Partial thyroidectomy

Hi Shelly,

i too am from the USA, I experience symptoms of both hypo & hyper am not sure where to start. I am being treated for mildly high blood pressure, my cholesterol is also just over the high range, i have ridges in my fingernails, have lost most of the hair on my arms and legs, my ears ring all the time, constipation most of the time, had to have my gall bladder removed because it quit working, i snore, grind my teeth, only sleep between 4 and 6 hours a night, have heart palpations, sometimes my hands shake.. with all that being said part of these don't happen everyday. And some of these can be attributed to menopause. I am having with my short term memory (not sure if that is a symptom), the skin on my hands, forearms, shins, and feet are very dry.

Hello Mona:

Yes, hair loss is a symptom of a low thyroid (Hypothyroid), also nails that don't grow or break deep down. Also constipation is a symptom of low thyroid.  Also memory and confusion is a sign. and dry skin.

 I go by symptoms more since blood work can change from week to week.  However in USA, your TSH is just an indicator and can be not the true picture since symptoms speak louder, if you know what I mean.

Normal T4 is between 4.5 and 11.2 but like I said, you seem to have many of the low symptoms. 

Forget the blood work for now, keep a log of your symptoms and bring it with you as it will help  let the Endocrinologist know.  You may need thyroid replacement meds.  There are many on the market. Some are Synthoid, Armour Thyroid, thyrolar and Cytomel.

You may be swinging back and forth between hypo and hyper, and it takes the gland time to settle down and to see if it can make enough hormone for your body.

So see an Endocrinologist - have your GP refer you. I hope this helps. be well,  Shelly

 

Hi Shelly,

i see where most who have had a partial thyroidectomy have taken meds soon after. Have you taken meds? I was never put on any kind of meds. Just wondering if thats normal.

Hello Mona:

I have Hashimoto's Thyroid Disease but I have not had my thyroid removed.  Since I have low thyroid (HYPO),  I am on meds for it.

The ones who have a partial thyroidectomy do start meds soon after because of the HYPO symptoms.  In some people, the remaining part of the thyroid can compensate and in some it sadly can't.

You most likely will need hormone replacement and it will help reduce your symptoms once your thyroid level is back in normal range.

I hope this helps, Be well Shelly

Hi Sketchy,

i experience signs of both at different times. The more prominent are constipation, dry skin, ringing in my ears, high blood pressure, ridges in my fingernails, loss of hair on legs and forearms. My Dr. wants to check my levels in 6 mths. I have already had my gall bladder removed because it quit working (not sure if it is connected ) i also have heart palpations randomly.. i am so confused and just dont know when to seek an Endo. By the way the ranges at the,lab that for tf40.8 - 2.2 (mine 1.3)

Tsh .47 - 4.68. (mine .43) .... i am so confused..

Hi Mona,

The best advice I can give is for you to arrange an appointment with an Endocrinologist as soon as possible so that all the necessary thyroid tests can be done.  Gp's do not know much about managing thyroid conditions and can leave you dragging on with unpleasant symptoms for months or years while they play around with TSH readings.

TSH is unreliable especially if you have had abdominal surgery .. it seems to change the blood work readings.  Mine changed after surgery and the TSH almost dropped to zero but I was quite well.  The GP insisted in reducing my medication saying I must be hyperthyroid (I was'nt) .. and I became very unwell within six months.  Your symptoms sound like hypothyroid.  Palpatations can happen with hyper. and hypo.

My TSH is almost zero.  I refuse to let GP's change my meds and make me ill again.  Always get copies of your thyroid blood tests so that you can keep track yourself.

Hi again Mona,

Just wanted to say .. It was about thirty years ago when I had half of my thyroid removed and at that time I was told that after the removal I would be given 100mcg Oroxine and that would supply my body with my complete thyroid needs for the rest of my life and the remaining half would go to sleep.  The general rule of thumb is 1.6mcg thyroxine per kilo of body weight and I weighed just under 60 kilo so I was given 100mcg which I am still on today.  Since that time I notice that there seems to be a 'wait and see' approach when half the thyroid is removed and I don't think it's a good idea at all.  As I have come into contact with people who have not been given medication and have struggled on for years with hypothyroid symptoms and massive weight gain because their GP's keep looking only at the TSH to guide them .. (TSH is unreliable).

You must see an Endocrinologist and explain your symptoms and have all the necessary blood tests done.  You must stand up for yourself and learn all you can so that you will be able to converse with doctors about your condition.  Get copies of all your blood tests.

 

Hi Sketchy,

yes weight gain has been a problem!! I have bouts of depression.. my ears ring and have soon after the surgery.. loss of sex drive .. high blood pressure.. just recently somewhat high cholesterol. . Constipation... more than average hair loss.. dark circles around my eyes.. sleep 4 to 5 hrs a night then tired in a couple hours want to go back to bed.. concentration is hard for me.. many more symptoms.. however at my age they consider alot of them to be menopause. . I am contacting my GP today to get a referral to see an Endocrologist. Thank you very much for all your knowledge and advise you dont know how very much it has helped ..

After very long discussion with my Dr he finally agreed to refer me to an Endocrinologist. July 9th.. YEAH .. Thank you for all your help..

YAY- good job!

Hi Sketchy,

I went to my Endo appointment and they took 5 vials of blood. She examined my neck and eventually did an ultrasound of my remaining thyroid because she felt nodules. My concern is she didn't want to see me again for 4 months then i am to have blood taken a week before i go see her. I guess my question is, is this normal. I have not heard or seen how my blood work was. And should i ask for a faxed copy of it?

Hi Mona,  It's good that you went to see the Endo because they know the correct tests to be done for thyroid problems.  The important thing is that you get a copy of your test results because 'you' need to know what they are so that you have the knowledge to plot your way to better health.  Always get copies of the tests!  It's your right to have them and you need to understand them.  When you get them post the results with the ranges here so that people can give advice.  However, it's just occurred to me that you may not get to see those results until you see her again in 4 months when she will compare the first lot of tests with the second ones.  I would have thought she would have made an appointment to see you in a few weeks to discuss the results of the first tests and the ultrasound?  So you have only seen her the one time when she ordered the tests?

 

Yes thats right.. i go and have another blood test for tsh only 1 week before i see her in November.. i called them today to have them fax me a copy of my tests.

Mona,  I find it very strange that your Endo would make you wait four months before she would even give you her initial thoughts based on the first blood tests.  If something appeared not right with those tests I would hope that she would call you to come in for a consultation.

Although we here in the forum advised you to see an Endo to get the right things tested they are notoriously bad at dealing with thyroid patients.  Many of us have been mucked about or had symptoms completely ignored by Endo's.  It's such a shame because they should posess all the knowledge to help us and we wait patiently for weeks or months to see them only to be sent away and told there is nothing wrong.  They stick rigidly to TSH (which is rubbish) and will not even give consideration to Ft4 or Ft3 which are just about to drop out of the range.  They are driven by ranges and will not budge beyond them regardless of symptoms.  

This is why it's so important that you get a copy of those results so that you can begin to understand for yourself what your thyroid is doing and you can compare them against any future tests that you have done. Also need the ultrasound results.

Anyway, for now lets just see what those blood test results show.

 

I just received the copies of my blood tests. I dont know much about them, but here they are.

tsh. .50

T4 free. 1.2

T3 total. 102

Thuroglobulin antibodies <1 thyroid="" peroxidase="" antibodies=""><1

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i would appreciate any feed back.>

Hello Mona:

I am an RN (Nurse) and live in the USA.  USA lab values are similar to UK's so here goes.   TSH normal is 0.34 -5.60.  Your TSH is within the so called normal.  However, symptoms of low thyroid could show through even if it is so-called normal.  It is just an indicator tool.  T4 free:  Normal is:  0.7-1.9 and you fall into the normal again. 

If you feel low symptoms, such as:  Weight gain, sleepy, low energy, mood swings or confusion, please call your Endo or GP and let them know. 

Sometimes our blood is good, but we feel crappy.  Blood work is an indicator and symptoms are also important to consider.  The more you complain and if needed document symptoms by a log or have another doctor record it, will be helpful.

Make sure your minerals are okay, as people with thyroid problems have low calcium and iron and B -12 and having the proper levels will help.  Also have Vit D level checked - ask your GP to order it.   I hope this helps.  Be well.  Shelly

Hi Mona,

It's good that you managed to get your test results.  When you post results in future can you please post the 'ranges' alongside them.  I am in Australia and the ranges for these tests are very different here.

When I look up US ranges I get confused as there are variations in the ranges showing on the net.

Can you give us your Free T3 results with the ranges please?  

  

Hello Sketchy: 

UK ranges for  Free T3 should 2.50-3.90  (I believe)  there are some small differences but most are within the range.  I am in the USA.

Hi Shelly,

Thanks for giving the correct FT3 ranges .. I've made a note of them now to save me always looking them up.  

TSH. .50.40 - 4.50

T4, Free. 1.2 .08 - 1.8

T3, total. 102 76 - 181

Thyroglobulin antibodies <1>< or="" -="" 1="" thyroid="" peroxidase="" antibodies=""><><9

b12. 294 200 - 1100

they moved my appointment to sept so we will see.

thank you all for your knowledge. b12.="" 294="" 200="" -="" 1100="" they="" moved="" my="" appointment="" to="" sept="" so="" we="" will="" see.="" thank="" you="" all="" for="" your="">

b12. 294 200 - 1100

they moved my appointment to sept so we will see.

thank you all for your knowledge.>

I don't see a free T3 on my test results, just T3 Total

Thank you Shelly i dont understand any of these test results

Hello Mona:

TSH means:  Thyroid stimulating hormone.  When your thyroid needs to make more Thyroxine hormone - TSH is produced and the TSH is a signal or activator,  and your body should make MORE thyroxine.  When TSH goes up high it means the body is low and it tries to make MORE.  It tells the doctor that your thyroid gland is working and it helps to show if  a problem with your gland is happening.  In a person WITHOUT thyroid problems, your thyroid should take T4 and make T3 which is another hormone. T3 is a useable hormone we need to function. With low levels of both T4 or T3 you will see, weight gain,feeling COLD,  mental fog, no periods, muscle aches, brittle nails, acne, etc....  There are a 1 & 2 but it is not used much. 

Now Free T4 is the amount in your blood when they took it.  It builds a level and it is good to know how much of it is around.

Free T3 is also in your blood and that level is measured.  In some people T3 or T4 can be off and the doctor can help diagnose much better from these 2 tests ALONE.  They are important to show the health of your thyroid gland.

T3 total is exactly that....the total in your blood.  We all have to have a certain level.  Some people have more T3 and low T4 or some have high T4 and hardly any T3.  It is complicated and so different tests tell different things.

Antibodies test is for Hashimoto's an autoimmune thyroid problem.  Many people can get it from a family history or from having "MONO" or now called Epstein-Barr syndrome.  It is a virus that young people get and it can damage the thyroid.  The funny thing, is you do not see the damage until later in life in most of us.  They now know a linkage between Epstein-Barr and thyroid problems and they can test for it.

In people who had a thyroid that was making way too much hormone or was overactive, they can remove a portion of the gland and when they do that, the theory is, your remaining thyroid will produce just enough of the hormone so you will be NORMAL again.  They need to test your blood for low symptoms as time goes on.  They like to wait 4 months and give the gland time to settle down.  Then they will test it again, at a later date.  Surgery is traumatic to the gland.  Your results look good on paper.  How do you feel?

I hope I explained this better, if you have a question, just ask.  Shelly

I have symptoms of both.. hair loss...ridges in my fingernails... constipation... sweating.. high BP.. i only sleep around 4 hours a night which in turn makes me tired... those are the most prominent... The hair loss & BP worry me more than any of the others.. I also have to take in to account that i am probably menopausal! !!! Trust me i don't want to mess with my thyroid if i can keep from it..I think that its done pretty good up to this point.. right side was removed in my early 20s... however i do have nodules on the remaining side

Hi Mona,

I'm glad Shelly explained the test results .. if you keep all copies of future thyroid blood tests you will gain an understanding of where you are sitting within the ranges for TSH, FT4 and FT3.  Those are the main ones for you to watch.  

So you do have nodules on your remaining thyroid side!  Nodules are a sign of a struggling thyroid.  IMO this is the result of you not being put straight onto a full dose of thyroxine when the original operation was done.  Although you say you have done ok .. you might have done a lot better if properly medicated in the first place.  You might not have struggled with weight gain and BP problems etc.

Now that nodules have been detected on the remaining side it will probably be just a matter of watching them over time if they have shown to be not too large and of a safe type.  If they now put you on medication they might actually shrink.

Although your blood tests are within the range .. the exception being the FT3 which was not tested!  Strangely!  I feel that your FT4 could be higher.  From my knowledge it should be near the top of that range.  TSH can be unreliable and contrary .. and should never be used alone to treat thyroid conditions.  Both myself and my daughter have suffered greatly before I became knowledgeable about our thyroid conditions because TSH showed very low readings when all was well or didn't show up at all when FT4 and FT3 were about to drop out of the range and my daughter was extremely unwell.

Temperature changes can be caused by hypo as well as hyper, I experienced unbearable ones during menopause and I eventually went on to HRT .. Premia 2.5 continuous.  It has made a huge difference to my life.  I have been off it once when I was having some chemo but the temperature thing was unbearable again so went back on and don't intend to stop it.

 I would hope that they would decide to fully medicate you now with thyroxine and if the dose is correct you will likely see weight loss and reduction of BP.

Please keep in touch and let us know how you are getting on.

Hello Mona:

Well from the sound of things, nodules (I have them also) make you have low symptoms, which are: hair loss,sweating, brittle nails, constipation, and if that is happening, you need extra thyroid.  Nodules interfere with the gland.

I know you look fine on the lab results, but symptoms mean more!   It can take a while (years in some of us), to have the symptoms and some of the symptoms are not at the same time.   Many are ignored by doc's or misdiagnosed as another condition.

I am also 54 and I have Hashimoto's which causes me to get HYPO or low symptoms.  Explain to your Endo what you feel and start on a low dose of thyroid.  Having the right amount in hormone is so important. You will need to build a level which could take up to 4-6 weeks, but it will help reduce the nasty symptoms.  Before I was diagnosed, I had horrible constipation and had to rely on meds to make me have a bowel movement. Once I was properly diagnosed, and had a level, I have normal bowel action.  My hair fell out but grew back after replacement hormone. My nails got better but still are thin. I can live with that.

I am also going through Menopause and it can cause some sweating, and insomnia but I feel more of your problem comes from low thyroid symptoms.  As we age, our thyroid gland slows down,  so some of your symptoms can be happening just from that.  If you have take replacement hormone it will even out now.  Why wait until it gets worse? There are many meds for this on the market today.  Keep us informed on how you do.  XO Shelly

 

Went to the Endo today tsh is slowly rising just wants to watch it. Will have another blood test in 3 months... changes my BP meds.. was severely dificient in D vitamin so prescribe 5000 IU daily.. low in B12 but not worried about that... and am post menapausal.. come back in 3 month and will check again..

Hello Mona:

Vit D is so important and once you build a better level of that you will see improvement with muscles or aches and pains in them. That is good your TSH is improving. Glad you are doing better and by the next appointment it should be much improved.

Stay well, Shelly