ELECTIVE SURGERY

[turkeydinner]

Hi

Can anyone offer advice about having Elective surgery with a suppressed TSH.

I'm currently on T3 only and doing well, slowly getting my life back after T4 only and T4/T3 combination not working.

I've been offered Elective ENT surgery, I know my TSH will be suppressed.

Will this make consultants/ Doctor's turn me away/ or attempt to change meds etc.

Thanks for any advice in advance.

[Jazzw]

Fully qualified and experienced anaesthetists tend to be well-informed about the relative “danger” of a suppressed TSH and will be much more laid back about it if your FT3 is in range. Unfortunately, as with all knowledge in all fields, the chance of having such an anaesthetist is starting to diminish over time.

I think I’d raise the issue early and start collecting research articles to back up your view and allow them to reassure themselves that the risk is minimal. Anaesthetists are traditionally far more concerned about high TSH than low TSH.

You may also get lucky given this is ENT surgery as ENT specialists may get involved in thyroid surgery and have more experience of thyroid issues than the average consultant.

[turkeydinner in reply to Jazzw]

Thanks Jazzw

That's given me something to think about.

I don't suppose it will help that I self source T3 and go against GPs - take T4 only advice.

I just don't want to be patronised by a consultant.

Getting some evidence together sounds good.

Thanks again

[TaraJR]

I had elective surgery last year and was worried too. Since I went n T3/T4 combination in 2016 my TSH has been suppressed. I was ready with my arguments (!) but the anaesthetist said nothing about my results! So I was ok.

If it's any help, I've asked several well known endos on webinars if it's a suppressed TSH itself that could cause problems, or having a high/over range T4 and T3. They all said it's not the TSH itself. Here's a summary of that in a jpeg. Feel free to use it if you want. Or message me if you'd like it in Word

Text

[turkeydinner in reply to TaraJR]

Thanks TaraJR

That gives me hope.

Thank you so much.

Xx

[1tuppence]

Having experienced remarks from 2 anaesthetists...one even wrote to my surgery telling them I was hyperthyroid! ( her understanding of thyroid blood tests left a LOT to be desired}, and said that had my operation not been so urgent she would have refused to anaesthetise me. I would take in as much information as possible to back up your case, and be well prepared to answer any queries . @TaraJR has given you very helpful quotes. I wish you an understanding, knowledgeable anaesthetist and a successful op.

[turkeydinner in reply to 1tuppence]

Thank you

Your op went ahead then and you survived.

Thank goodness.

So confusing when your up against the people who should be clued up and often aren't.

Thank you for replying

[Regenallotment Ambassador]

I had an ENT and radiographer write on my file that the GP was causing me to have poorly managed thyroiditis and I would benefit from an increase in dose... she was reading my notes out loud and went... oh no... listen to this, and promptly upped the dose increase I'd gone in to ask for. She was very nice about it. Sometimes you come across good ones

[turkeydinner in reply to Regenallotment]

That's encouraging

Bit of a lottery then.

Cheered me up a bit.

Thank you xd

[Judithdalston]

I’m going in for the ‘anaesthetic assessment’ tomorrow related to knee replacement, never thought that my supressed TSH at 0.03 would be a problem…interesting!

[Sparklingsunshine in reply to Judithdalston]

I think they increasingly use spinal anaesthetics for knee ops these days. I dont know if they are as problematic as a general, if you have low TSH.