Hello Folks!

[sheenah]

Got to have Vascular surgery in the next few weeks. Bloods showed up that T3 and T4 were out of kilter. I don't think I have been taking enough (Thyroid - S) I have now increased the dose - Do we think that will do the job or do I need something else to boost things along?

[GlowCoach Administrator]

It would help if you shared actual blood results along with their reference range.

How much Thyroid S were you taking and what have you increased to?

How did you take your blood test? Time of day and time of last dose before the test?

Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw, last T3 dose 8-12 hours before blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process).

Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.

For NDT testing, split dose day before test and take last portion 12hrs before the test.

[tattybogle]

just to make you aware if you are not already ~ having a supressed TSH can create issue's if having General Anaesthetic , or rather , it can cause the medics to have issues and postpone surgery .

It comes down to the opinion of the individual anaesthetist . some understand that low TSH is not a problem with general anaesthetic as long as T4/T3 levels are not too high and are comfortable to go ahead , but others don't get it and will postpone op.

so depending on what your recent TSH / fT4/ fT3 levels were, and whether you have already had pre-op bloods done or not , increasing your dose ( and lowering TSH further) could possible cause your op to be delayed while you have a repeat round of 'low TSH / lower your dose' argument with them.

some people have sorted it by simply discussing T4/T3 levels with anaethetist, but others get a brick wall.

[sheenah in reply to tattybogle]

Thanks for your responses. The nurse said that the pre-op blood TSH level was Ok but that there was a problem with T3/T 4 balance - no numbers were specified. He (the anaesthetist) also said that I needed an additional inhaler (COPD). They have put the op off for 6 weeks as I have just had a chest infection. The surgery is to remove blockages in both my groins and a couple of stents "further upstream". I have reached the point now where I can hardly walk at all - certainly not outside of my home. Such is life.

Many Thanks

Sheena

[pennyannie in reply to sheenah]

NDT presents differently in blood tests to how synthetic thyroid hormones present - does the anaesthetist know you are taking Thyroid S - ?

[sheenah in reply to pennyannie]

I told the nurse so I presume he does

X

[pennyannie in reply to sheenah]

Did the nurse know of Thyroid S and how it presents in a blood test ?

[sheenah in reply to pennyannie]

I really don't know. He seemed to know. I shall have try and make an appointment with the GP - wish me luck - to see if I can find out more. It was all done very quickly at the hospital - I have no access to blood tests!!

X

[tattybogle in reply to sheenah]

GP may not have access to hospital thyroid blood results. ( different system , not neccesarily sent to GP )

I'm not sure what is the easiest way to get hold of them directly from hosp, as i've never tried , but check this out before making GP appt , other wise it may be waste of time

[sheenah in reply to tattybogle]

Many Thanks

X

[SoulfulS in reply to sheenah]

How many pills of Thyroid-s are you taking daily?

[sheenah in reply to SoulfulS]

Sorry for the lack of replies - I have been out of it for a couple of days! I am now taking 4 per day - for a long time I was taking 3 per day - maybe not enough. One other concerning thing is weight loss- since Jan 3rd I have lost 6lbs and still losing - not that I am eating; my husband has taken to making me an omelette every morning and making me eat it. I am also now taking a selenium supplement to try and boost T3. I need this op - without it I will unlikely be able to walk outside again. Any ideas and suggestions are more than welcome!

Love Sheena X

[tattybogle in reply to sheenah]

Hi sheena , in order to give any sensible advice about thyroid we need see the results( and lab ranges) for latest TSH / fT4 / fT3 tests

and how many hrs before test the last dose was taken .

[sheenah in reply to tattybogle]

I am afraid I don't have any of those - working in the dark here!!

X

[tattybogle in reply to sheenah]

increasing your dose of Thyroid-S from 3 to 4 grains without knowing what your TSH / fT4 / fT3 results may mean your operation is postponed again ,(if the higher dose sends TSH lower /or fT3 higher than the anaesthetist is happy with) .

[sheenah in reply to tattybogle]

God knows.

I went for a pre-op appointment last Weds at Musgrove Hospital in Taunton. I had 2 filthy infections, one UTI and a chest infection for which I was taking the dreaded Amoxillin. The nurse did extensive blood tests, which came back almost immediately. The anaethesist said my TSH was OK but T3 and T4 were out of kilter . He also said that I needed another inhaler besides the Duaklir that I already take. This means a visit to the respiritory nurse which has not yet been arranged. It is pointless trying to get these appointments over the phone. The staff there have an obsession with the word "appropriate". The only way I get any where is by writing to my GP - which I will be doing later and handing it in tomorrow. I will also ask if I can get a copy of the bloods!! The anaethitist said we are now looking at the end of Feb for the Op which does give me some time to try and sort it all out Thanks very much for your concern.

I am finally feeling a bit better now - never going away for Christmas again!!****

Sheena X

[tattybogle in reply to sheenah]

, yes i got given flu ( or something godawful) for christmas too .. so much for the benefits of making the effort to be sociable ....won't make the mistake of doing that again. Glad you're starting to feel a bit better now , me too ,but still coughing up gunk

maybe they won't do another pre op if it's so close ?, but i don't know .

[arTistapple]

Yes this is a ‘biggie’ not helped at all because of the (dare I say) unseemly speed with which this can all come about, without proper consultations taking place/proper circumstances being recorded - and patient being properly informed, I have found.

Lots of mistakes/unimportances to doctors ending up with incomplete notes and incomplete planning for procedures.

I would say, you at least need to ensure everything has been recorded and definitely make yourself aware of your blood test results. As previously mentioned, anaesthetists often have more knowledge of thyroid conditions than other doctors or surgeons. However you can’t totally rely on even that.

You are right to wonder if “all your ducks are in a row”. You will have more confidence in your procedure if you feel they are.