GRAVES PATIENT 10 WEEKS THYROIDECTOMY

[NIKEGIRL]

Bloods at 4 weeks post surgery were on 150 levothyroxine

TSH <0.01 range 0.40-4.0

T4 18.9 range 10-22

T3 2.9 range 2.5-6.0

AND now 5 weeks later on 175 levothyroxine 

TSH <0.01 range 0.40-4.0

T4 16.9 range 10-22

T3 2.9 range 2.5-6.0

Hi guys. Well I hoped having surgery would give me rainbows and unicorns but I am having a few issues.

the question is what to do next?

There is no t3 in New Zealand but NDT is here.

Any advice for seeing gp. I don’t even think 200mgs of levo a day would dramatically change my levels.

I did the withholding of levo before test. Fasting and before 9am.

[Lalatoot]

Nikegirl a working thyroid produces around 100mcg T4 and 10mcg T3 per day. Some folks find that with no thyroid their body runs fine on levo only. Others find that they need to add T3 into the mix. This could be because conversion is poor but it can also be because their body is still wanting that 10mcg that the thyroid would have produced and that they can't seem to get it from conversion alone.

It is early days yet for you but I personally would be looking at NDT now. Your TSH may never get into range and you have no thyroid to stimulate so I would consider the feedback mechanism well and truly broken and out of the equation. You need to go on ft4, ft3 levels and symptoms. I can't see any benefit in trying higher levo doses and prolonging the agony. It will take a while for you to settle on NDT doses so the sooner you start the better in my opinion.

[NIKEGIRL in reply to Lalatoot]

I see my gp next week. Endo knows about NDT. GP does not know. Thank you though. I am happy to pay for the NDT here as it’s not a funded medication.

[eeng]

Graves is very hard on your body and tends to deplete it of major nutrients such as B12, Folate, Vit D and Ferritin, which make it difficult for your body to use the Levothyroxine. It's definitely worth getting these tested to see if you have low levels, probably before increasing your Levothyroxine dose still further.

Are you taking anything else apart from Levothyroxine? there was a post here earlier this week from someone who was in the habit of taking 3 or 4 different pills together including the Levothyroxine, and found that increasing her dose made no difference to her blood test results. She was told to take the levothyroxine on its own, on an empty stomach, and warned that she might need to lower her dose.

I hope you find some answers to your questions here - there are some very knowledgeable people.

[NIKEGIRL in reply to eeng]

Hi. Only taking levothyroxine with water at 1am 4 hours away from eating. No other supplements being taken at all. Thank you for your post.