Test Results after Hemithyroidectomy

[TwoAlaskans]

Just had my right thyroid lobe removed about six weeks ago due to a suspicious nodule that ended up being benign. Lost one of my parathyroid glands in the process also. TSH before surgery was .477 (.358-3.74 normal) and Free T4 was 1.55 (.76-1.46 normal). At five weeks post op, TSH is .26 and Free T4 is 1.20, same lab values for both as previous test. My thyroglobulin antibody measured 13.3 (1.5-38.5 normal) and thyroid peroxidas AB measured <9 (0-34 normal). I have been on 100 mcg levothyroxine for about 8 years and had been diagnosed with Hashimoto's although this is the first time any antibody testing was done. Am wondering if it now appears I am wandering into hyper range and perhaps do not have Hashimoto's. Can anyone clarify any of this for me? Thanks, in advance.

[jrbarnes]

I had a hemi for a suspicious growth. Your FT4 levels are lower than before your surgey so I wouldn't say you're in a hyper range and the TSH can fluctuate throughout the day, usually higher in the morning , but it's hard to say because the Free T3 and Total T3 wasn't tested. I had a period of time after the surgery where I lost weight and had good energy. Two years later I was tired and placed on Levothyroxine with a TSH of 5. I'd give it more time.

[greygoose]

Am wondering if it now appears I am wandering into hyper range and perhaps do not have Hashimoto's.

Why would 'wandering into the hyper range' prove that you do not have Hashi's? I would have said the opposite was true. Hashi's is where you swing between hypo and 'hyper' and back again - although it's not true hyperthyroidism, only temporary.

To know that you had nodules, you must have had an ultrasound, no? That would have shown if you had Hashi's. Have you seen the report?

Having said all that, no way are your results 'hyper'. The TSH is too high and the FT4 too low for you to be 'hyper' - be it permenant or temporary - nor are you over-medicated. But, it's too soon to know if your on the right dose of levo.

jrbarnes is right, you do need your FT3 tested. But no point in testing the TT3 because it doesn't give you any useful information.

[SlowDragon Administrator]

How do you feel?

On levothyroxine TSH should be low when correctly treated

Most important results are always Ft3 and Ft4. Just testing Ft4 and TSH is completely inadequate

Also important to regularly retest vitamin D, folate, ferritin and B12, especially with Hashimoto’s

What vitamin supplements are you currently taking?

[Batty1]

How much medication are you on?

[TwoAlaskans]

Thank you all for your thoughtful comments above, I really appreciate your sharing your knowledge. My ignorance of my condition is showing and I need to better inform myself as to what is happening. I do agree that I need a little more time to see how things settle out after my surgery -- from what I have read, perhaps another month or two. It seems to me that I am more tired and having more trouble staying asleep -- falling asleep is easy as I'm so tired, but I have many awakenings during the night. I am on cpap therapy which is a work in progress. I am 5'4" and weigh around 135 tops and my weight is pretty stable although recently I made an effort to knock off my covid weight by eating lower carb and being more active and that worked okay. I've weighed this amount most of the last 40 years but did notice a 7-8 pound weight gain that I could reasonably attribute to inactivity and too much snacking, so hence the recent diet to rid myself of that rather than buy new pants (LOL). My apneas initally were about 50/50 obstructive and central; they are now mostly central and peg typically 5-10 nightly. I'm sure that's part of my sleep issue. I'm not sure how my thyroid issue may or may not be affecting this.

Daily I take B12 (500mcg), D3 (125mcg), K2 as MK-7 (100mcg), calcium citrate (1,000IU), CoQ10 (300mcg) and occasionally fish oil. My levothyroxine dose is 100 mcg/daily. I also take omeprazole (40mg in the late afternoon/early evening) along with simvastatin (10mg).

I did have an ultrasound and CT prior to surgery. How would the ultrasound confirm Hashimoto's? I have seen the report but there is no specific mention of Hashimoto's.

My last test results were fasting, early morning. Levo taken after blood draw.

My ferritin was tested in late February and was 65 (16-288 ng/mL reference range). What I have noticed is that my ALP has been low for years and was 37 (44-147 mg/dL) but there's never been mention of this by either of my physicians. B12 was 383 (200-1100 pg/mL) and my physician recommended supplementing for this as she said she'd like to see at least 400 or better.

That's a lot of information! Am wondering, is there a gold standard for diagnosing Hashimoto's?

Thanks again for all your help. I know that overall I am doing well, but not sure things are optimized yet. My heart goes out to those on this forum who clearly suffer or have suffered so much in their quest to bring their systems into check.