Total thyroidectomy - what to expect?

[AiryFairie]

A family member has just had her thyroid removed. She has Hashimoto's, the thyroid had become very hard and contained pre-cancerous cells. Does anyone have any advice/tips I could pass on to her? What should we expect now? She is not UK based.

[SlowDragon Administrator]

With Hashimoto’s it’s ESSENTIAL to maintain optimal vitamin D, folate, ferritin and B12

Never dose by TSH…..always test Ft4 and Ft3

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

If eventually on T3 alongside levothyroxine - day before test split T3 as 2 or 3 smaller doses spread through the day with last dose 8-12 hours before test

Strictly gluten free/dairy free diet often beneficial or essential

[AiryFairie in reply to SlowDragon]

Thank you SlowDragon, I will pass this information on. I am hoping my relative will have a smooth road ahead - Hashi's has been a rollercoaster for her over the years, one minute underactive, then switching to overactive, as high antibodies randomly nibbled away at the thyroid. Am I right in assuming that her condition will be easier to manage in the future without these random surges? (Assuming she is optimally treated, of course!) And she is aware of the importance of vitamins, as above, which is good.

[SlowDragon Administrator in reply to AiryFairie]

Sounds like she wasn’t on high enough dose levothyroxine before thyroidectomy

Many Hashimoto’s patients only feel well on a dose that suppresses TSH and turns their own thyroid off completely