but now it has me curious and worrying if it would be better to take it in the morning.

When do you think it would be safe for me to sleep leaning on my incision? I have gotten literally next to no sleep in days because I sleep on my stomach with one arm under my one thin pillow every night for my entire life, I am autistic so this routine is very important to me but I don't want to cause any damage.

Are pins and needles/tingling in the feet and hands normal after this surgery? I understand this is something to look out for because of low calcium, but I mentioned it to both my surgeon and endocrinologist earlier and they both said my levels were totally fine even after running another blood test so they don't know what's causing it. Should I bring it up again? It typically happens in certain positions, like when sitting on the toilet, and then goes away when I stand up.

I am feeling very overwhelmed and out of control of my life right now, I am so sorry for all the questions, but if anyone has absolutely any answers for me that would mean so incredibly much. I understand some of these I may need to get from my endocrinologist, but any advice you may have for now is incredibly appreciated, I don't have anyone else to turn to and I feel so isolated in my condition.

I hope everyone is safe and doing well !

Kind regards

Mika

[SlowDragon Administrator]

Hopefully someone who’s had thyroidectomy will pop along with some advice

If wanting to change to taking levothyroxine in morning

Levothyroxine is a storage hormone. So yes, you can just change over time

If wanting to change.....take your bedtime dose a bit later on first night

2nd night ....perhaps take it in the middle of night when get up for the loo

3rd night/morning - take levothyroxine early morning

If taking levothyroxine in morning, it must be at least an hour before eating or drinking anything other than water

How much levothyroxine have the doctors started you?

Which brand of levothyroxine is it?

[Hidden in reply to SlowDragon]

Thank you so much for taking the time to reply, SlowDragon! It means a lot, and it makes me feel a little better having the basic knowledge on how to adjust times. I've been started off on 100mg and I'm pretty sure the brand is Mylan; that's what it says on the bottle, at least. 😅

[SlowDragon Administrator in reply to Hidden]

So you obviously aren’t based in U.K.

Helpful to add country you reside in on your profile, especially if not the U.K.

[Hidden in reply to SlowDragon]

Oh my goodness, I'm so, so sorry. I can totally delete my posts if need be. I live in New Zealand, I was just so desperate for answers that I didn't process where I was posting, you have my sincerest apologies. I'll be sure to stick that on my profile, too. Still, I wholeheartedly appreciate you and everyone else's help.

[helvella Administrator Thyroid UK in reply to Hidden]

We have members from round the world - though I don't remember many from New Zealand. Far from being a problem, it helps for us all to understand that many issues are universal. And what differences there are.

It is simply that people can refer to your profile rather than you needing to say so on every post! (And no-one would remember to do that.)

[Hidden in reply to helvella]

Ah, I'm so glad! Thank you very kindly, and no worries! I can't imagine there being many other New Zealander's on here; I'm just glad I didn't cause any trouble! I made sure to add my location to my profile, bless.

[SlowDragon Administrator in reply to Hidden]

Welcome from the other side of the world

We have a other few members from New Zealand on here

Posts mentioning New Zealand

healthunlocked.com/search/p...

[Hidden in reply to SlowDragon]

Thank you very much! You have no idea just how much I appreciate it, I'll be interested to look through said posts!

[Nanaedake]

It takes a while for an incision to fully heal and you would be best to ensure good healing before putting any pressure on the scar. I would have thought that in 4 to 6 weeks it will feel comfortable enough to turn in different directions at night without discomfort. Your body will let you know if it's uncomfortable.

From my experience anaesthetic can affect your bowels so once the effect of the surgery have fully gone out of your system things should return to normal so you're unlikely to become dependent on laxatives. You coukd eat no more than 6 prunes a day, they are good for keeping things moving and good for bones. A little magnesium citrate and plenty of water through the day will help once you are back to normal.

If you continue to suffer over the next week with constipation then you really need to speak to your doctor. There's no need to suffer.

[Hidden in reply to Nanaedake]

Understood, thank you so much for taking the time to reply to me, Nanaedake! I look forward to when those days come. 🤗 It's reassuring to hear that this can be an effect of the anesthetic, but I'll be sure to bring it up with my doctor next week should the constipation continue.

[Batty1]

Hi gocatboygo....

Meds: I take 1/2 of my thyroid meds 2 hour BEFORE I go to sleep and I sleep fine the only way to know this for yourself is try it a few times and see how your sleep goes.

Constipation: Magnesium Citrate has been my savior (I have IBS-C) and no thyroid equals a nightmare! I take 2 capsules 4 hours BEFORE my thyroid medication.

Scar and sleep position: JUST SLEEP however you sleep and if it hurts you won’t do it.

Pins and needles: sounds like you need calcium supplements.... others here better to advise on this.

[redjaime]

I had pins and needles for a while after my thyroidectomy op last year, it's due to the supine position you are in during the procedure unfortunately. Your neck is put in a rather unnatural backwards bend throughout, with your arms down by your side, and it can take a little while for your nerves in your spine to settle again afterwards in some cases. As I already had some slight damage in my neck it meant I woke up with a completely dead left arm and it took me a bit longer than some to get back to rights, but for most people it is not too much of a problem.