1 year after thyroidectomy

[Raoudha]

my TSH is 0.07 and endo put on 50 mg levo I wonder if it s too low ? 🙏🙏🙏 for feed back

Ps is my cancer back?

[SlowDragon Administrator]

previous post a year ago you were on 100mcg levothyroxine

healthunlocked.com/thyroidu...

Why was dose reduced

Likely reduced far too much

You need TSH, Ft4 and Ft3 plus vitamin D, folate, ferritin and B12 levels tested

Test early morning and last dose levothyroxine 24 hours before test

[Raoudha in reply to SlowDragon]

Merci beaucoup

[pennyannie]

Hello again :

A year ago you were taking 100 mcg Berthrox which I presume is T4 - thyroid hormone replacement :

Do you have any results for this year and why has your dose been reduced to just 50 mcg ?

Your last results were a T3 of 5.35 in a range of 4.00 - 8.30 around 31%

with a T4 at 19.88 in a range of 9.00 - 22.00 at around 85%

and a TSH of 0.09 in a range of 0.25 -5.00 : but this below range but it is OK :

Did you manage to buy any Desiccated Thyroid ?

A fully functioning working thyroid would be supporting you on a daily basis with trace elements of T1, T2 and calcitonin + a measure of T3 at around 10 mcg + a measure of T4 at around 100 mcg.

Why has your dose of T4 been reduced ?

[Raoudha in reply to pennyannie]

thanks for replaying I had full thyroidectomy for papillaire carcinoma after 6 months of 100 mg berthyrox my TSh drop at O.O5 so my endo drop my levo at 75 mg 6 weeks later lab test comes TSh 0.07 so rétropédalage levo at 50 mg I think I have to change my endo because all this year no T4 was check

[pennyannie in reply to Raoudha]

Yes change your endo :

You must not be dosed by your TSH:

The TSH needs to be kept suppressed you have had cancer.

You must be dosed on your Free T3 and Free T4 readings like that first set you had that I rewrote on here :

Ideally you need a T4 at around 80% and a T3 at around 60% through the ranges.

You probably would feel better with having some T3 - Liothyronine prescribed :

You do need to make sure your ferritin, folate, B12 and vitamin D are all about 50%/60% through their ranges :

Can you get Desiccated Thyroid where you live - another treatment for hypothyroidism which contains T3 and T4 thyroid hormones ?

[lovelab in reply to pennyannie]

totally agree with Pennieannie on TSH having to be suppressed with thyroid cancer. Very important point. Usually this means large/larger doses of levothyroxine. My husband is on 200 mcg atm specifically to suppress the TSH to avoid metastases developping/spreading.

[Raoudha in reply to pennyannie]

you give me hope thanks for been clear 🙏

[Batty1 in reply to Raoudha]

Find a difference Endo you need to have a low TSH so the cancer doesn’t return and you need to have a completely thyroid test as other have told you ….. Im also thyroid-less because of pap cancer.

How do you feel?

[Raoudha in reply to Batty1]

I feel down and I hope I find a good endo thanks to people at Healhunlocked blessed to find you on my way

[Batty1 in reply to Raoudha]

why are you feeling down?

[Raoudha in reply to Batty1]

sorry for complaining but I really feel better after your feed back thanks to you all have nice end of year and Happy Christmas to all nice people in HealthUNlocked😍😍😍😍

[Batty1 in reply to Raoudha]

complain away its nice to know its not just you.

[foxycry]

I had thyroidectomy 8 years ago. I am on eutirox 125 since than now they want to reduce my dose to 100 for 5 days and 125 for 2 days at week

[annnsandell]

Please don't compare the amount of medication you are being given to another patient. You obviously need the right amount to continue suppression which should also mean you feel well. .007 TSH would appear quite low depending on the range. Endos advise that if you stay too low you are at risk of bone and heart problems. My medication has continued to be reduced over the years and now the surgeon has advised reducing in range as the cancer risk after over 11 years is very low. Agree you need a full range of tests though to ensure you are absorbing and that there are no signs of cancer. Do you feel well? Has your Endo explained their actions?

[waveylines in reply to annnsandell]

It's not true that having a suppressed TSH causes heart & bone problems. There is absolutely no evidence to substantiate that claim! What matters are the actual thyroid levels -Ft4 & Ft3. Largely, these need to stay in range - though some people need their ft4 a little bit over range. Ask your Endo for the body of evidence proving that a suppressed TSH cause heart & bone problems. He/she won't be able to produce it because it doesn't exist!

[annnsandell in reply to waveylines]

Hi Waveylines, Yes, that is why I said "Endos advise", you will have a hard job persuading most professionsals although, I believe there is some evidence in support of brittle bones, I remember reading of a couple of cases of people taking higher unprescribed doses of T3, but of course, they might have developed it anyway or were calcium deficient. Heart professions will also tell you that high T4 causes heart problems, whether or not there is sufficient evidence to back that up. Suppression is of course, required to prevent new thyroid growth in the case of cancer which requires higher doses of T4 (or T3) particularly in the initial stages and needs handling slightly differently to just deficiency.

[tattybogle in reply to annnsandell]

the crucial point is to differentiate between a low/ supressed TSH that comes as a result of high T4 /T3 levels ....... and low /supressed TSH in the presence of moderate/ normal T4/T3 levels .

yes , it IS accepted that high T4/T3 levels have association with increased bone turnover and risks for AF ~it is the high T4/T3 that is responsible for the bone AF effects ... the low level of TSH itself has nothing to do with it .

But in cases where TSH is low /supressed in the presence of moderate / normal T4/T3 levels , it is NOT accepted that the low TSH itself relates to any increase risk to bones or AF risk .

healthunlocked.com/thyroidu... longterm-subclinical-hyperthyroidism-does-not-affect-bone-density-in-patients-having-had-thyroid-ablation-for-cancer

[waveylines in reply to annnsandell]

High level of thyroid hormones - ie well over range for a very prolonged period yes can cause problems.. Suppressed TSH with in range thyroid hormones -no. There's nothing and certainly no body of evidence. Odd pieces of research done is not enough there has to be several consistsnt pieces of research. My lovely Endo told me this.

[Raoudha in reply to waveylines]

thank you really make sense since no thyroid ……

[Brightness14]

I am lucky when I left hospital in France after my Thyroidectomy I was given a letter by my Professor Surgeon. It states that my TSH must always be suppressed. This letter was also sent to my GP. Now I have moved I have copies of this letter for the new GP and future reference. Nobody wants to argue with one of the best professor surgeons in France. Your endo is wrong they need changing.

[Raoudha in reply to Brightness14]

my endo don’t explain me anything I me going to change here I start to have AFib my heart beat speed and I start beta blockers thanks you to take time to explain the problem ❤️❤️

[SlowDragon Administrator in reply to Raoudha]

A fib can be due to not being on high enough dose levothyroxine

Highly likely you are very under medicated

ESSENTIAL to test TSH, Ft4 and Ft3 together. Test early morning and last dose levothyroxine 24 hours before test

Test vitamin levels too

Guidelines on dose levothyroxine by weight is approx 1.6mcg per kilo of your weight per day

After thyroid cancer you may need higher dose to keep TSH suppressed

Never agree to dose reduction on just TSH Test

You’re only over medicated if Ft3 is over top of range

Approx how much do you weigh in kilo

[Raoudha in reply to SlowDragon]

thanks for explaination I ame 67 kg

[SlowDragon Administrator in reply to Raoudha]

67kg x 1.6mcg = 107mcg as guidelines dose levothyroxine per day

Some people need higher dose than guidelines, a few might need a little less

Get dose increase in levothyroxine to 75mcg daily initially and retest in 6-8 weeks

always test thyroid levels early morning and last dose levothyroxine 24 hours before test

Then likely to need increase to 100mcg daily after this

ESSENTIAL To test vitamin levels and get all four vitamin At GOOD levels

[Raoudha in reply to SlowDragon]

thanks I was not knowing this very helpful I me thankfull

[Raoudha in reply to Brightness14]

exellent Doc in france

[annabianca]

50mcg for someone without a thyroid is an extremely low dose, even for someone very slim and short. If that is the amount of levo you need to have normal thyroid blood tests, I would be worried that your surgeon didn't take out your whole thyroid, or that you have some ectopic thyroid tissue somewhere.

[Raoudha in reply to annabianca]

how to know if there is ectopic thyroid?