Hi all.
I had my thyroid removed in June and had my first blood test to check TSH levels last week. The test was at 9.40 am, no levothyroxine for over 24 hours and only water before the blood was taken.
Serum TSH level 0.29 mlU/L [0.27 - 4.2]
My only other result from before my thyroidectomy was 0.91.
Thyroid was removed because of large cyst/swelling.
Can anyone tell me if my TSH level is ok please? I’m still learning!
Thank you x
How do you feel?
The TSH level looks great, however thats only a tiny part of the whole picture.
To make a full assessment you need to test for TSH, FT4 & FT3. Suggest you get some private bloods run yourself. See link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/testing/priva...
There is also a new company offering walk in& mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...
Only do private tests on a Monday or Tuesday to avoid postal delays.
Have you tested and now supplementing key vitamin levels?
What supplements are you taking?
I think I feel ok really! I would like a bit more energy sometimes but I think I felt the same before my thyroid was removed. I’m not on any supplements and I haven’t any idea about my vitamin levels. I will get myself a private test sorted so I can see everything that’s going on, not just the TSH. I’ll be back to ask about the results 😊.
I’m struggling to understand the point of testing tsh when I haven’t got a thyroid to stimulate!
I’m struggling to understand the point of testing tsh when I haven’t got a thyroid to stimulate!
The point is that the pituitary, which produces TSH in response to low levels of thyroid hormone in the blood, doesn't know that you haven't got a thyroid. It only knows how much thyroid hormone is available for use. And if there's not enough, it increases out-put of TSH because that's what it does.
So, but some twisted logic the medical profession has decided that therefore, the TSH is all they need to test to dose by. They do not have the profundity of knowledge to understand the illogicality of that, that a mere TSH number cannot tell you exactly how much thyroid hormone there is is in the blood, nor if it is T4 or T3, not how well, you convert, nor any of the other complexities of treating hypothyroidism. And they are also assuming that everyone has a perfectly functioning pituitary, which is far from being the case. But all they want is a quite life and therefore reduce everything to the lowest common denominator, and if the patient isn't happy with that, then it's the patient that is wrong, not them.
That's why they test the TSH.
Got it! Thank you ☺️
You're welcome. 
Hey there :
It is essential that you are dosed and monitored on your Free T3 and Free T4 readings and not a TSH seen in isolation.
The TSH was originally introduced as a diagnostic tool to help identify someone suffering hypothyroidism and was never intended to be used once the person became a patient and taking any form of thyroid hormone replacement.
We generally feel best when the T4 is up in the top quadrant of it's range at around 80% with the T3 tracking just behind at around 60/70% through its range :
You have had a medical intervention - and now without a thyroid -
and your HPT axis - the Hypothalamus - Pituitary - Thyroid feedback loop now does not work as there is no thyroid in situ to complete this circuit loop -
the TSH blood test is based on the idea that this feedback loop works well and is - in situ :
Are you are under the hospital endocrinology team for a follow up appointment as I'm sure they will require the TSH, Free T3 and Free T4 in due time -
if not you can always run your own - Medichecks currently have 20% off - and we can talk you through the results - but I think it may still be a little early in your recovery :
medichecks.com/products/adv... - this test covers all the bases we need to advise on - and I think between them - this company and Blue Horizon cover most of the country with a nurse home visit option - at an extra charge - if you would prefer an ' at home ' venous blood draw.
That’s really helpful, thank you for explaining.
I’ve got my follow up appointment next Friday so I’ll see what the Dr says. If it turns out that the T3 or T4 levels aren’t at their best, what happens? Would it be a change of dose of levothyroxine?
Are you having to have further blood tests run in preparation for this follow up appointment with the hospital endocrinologist or the surgeon ?
Let us wait and see what is said - ideally there needs to be full thyroid panel run in order to make any adjustment to your dose and at this point in time it will be adjusting the dose of Levothyroxine - what dose were you put on ?
Very important that the body's core strength building blocks of ferritin, folate, B12 and vitamin D are up and maintained at optimal levels as they assist in the conversion of T4 into T3.
Extremely important to test vitamin levels too
For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must have GOOD Vitamin levels
Test folate, B12 and ferritin at least annually
Vitamin D twice yearly when supplementing
What vitamins are you currently taking
how much levothyroxine are you taking
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
Which brand of levothyroxine are you currently taking
For full Thyroid evaluation you need TSH, FT4 and FT3 tested
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)
Post all about what time of day to test
healthunlocked.com/thyroidu...
Testing options and includes money off codes for private testing
Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins
bluehorizonbloodtests.co.uk...
Only do private testing early Monday or Tuesday morning.
Link about thyroid blood tests
thyroiduk.org/testing/thyro...
Link about Hashimoto’s
thyroiduk.org/hypothyroid-b...
Symptoms of hypothyroidism
thyroiduk.org/signs-and-sym...
Tips on how to do DIY finger prick test
support.medichecks.com/hc/e...
Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee
Thank you for all that information. I’m not taking any vitamins at the moment. All this happened fairly quickly with no symptoms other than a swollen neck so I’ve never needed to know all this before! I’m on 125mcg levothyroxine and in the last 7 weeks I’ve had 3 different brands I think. I’ve felt ok though which is great. X
Many people find Levothyroxine brands are not interchangeable.
Most easily available (and often most easily tolerated) are Mercury Pharma or Accord
Mercury Pharma make 25mcg, 50mcg and 100mcg tablets
Mercury Pharma also boxed as Eltroxin. Both often listed by company name on pharmacy database - Advanz
Accord only make 50mcg and 100mcg tablets. Accord is also boxed as Almus via Boots,
Wockhardt is very well tolerated, but only available in 25mcg tablets. Some people remain on Wockhardt, taking their daily dose as a number of tablets
July 2024
Crescent levothyroxine. Dosages: 12.5, 25, 50, 75, 100
(Not yet known if all approved dosages are or will be available).
Excipients: lactose monohydrate, maize starch, croscarmellose sodium, gelatin and magnesium stearate.
Lactose free brands - currently Teva or Vencamil only
Teva makes 25mcg, 50mcg, 75mcg and 100mcg
Many patients do NOT get on well with Teva brand of Levothyroxine.
Teva is lactose free.But Teva contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol seems to upset many people, it changes gut biome
Teva is the only brand that makes 75mcg tablet.
So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
But for some people (usually if lactose intolerant, Teva is by far the best option)
Vencamil (currently 100mcg only) is lactose free and mannitol free. 25mcg and 50mcg tablets hopefully available from summer 2024
March 2023 - Aristo now called Vencamil
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Helpful post about different brands
healthunlocked.com/thyroidu...
List of different brands available in U.K.
thyroiduk.org/if-you-are-hy...
Posts that mention Teva
healthunlocked.com/search/p...
Teva poll
healthunlocked.com/thyroidu...
Once you find a brand that suits you, best to make sure to only get that one at each prescription.
Watch out for brand change when dose is increased or at repeat prescription.
Government guidelines for GP in support of patients if you find it difficult/impossible to change brands
gov.uk/drug-safety-update/l...
If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.
If symptoms or poor control of thyroid function persist (despite adhering to a specific product), consider prescribing levothyroxine in an oral solution formulation.
academic.oup.com/jcem/artic...
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
And here
pharmacymagazine.co.uk/clin...
Discussed here too
HiI had my thyroid removed 12th June. Large nodules.
I'm having my first thyroid bloods on Thurs 1st August.
I'm taking 150 of levothyroxine daily.
Not had my post op yet as not quite fully recovered yet. Voice is coming back slowly. Wound healing nicely. Feel bit tired but not worried as I'm 63
I'm derbyshire trust. Hope u r getting better
Hi Dollydreamer,
I had my op on June 13th so very close to yours. My voice has struggled too, it still won’t go high and gets much hoarser when I’m tired or talk too much! It’s amazing how quickly it heals isn’t it?
My follow up is next Friday. I’m a bit nervous and hoping everything tested was ok. It’ll be lovely to hear how you get on. I’m in Devon. X
Hi baby elephant. Great to hear from u. Yes how close we are to operation dates. I'll let u know. I have blood test on Thurs and the results will be the following week.Did u have Yr neck muscles cut, do u know? Mine were cut, I'm not sure if they are routinely cut for everyone who has TT.
Even tho I'm not fully recovered yet, I still feel fantastic and much better than pre op tbh.
It's amazing really. I hope u go on alright. I'll let u know next week. Take care in beautiful Devon x.
Hi Baby elephant.
My results are in as attached. Greygoose has explained them to me on another thread.
I just wanted to let u know as I said I would. Also I hope u r going on OK and u have had Yr tests done too
Take care xxx
hi Dollydreamer, I’ll find your other post to see what the results mean but it’s good to see you had your T4 and T3 tested too. I only had my tsh done but my follow-up is on Friday so I can ask the consultant more. I’m really nervous now about hearing what my nodule was, I just really hope it’s all gone.
I hope you’re doing well xx
Hi babyelephantI really hope u have great news at Yr follow up. It's a journey we are on and I too have yet to have my histology report. It won't b till I see my consultant for post op. I've been bit too poorly post op for that, but things r looking up now. Just need to get correct dose of levothyroxine.
I am feeling much better tho. Take care and good luck xxxx
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Thyroidectomy or not? Thyroidmegaly and multi modular goiter. 
