I have had a full womens health blood test with Medichecks which I do annually.
I had a diagnosis of enlarged multi-noduled goitre with isolated T3 toxicosis. I was on a very low dose of Carbimazole since 2011.
On 25th May 2022 I had a full thyroidectomy as the enlarged goitre had begun to cause problems. Histology shows nothing sinister - the mass removed was ten times the size of a normal thyroid.
I am now on Levothyroxine 100mgs.
My question - how long before my body rebalances. I know this is rather an abstract question!
All the results are ok except a low folate. The doctor’s review suggests my medication is too high.
My symptoms - very tired (although I accept this in part is due to the surgery and body rebalancing), very low mood, intolerance to temperature changes feeling cold and shivery mainly.
Any thoughts would be very helpful. I am not due to see the specialist until end of August but will try and get some help in the meantime.
Carole
The numbers are:
TSH 0.04 (0.27-4.2), T3 5.1 (3.1-6.8), T4 23.9 (12-22)
Folate 3.74 (3.89-19.45)
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C1949K
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Thorne Basic B or Jarrow B Right are recommended options that contains folate, but both are large capsules. (You can tip powder out if can’t swallow capsule)
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
Thank You! Just trying to understand the new scenario having being medicated overactive for so long.Yes bloods taken in the morning but Levo had been taken earlier. So I will bear this in mind for next time.
Vit D low but in range so will up that dose.
B12 etc high as I do supplement.
Of course, my old voice still not back and that is pretty draining too trying to speak! But specialist confirmed no damage to vocal chords.
Levo started 27th May - after the surgery - so five weeks 2 days!
I had to increase the Carbimazole to reduce the toxic levels as much as possible pre-surgery - so was feeling pretty rubbish before the op!
Thank You for the info re the folate which I will study.
Thank You! This is all very helpful. I feel as though I am starting from scratch again with a new thyroid disease. I always took Carbimazole pm and so bloods taken early am. This time I had a nurse visit which was middle morning.Vitamin D - 85 (50-200)
B12 97.8 (37.5-150)
Ferritin 66.3 (13-150)
I take B12 occasionally as I have very little meat in my diet.
Very common for ferritin levels to drop on levothyroxine
Look at increasing iron rich foods in your diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
Again this is all very helpful. throughout my life of almost 73 years I have often been anemic and so do include liver once in a while! I will write up all this new info in my thyroid journal and make a start on this new regime.Thank You! You give me hope!
A fully functioning working thyroid would be supporting you, on a daly basis, with trace elements of T1. T2 and calcitonin, plus a measure of T3 t around 10 mcg plus a measure of T4 at around 100 mcg.
T4 - Levothyroxine is basically a storage hormone and needs to be converted by your body into T3 which is the active hormone that runs the body including your physical, mental, emotional, psychological and spiritual well being, your inner central heating system and your metabolism.
T3 is said to be around 4 times more powerful than T4 with the average person needing to convert / find / utilise around 50 T3 daily, just to function.
No thyroid hormone replacement works well until your core strength vitamins and minerals are up and maintained at optimal levels and this is especially true of ferritin, folate, B12 and vitamin D.
Once on any form of thyroid hormone replacement, and especially since you now do not have a thyroid you must be dosed and monitored on your Free T3 and Free T4 levels and not a TSH reading.
We generally feel at our best when our T4 is in, up and or towards the top quadrant of its range ( or slightly over ) as this should in theory convert to a good level of T3 at around a 1/4 ratio of T3/ T4 :
Some people can get by on T4 - Levothyroxine only :
Some people find that T4 seems to stop working as well as it once did and find a little T3 - similar in dose maybe to what their thyroid supporting them with, helps and they re prescribed T3 - Liothyronine along with T4 making a T3/T4 combo.
Some people can't tolerate T4 and need to take T3 only :
Whilst other people find that they feel better on Natural Desiccated Thyroid which contains all the same known hormones as that of the human gland and derived from pig thyroids, dried and ground down into tablets referred to as grains.
Currently on the NHS you are routinely prescribed T4 - Levothyroxine only.
Twenty odd years ago your doctor was fully able to offer, trial and monitor you on all of the above options but today, if T4 doesn't work well for you, a referral to an endocrinologist is required to assess your medical need.
Unfortunately it has become something of a post code lottery as various CCGs throughout the country have restricted prescriptions of anything other than T4 - due, basically to being down to costs.
I'm with Graves Disease post RAI thyroid ablation in 2005 and am now self medicating and buying my own full spectrum thyroid hormone replacement and running my own lab tests as again, in primary, the appropriate blood tests seem not to be available.
I only became well when I found Thyroid UK, and whom support this amazing forum around 6 years ago, and thanks to the members on here, my health has much improved and why I now give back when I think I maybe able to help somebody else asking for advice.
It's early days, so just look after yourself and read around as you owe it to yourself to be your own best advocate.
Thank You for posting. I have received advice (and given) on this forum as an overactive thyroid. And yes the information is always helpful and appreciated. I stayed on Carbimazole for a long time because other challenges were happening in my life and RAI was not an option because of the goitre (which I understand can become hardened and still grow) and my dose was so low. However, in trying to keep the T4 high was not easy because the T3 would ping out of range! I now feel my body has been turned upside down and I have to look at how to monitor my supplements/meds. I tend to work with the specialists but knowing how my body works best. I have no gallbladder and also AF episodes - which may be less/better without the thyroid?
Patience until my body settles into its self again.
Thank You for your post - which I will keep in my thyroid journal and review with the other information.
Yes, it will take time so stay with the specialist you trust.
Well I wouldn't recommend RAI to anybody anyway and believe it should be withdrawn as a ' therapy ' so you haven't missed anything there, not having it !!
My surgeon was absolutely lovely. And my endocrine specialist has also been extremely helpful/understanding. It is interesting not to have a proper voice - still not able to hit the high notes yet! x
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