[Talley]

#1060109

Hi there,
I had my bloodwork done last week and got my numbers back. Blood was drawn 4 weeks after TT and starting 100mcg Synthroid

Pre-surgery – T4, 2.33 (.82-1.77)
Post-TT – T4, 1.42 – didn’t give me reference numbers.

Pre-TT, Tsh .006, post .009 – no surprise this will take time

Seems like a huge drop to me! I had thought they would wait for 6 weeks. I’m concerned in 4 more weeks ill be hypo. I did not want to start at 100mcg, wanted 112…I will talk to ent tomorrow – sure he will be thrilled with my number.

Curious about thoughts here…am I worried about nothing? I would prefer to stay at the higher end of normal. Do numbers generally go down for a few months before stabilizing? My sister is on a higher dose – she has a thyroid, weighs less than me and has been on meds for 20 years…

Any thoughts are appreciated!

Talley

[SueAndHerZoo]

#1180446

Do you feel good at the levels you’re at right now? Perhaps you’re done excreting (or whatever we do with) the leftover natural hormone and you are strictly running on your 100 mcg of Synthroid right now. If so, then maybe you’re going to pretty much level off at these numbers?

As you know I’m newer at this than you but I don’t think I’d worried yet. Of course, that’s easy for me to say.
Sue

[Kimberly]

#1180447

Hello – Hopefully, you will get some other responses here, but I suspect that if we did a survey, everyone’s experience would be a little different. Finding that “sweet spot” of replacement hormone can take some trial and error, so it’s really impossible to predict if you have already found that spot now…or if your levels will continue to fall. The keys going forward will be to keep tabs on your symptoms, get regular lab work, and make sure to ask your doctor for further explanation if you don’t understand his/her dosing or testing recommendations.

[Talley]

#1180448

So very annoyed this afternoon. The doctor called and wanted to lower my dose because of my TSH level! Didn’t event room that my T4 is in the normal range now! I told him no. I said it was my understanding that it takes time for the TSH to move and that since the T4 had dropped so quickly, I wasn’t comfortable lowering my dose! Geesh, here I wanted to discuss upping my dose! He agreed to wait for four more weeks and retest.

I need to get back to my Endo. Hopefully he will be better with the dosing. The ENT didn’t want to “release” me back to my Endo until he was OK post-surgery…think I’ll make my Endo appt now for next month!

I’m really nervous about how difficult this is going to be to get me “stable”…I do understand the need to adjust dosing, but I do not feel the least bit hyper – if anything I’m more tired, so decreasing based on my TSH level after 4 weeks seems wrong. I hope my Endo will be better.
Talley

[Gabe]

#1180449

Hi Talley. My Endo doses off TSH. My TSH went up to 24.9 (very hypo) within 3 weeks after TT and my T4 was in normal range. Since I was so hyPO so quick my dose was doubled to 100 mcgs (or .1). So it’s not necessarily true that TSH can’t change quickly…mine did. I can understand why your doc might want to adjust your dose…your TSH is very, very low…still considered hyper.

But we’re all different and what’s normal for me might be different for everyone else. You could also be so used to being hyper that it might feel normal to you. That’s a tough call on the dosage…sounds like its time to see your Endo. My surgeon released me immediately to my Endo for dosing….now that your surgery is done not sure what the reason could be for your surgeon being involved in your maintenance. Interesting….

Im not a doc but your labs would clinically appear to indicate you are still hyper. I’m coming up on 8 weeks post TT and feeling pretty good but suspect I might need one more dosage change at my next labs in 3 weeks. My TSH got so high so quickly I’ll probably need a little bit more. But who knows! Most folks I’ve followed on this forum indicate that the average time to feeling ‘good’ is 3-4 months.

I hope you get some answers soon….Karen

[Talley]

#1180450

Thanks Karen, this is all so confusing! I think I’m starting to understand TSH, T4,T3, then I find out I really have no clue;)

I’ll see where my numbers are in 4 weeks and will make an appt with my Endo – will probably take that long to get in to see him.

I will do more reading too. So, with no thyroid, am I considered hypo not graves now? But, T3 won’t be checked since the Synthroid is only T4…?

I see my PCP in a couple weeks for my annual, I think it’s been a year + since my last bone density test (always been good, but due to a malabsorption disease they check me regularly) so ill schedule that too.

Have to say, getting older stinks…but I suppose it’s better than the alternative. Hoping a year from now I don’t give the thyroid (or lack of one) another thought.

Thanks again for the info and support!
Talley

[Gabe]

#1180451

Hi Talley,, I’ll try to answer your questions but let’s both hope someone who understands labs better than you and I weighs in!

With or without our Thyroid you will always have Graves’ as long as you have the Graves’ antibodies swirling around your body. Antibodies are measured by two other tests (TSI and TRab — don’t ask me what they mean!). The Graves’ antibodies attack your thyroid, or your eyes, or your shins and do bad things to them. So even without your thyroid, you still have Grave’s since it’s an autoimmune disease.

Your questions about T3, T4 also confuse me. My Endo doesn’t check T3 when patients are post TT but I’ve read that it should be checked to make sure your body is ‘converting it’ correctly (?). This is where things like Armour and other drugs can come into play if that’s not happening. So the Synthroid is a synthetic version of the hormone that used to be naturally secreted by the thyroid. So that dose needs to be regulated to make sure it’s not too high (hyper) or not to low (hypo). You can still clinically be hyper or hypo without your thyroid if your Synthroid dose is not correct…hence the need to check TSH and T4.

Your next set of labs should be a good comparison to see if your body is using up the stored (pre-TT) hormone and adjusting to the new synethic levels.

Isn’t this fun! I too hope that real soon I can stop worrying about all this…unfortunately for me, I’ve now got a bad case of thyroid eye disease that is another annoying, scary, frustrating journey. And being menopausal/older makes the fun just that much funner in a not so funny way!!!

Take care…Karen

[Kimberly]

#1180452

Just a couple of quick notes…

The medical guidance only recommends TSH testing after thyroidectomy – which seems odd to me, as they recommend Free T4 and Total T3 after treatment with RAI. If I ever end up going this route, I will push for the T3/T4 as well, as the tests are easy and inexpensive.

TSI = thyroid stimulating immunoglobulin
TRAb = thyrotropin receptor antibodies

Some doctors use the word “cured” in response to patients who have been through RAI or TT. But it’s really more accurate to say that one’s *hyperthyroidism* is cured following these procedures. As Karen noted, eye/skin involvement can still occur after RAI/TT.

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