Help underactive thyroid after hemi thyroidectomy

[Sasah]

After a hemi my TSHnis reading 4.1 and my T4 11.The consultant reluxtant to acknowlede this is underactive as 'in range'. But i feel.isn't optimol and i am loosingnlots of hair and really distressed. I am under the impressiln i need a lower TSh and higher T4 to help!

[SlowDragon Ambassador]

Welcome to the forum

Loosing hair suggests low iron/ferritin ….very common when hypo

Request GP test full iron panel including ferritin

What was reason for hemi thyroidectomy

How long since it was done

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once for autoimmune thyroid disease

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

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

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

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/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...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Only do private testing early Monday or Tuesday morning.

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

[Sasah in reply to SlowDragon]

Thanks for the reply. I had the op for a small nodule. Turned out to be benign so a waste of time! I now have whatbi thingnare hypothyroid symptoms. I have had TSH, T3 and T4 and most vitamin tests.

These are in range but my TSH is high 4.1 and T4 low 10.9.... and i feel is not optimol for me.

[SlowDragon Ambassador in reply to Sasah]

I have had TSH, T3 and T4 and most vitamin tests.

Please add vitamin results

Please add range on Ft4 …..looks very low, but depends on range

[Sasah in reply to SlowDragon]

I think I need some more up to date vitamin results, as mine are from soon after my op and before I had symptoms. But I don't think they will test them before 3 months.

TSH 4.1

T4 11 (RANGE 9.1-17.6)

T3 4.1 (Not sure on range)

I am at my wits end. Consultant treat me like I am mad if I ask questions and fob me off.

[SlowDragon Ambassador in reply to Sasah]

Results suggest hypo

Get vitamin levels tested and improve to GOOD levels as first step

[Sasah]

why do they suggest hypo if all in range. Both my ENT consultant and private endocrine wont commit to this and have said the thyroid is not at fault for any of my issues!

[pennyannie in reply to Sasah]

Hello Sasah:

Once taking thyroid hormone replacement it is suggested that the TSH is kept under 2 - which means increasing the dose of thyroid hormone replacement prescribed.

A TSH over 2 - suggests hypothyroidism symptoms are starting to occur and years ago a TSH over 3 was enough to be diagnosed with hypothyroidism and treatment with thyroid hormone replacement commenced -

We generally feel best when the T4 up towards the top quadrant of its range at around 80% through and this should then convert to a decent level of T3 tucked in just behind the T4 in % terms through the ranges and around a 1 / 4 ratio T3/T4.

Currently you haven't enough T4 circulating in your blood stream to convert easily to good level of T3 - and it is T3 - the active hormone that runs all your bodily functions much like fuel runs a car with your thyroid synchronising all your needs - from your physical ability and stamina through to your mental, emotional, psychological and spiritual well being, your inner central heating system and your metabolism.

No thyroid hormone works well until ferritin, folate, B12 and vitamin D are up and maintained at optimal levels which we can advise on if you care to share any readings you have there.

Some NHS ranges are too wide to be sensible. and just being in a range somewhere, anywhere means you don't qualify for any further investigation or if looking at supplements - you do not qualify for a prescription of same -

and just being a range is not conducive to optimal health and well being -

and I'm afraid the reality is that hypothyroid is within the low end of the thyroid function T3 and T4 ranges.

[Sasah in reply to pennyannie]

I think i need more up todate vitamin bloods. What meds should i be requesting .

[pennyannie in reply to Sasah]

The thyroid function test is the TSH + Free T3 + Free T4 - but the trouble is you are in the ranges and why the NHS are reluctant to start prescribing you thyroid hormone replacement.

It's a common problem we see with people struggling on with 1/2 a thyroid and making do, getting more and more unwell, and in over reach struggling on with the part gland and making do as best they can - and it's quire ridiculous but that's the NHS guidelines.

If you can afford to go Private, just to get diagnosed, maybe the NHS will acknowledge the diagnosis - try and see a thyroid specialist who is NHS &Private - Thyroid UK - the charity who support this forum have a patient to patient recommended list of thyroid specialists and endos - some of whom work both privately and through the NHS.

Email admin @ thyroiduk.org asking for the Patient to Patient recommended list of thyroid specialists.

[Sasah in reply to pennyannie]

I went to a private guy but he his good friend with my NHS ent surgeon and seem recluctant to go against his advice. And also saying the same. !!!

[pennyannie in reply to Sasah]

Just press the link in blue in my reply to you -

I think it didn't work as you typed 1 too many full stops.

[pennyannie in reply to Sasah]

Well, the better you understand your situation the more able you will be to self advocate for yourself -

so just keep reading around and see who is on the Thyroid UK Patient to Patient list who you might like to consult -

Many consultants still offer video consults - so distance need not be a problem -

and you can always start a new post either asking for recommendations - specify area if wanting a face to face - or ask for feedback on someone you are thinking of seeing -

All replies will be by a Private Message ( PMs ) and this is a second screen only viewable by you and the one other person as we are not allowed to openly discuss any medical professional and your Chat icon on the task bar that looks like a paper plane lights up if anyone replies to you.

[SlowDragon Ambassador in reply to Sasah]

was test done early morning for highest TSH

TSH over 3

Graph showing median TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

Free T4 (fT4) 11 pmol/L (9.1 - 17.6) 

Ft4 only 22.4% through range

Low thyroid levels results in lower vitamin levels

Low vitamin levels tend to lower TSH

Vicious circle downward

[Sasah]

So will the NHS not prescribe me anything! I am fed up of it all... and when i put this to tge expersts they say i am fine and don't need medicating.

[pennyannie in reply to Sasah]

I believe the thinking is after a hemi- the rest of of the gland ' picks up ' the production -

I think the reality more like you are with 50% of the power you once had -

though still expecting to be as you were before surgery - which you were promised -

but the reality is you are running on empty 50% of the day and totally exhausted -

A fully functioning working thyroid would be supporting you with trace elements of T1.T2, and calcitonin + a measure of T3 at around 10 mcg + a measure of T4 at around 100 mcg.

[SlowDragon Ambassador in reply to Sasah]

Get your vitamin levels tested and improve to good levels

Then retest thyroid and always test early morning, only drinking water between waking and test ideally

[Sasah in reply to SlowDragon]

What vitamin test exactly please?

[SlowDragon Ambassador in reply to Sasah]

I gave you links in my first reply

Here they are again

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

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

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/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...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Only do private testing early Monday or Tuesday morning.

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

[SlowDragon Ambassador]

with 2 NHS tests with TSH over 5 and symptoms you should be started on levothyroxine

Starting levothyroxine - flow chart

gps.northcentrallondonccg.n...