High tsh recent open heart surgery 22/8/22

[sheleen]

I've been getting severe muscle pain in lower upper leg muscles and buttocks. Severe nerve pain left shoulder. I thought it was after effects of surgery and all the meds. But my TSH just came back severe high. I'm on 75 mcg. No resp from endos. Should I just take extra 25mcg on alt days . I'm worried about heart rate and meds. No energy.

[SlowDragon Administrator]

Make appointment with GP for Monday

Request/insist on Full thyroid testing TSH, Ft4 and Ft3

Essential to also test vitamin D, folate, ferritin and B12

Book early morning blood test, ideally around 9am and last dose levothyroxine 24 hours before test

Looking at previous post you were on 100mcg levothyroxine previously

Which brand of levothyroxine are you currently taking

How long since heart op

Likely you had extra blood during or after op ?

What other medications are prescribed

Are you taking these several hours away from levothyroxine

[sheleen in reply to SlowDragon]

I forgot to do all you listed I think I have brain fog. No energy to even think straight. Im running around in circles trying to make appointments with no reply doctors. I will have to get gp to help. I did get B12 done last week. 246.8 (200-835 pg/ml). I have spent most of the summer indoors so hardly any vit D. Will get the other tests done. Thanks for the prod.

Before op I was informed that I would need to take warfarin for life. I wasnt very happy about that as Im a bit of a health freak. I ended up taking 14 tablets daily until about 3 weeks ago when I managed to get the cardiologist to reduce the meds to 6 daily. The muscle pains in legs which I still have now I felt were hindering what was a very rapid recovery from the op. I was waking with terrible leg muscle pain in both legs, calf thigh buttocks. I thought it was the statins. Now Im wondering if it is related to High TSH.

Levothyroxine: Last month I had L thyroxin 75 mcg berlin-Chemie but Ive just started Euthyrox 75 mcg Merck as they didnt have the other brand. I was previously on a dose of 75/100 on alternate days.

I was told I was anaemic and my operation was delayed 3 days. Yes I did have donor blood when I was on heart and lung machine. It has been 10 weeks since my operation on 22/8/22.

My current meds are: before breakfast: L-thyroxine 75mcg, Nolpaza 20mg (stomach), Carditrust 25mg. After breakfast: Concor 5mg 1 tab. Trifas (diuretic) 5mg. Lunch: Sintrom/Warfarin. 6pm Aspirin 100mg Note: Before Heart problems I had preferred to take L thyroxine at night before bed or better absorption. Hospital insisted on giving it with lots of other meds??? They also insisted on stopping HRT which was helping with all joint pains.

Im supposed to be taking Calcium and D3 as was diagnosed with osteopenia in 2016? Cant remember. I have terrible shoulder nerve pain at the moment. Also have cervical spondylosis and most recently tested positive for rheumatoid.

Thanks for your tips.

[SlowDragon Administrator in reply to sheleen]

first step is change Levothyroxine to bedtime. That will help improve absorption levels

Two weeks later

Start on daily B12

Meanwhile get folate, vitamin D and full iron panel test for anaemia including ferritin tested

Look at adding separate vitamin B complex couple of weeks after starting B12. But get folate tested first

come back with new post once you get results

[sheleen in reply to SlowDragon]

Ok thanks

[humanbean]

These links may be helpful (but may be irrelevant) :

ncbi.nlm.nih.gov/pmc/articl...

healthunlocked.com/thyroidu...

link.springer.com/article/1...

ahajournals.org/doi/10.1161...

ncbi.nlm.nih.gov/pmc/articl...

...

Some suggestions that would be worth checking up ...

When people have surgery they may lose a lot of blood. It might not be enough to prompt a blood transfusion during or after surgery, but may be enough to cause problems for the patient. And even if a transfusion is given the donor blood may be too low in nutrients for a thyroid patient to feel well.

Losing blood will affect the levels of many nutrients, particularly iron and ferritin (iron stores). It would be worth getting a full blood count and an iron panel done, which should show if you are iron deficient and/or anaemic. Note that iron deficiency needs to be treated with or without anaemia.

Other things that can be affected by surgery / anaesthesia are vitamin B12 levels :

b12-vitamin.com/anesthesia/

pubs.asahq.org/anesthesiolo...

And if B12 levels are affected you could also end up with low potassium :

health-boundaries.com/what-...

drmalcolmkendrick.org/2013/...

Info on B12 supplements :

perniciousanemia.org/b12/fo...

In order for the body to make use of B12 it must have sufficient folate. For info on folate supplements :

takecareof.com/articles/ben...

chriskresser.com/folate-vs-...

Painful muscles could be caused by low vitamin D. It will also slow wound healing.

healthline.com/nutrition/vi...

Some HU threads on the subject of low vitamin D :

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

It is essential to take vitamin K2 and magnesium when taking vitamin D supplements. They both get mentioned a lot on the forum. Vitamin D helps the body to absorb calcium from the diet. Vitamin K2 and magnesium help calcium to go into bones and teeth rather than end up lining the arteries.

Note that testing magnesium is pointless. As long as your kidneys are functional they will excrete excess magnesium via the urine. So supplementing magnesium at sensible doses but without testing is safe with functioning kidneys.

...

Talking about your thyroid hormones, I wonder if your body needs a higher dose because you have had surgery and the body is desperately in need of thyroid hormones to repair itself. It wouldn't surprise me. I would suggest that you raise your dose. Whether that raise in dose needs to be permanent or temporary is something I can't predict.

Good luck.

[humanbean in reply to humanbean]

I forgot to say...

Make sure you take a decent dose of vitamin C as well.

[sheleen in reply to humanbean]

Thank you.

[sheleen in reply to humanbean]

Thank you very much I will look into all this.

[Lovecake in reply to humanbean]

humanbean, if @sheleen is on warfarin should they take k2?

(Sorry if I haven’t tagged you properly, never have got the hang of it 🤪)

[APAscot]

I was told no K vitamins whilst taking warfarin.

[humanbean in reply to APAscot]

Vitamin K1 and vitamin K2 aren't the same thing. K1 is the vitamin which mostly affects blood clotting. I hadn't heard that K2 affects clotting but this link suggests that K2 should be avoided in people on warfarin/coumadin, as you say :

thehealthyhomeeconomist.com...

[APAscot in reply to humanbean]

Thank you humanbean for your link. I think I’ll continue to avoid the Ks. I hate green and most other coloured vegetables anyway. Can’t afford to upset my blood with so many complications. Hope this doesn’t sound rude - it isn’t meant to in any way.

[sheleen]

I am on warfarin. I'm still trying to balance the diet and inr. Last 3 inr's were too low. I used to love my greens. Now I'm trying to get sorted to balance it. Many say eat what you want and just alter your dose.