T3 on NHS

[1342fire]

hi all

Just thought I would check in.

From finding out I had thyroid problems around this time 4 years ago and had to cancel my spinal surgery because of it.

To having lots of help here and learning to pushing my gp for the right dose and then the endo with the tsh only.

I sat him down and told him that it’s my appointment my time and you are going to look at this video explaining about t3.

after I was put on t3 on the NHS.

Its a year on and I’ve had a few bumps with my gp that told me I will never get it.

With my scripts but I’m still getting it ok now.

Just wish I could get my back problems fixed like this.

[Buddy195 Administrator]

I’m glad that your thyroid medication is working 1342fire, but so sorry you are no further forward with your spinal issues. Have you been given any dates for surgery?

[1342fire in reply to Buddy195]

Thank you

Looks like I’ve got to have more back surgery’s.

I’ve just got my mri report back and it’s a lot to take in.

MRI cervical spine

CLINICAL HISTORY

FINDINGS

Loss of the normal cervical lordosis. Alignment is otherwise maintained.

Normal craniocervical junction.

Normal vertebral heights.

Normal signal of the imaged part of the spinal cord.

Axial images:

C2-3: Disc desiccation. No disc herniation or neural compromise.

C3-4: Disc desiccation and mild uncovertebral arthrosis. No neural compromise

C4-5: Moderate reduction in the disc height, disc desiccation and mild bilateral uncovertebral arthrosis, more pronounced on the right side, resulting in significant narrowing of the right exit foramen and compression of the right C5 exiting nerve root.

C5-6: Disc desiccation and bilateral uncovertebral arthrosis. No neural compromise.

C6-7: Disc desiccation and circumferential disc bulge. No neural compromise.

C7-1: Disc desiccation and minimal posterior disc bulge. No neural compromise.

T1-2: Disc desiccation. No disc herniation or neural compromise.

CONCLUSION

Multilevel degenerative changes, more marked at C4-5 level with compression of the right C5 exiting nerve.

RED ALERT

The radiology department has been notified.

MRI of the lumbar spine

CLINICAL HISTORY

Known history of lower neck pain Gamma lower back pain for a long period of time, walking with crutches. He had previous lumbar spine decompression and fusion, worsening back pain and leg numbness as well as arm pains, pins and needles and tingling.

FINDINGS

Comparison has been made with the previous MRI scan of 24 August 2023:

Straightening of the normal lumbar spine lordosis seen on sagittal sequences with preserved normal vertebral alignment

The patient has had previous arthrodesis L4-L5 with lumbar arthrodesis plate with transpedicular screws showing normal positioning and responsible of some mild metallic artefact on periphery.

The combination of moderate degenerative annular disc bulge with severe degenerative facet joint disease, hypertrophic ligamentum flavum and background of lumbar canal narrowing is responsible of severe acquired lumbar canal stenosis at L3-L4 seen just above the level of the lumbar arthrodesis with no cauda equina rootlets are recognised; no CS is visible, giving a homogeneous gray signal to the sac, while minimal epidural fat remains posteriorly. This appearance is slightly more severe than on the previous exam however, normal previous axial TZ sequences available covering this area.

There is also moderate acquired narrowing of the right exiting foramina at L4-L5 with possible irritation of the corresponding exiting nerve root right L4.

No other significant modification is seen within the rest of the exam in particular no additional external compression of the terminal spinal cord or the rest of the cauda equina nerve roots.

No height loss of the vertebra bodies or fracture.

There is a mild diffuse heterogenous aspect of the bone marrow related to the age of the patient..

No abnormalities seen on the peripheral soft tissue.

CONCLUSION

Severe acquired lumbar canal stenosis at L3-L4 with significant compression of the cauda equina nerve roots. This appearance is slightly more severe than on the previous exam however, normal previous axial 2 sequences available covering this area.

Moderate acquired narrowing of the right exiting foramina at L4-L5 with possible irritation of the corresponding exiting

nerve root right L4.

Need spinal surgeon opinion.

[Buddy195 Administrator in reply to 1342fire]

Hopefully the surgery you need will not be postponed again 1342fire. I hope your meeting with the spinal surgeon gives you confidence going forward 🦋

[Britpol]

Hi

Well done. I don’t know what your back problems are but do not rush to surgery because overall, the outcomes are poor. A lot can be done with carefully prescribed exercises that an experienced physio can do. I have been having back problems for over 25 years (spinal stenosis where the holes in the vertebrae allowing the nerves to come through grew too small , pressing on the nerves) but am managing the condition with daily exercises. These have changed somewhat over the years, so visits to good physios periodically may be necessary, but from what I hear about surgeries, non-invasive treatment is better.

[1342fire in reply to Britpol]

Yes I’ve got all the types of stenosis

And had two back surgery’s so far for it.

Funny enough i called my GP yesterday about it and I’m to complex for her to help🙈

I’m no meds from the pain team that she do not give out.

I’m waiting for them to contact me today hopefully.

It’s a horrible thing.

[annesarah]

Hello 1342fire

I hope you can get your back issues sorted soon. I was curious as to which video you showed the endo that persuaded him to allow T3?

Take care

[1342fire in reply to annesarah]

This plus one youtu.be/KiAGg1fc3RE?si=UTV...(Not working as expected?)

He is tsh obsessed!. And I told him that and this doctor is higher up than him. You are going to look at this video it’s my time now.

[annesarah in reply to 1342fire]

Thanks for the link to the video- very good summary. I notice it is 15 years old and we are still trying to educate doctors!

[1342fire in reply to annesarah]

My Endo was keeping on about tsh.

Yes it’s an old link however they all should be upto speed with this.

But my plan worked and I’m now on 50 mcg a day t3.

I see some places will only give out 10mcg a day

That’s not good if you need more.

[SlowDragon Administrator]

Well done on getting T3 on NHS

Presumably you have suppressed TSH on T3

You need to make anaesthetist aware BEFORE surgery

you will need Ft4 and Ft3 tested

Also make sure your B12 levels are good before anaesthetic

Do you normally take a daily Vitamin B complex/B12

[1342fire in reply to SlowDragon]

Good afternoon sd

Yes i know about that now.

Remember my second op you picked up my blood test results and pre-op did not pick it up.

I had to call to cancel it 🙈

Yes I’ve been taking b- complex the one you told me about a while ago now thank you

[SlowDragon Administrator in reply to 1342fire]

Test vitamin D, folate, B12 and ferritin at least annually

Remember to stop B complex 5-7 days before any blood tests as contains biotin (biotin often used in lab equipment and can give false results)

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)

[Wua13262348]

Helvella posted a research paper a few days ago which you should be aware of to use as a weapon in your arsenal as you navigate your treatment , going forward. It is Indian, and from the " Journal of Anaesthesiology Clinical Pharmacology, July-Sept 2024, Pain as a presenting symptom of hypothyroidism". Look up , journals.lww.com/joacp/full...

I can empathise with your tragically , horrible situation. You seem to be much worse than I am. I refused spinal fusion in 2001, though in agony. By 2007, techniques had advanced to the point that there was an alternative to spinal fusion to free my firmly trapped sciatic nerve. I had keyhole spinal surgery to shave the disc in 2007. I recently acquired my hospital records and found that my thyroid wasn't even checked prior to surgery. Over range bloods pre surgery show a possible Vit B12 problem, pre surgery ,which was ignored, and probably written off to likely stress.

Going forwards, nerve pain (radicular pain) could be a problem for you. The 2 active forms of vit B12 (adenosylcobalamin and methylcobalamin), in high doses, are quoted , if google questions, as a possible aid to treat nerve pain, and to attempt to regenerate the nerves.

Hope it all goes well for you.

[helvella Administrator in reply to Wua13262348]

Here is a link:

Pain as a presenting symptom of hypothyroidism

healthunlocked.com/thyroidu...

[Wua13262348 in reply to helvella]

No idea how you do that!

[helvella Administrator in reply to Wua13262348]

The trouble is, if you copy the link as it appears - with dots at the end - it only appears as text and never goes blue!

If you click on a link in a post or reply, and you get to the page which says:

Redirect Notice

Looks like you clicked

[ link in blue ]

You can copy the blue text and paste that.

[Wua13262348 in reply to helvella]

I'm very proud that I can tag now, though sometimes it doesn't work. Don't understand clicking on a link and copying and pasting it. Sorry! Too advanced! I took a note of the web address on your original post so that i can put it in the google box on my computer if I want to find it again, and I quoted that from my notes. Think I have a mental block for that kind of thing.