# High TSH & High T4 after Thyroidectomy



## adenure

Hi,

Please help me understand what's going on. I have Graves Disease and had a thyroidectomy 4 weeks ago. I started 100 mcg. Synthroid (brand name) 2 days after surgery. I had my labs done and here they are:

TSH: 4.15 (normal: .35-4.00)
Free T4 : 1.24 (normal: .81-1.54)

My endo. said testing T3 wasn't necessary. My T4 is higher now than it was before surgery (regulated with methimazole). At that time it was .91 and my TSH was 1.28. Why is my T4 & TSH high? Am I not converting to T3 well? I don't understand the numbers. It seems like giving me more Synthroid wouldn't make sense as my T4 is high, but based on my TSH, it seems like I need more? I'm confused. I have bad headaches and can only sleep 5 hours a night. I'm miserable. I emailed asking my doctor about testing T3 anyway and what to do. Any help is appreciated. 
Alexis


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## adenure

Also wanted to add- just got an email from my doc. He's willing to order T3 and T4 for next labs with TSH. But, he wants me to wait 3 weeks. Will I go more hypo? Does my body still have hormone stores in it from 4 weeks ago? I was euthyroid for 6 weeks before surgery. Any help appreciated.

Alexis


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## Octavia

Honestly, I think your body may be confused. You may have experienced a "thyroid dump" during surgery. And your own gland was removed, and now your body is needing to adjust to the meds. I suspect you will end up needing more than 100 mcg of replacement hormone, but if you can stand to wait a few weeks for your next labs, they may be more accurate/insightful.

Let's see what others have to say, too.


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## desrtbloom

What you are experiencing is normal for many. The thyroid dumps during the surgery. It takes six to eight weeks to stabilze and you are only four weeks out. It takes time. You might need a Synthroid adjustment, but you need to hang on another two to four weeks to allow your body to adjust and see what your blood levels are. It is not uncommon to go hypo and then hyper and then hypo a couple times while your body/system is adjusting. Until you have a blood panel at the six to eight week mode you won't know for certain where you are at.

Hang in there!


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## Andros

adenure said:


> Hi,
> 
> Please help me understand what's going on. I have Graves Disease and had a thyroidectomy 4 weeks ago. I started 100 mcg. Synthroid (brand name) 2 days after surgery. I had my labs done and here they are:
> 
> TSH: 4.15 (normal: .35-4.00)
> Free T4 : 1.24 (normal: .81-1.54)
> 
> My endo. said testing T3 wasn't necessary. My T4 is higher now than it was before surgery (regulated with methimazole). At that time it was .91 and my TSH was 1.28. Why is my T4 & TSH high? Am I not converting to T3 well? I don't understand the numbers. It seems like giving me more Synthroid wouldn't make sense as my T4 is high, but based on my TSH, it seems like I need more? I'm confused. I have bad headaches and can only sleep 5 hours a night. I'm miserable. I emailed asking my doctor about testing T3 anyway and what to do. Any help is appreciated.
> Alexis


Your FT4 is below the mid-range of the range given by your lab. (1.27) Therefore it would appear that you are converting.

There is a lag time between the FREES and the TSH; be a patient patient. It will take time for your system to settle down and then somewhere along the line, it may be good to run FT3 but it really is too early in the game; it would be a waste of money right now.

Humble opinion.


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## webster2

Andros said:


> be a patient patient. It will take time for your system to settle down


This is good advice. It took me awhile to be patient. Hang in there!


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## adenure

Thank you so much!!!hugs3 I really appreciate it! Yes, patience... and trusting that things will be okay are hard for me. But, I'm trying. I'll let you all know how things go. I think I am swinging between hyper and hypo with the symptoms I go through. Some nights- insomnia, some headaches, constricted breathing (anxiety even though I don't feel anxious- weird)- ups and downs. My heart rate is good though- so that's a plus!!  Thank you again! -Alexis


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## Andros

adenure said:


> Thank you so much!!!hugs3 I really appreciate it! Yes, patience... and trusting that things will be okay are hard for me. But, I'm trying. I'll let you all know how things go. I think I am swinging between hyper and hypo with the symptoms I go through. Some nights- insomnia, some headaches, constricted breathing (anxiety even though I don't feel anxious- weird)- ups and downs. My heart rate is good though- so that's a plus!!  Thank you again! -Alexis


Alexis; you have been through hell and back. It will take time for your poor body to recoup and that goes for the psyche too.

Graves' is bad.


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## adenure

Hi Andros,

Sometimes I feel that way! But, I am fortunate as my doctors caught that it was Graves right away (I had a rough time for about 2-3 months, but I know others have been through much worse and longer!). When my endo. said I was dealing with "mild Graves", I thought- wow, I don't want to know what a severe case is like! I give a lot of credit to those who have dealt with this for years and been misdiagnosed for a long time. My heart rate was 123 at it's worst, I had the typical symptoms of slight tremors, shakiness, no appetite, lost 13 lbs. in a month, insomnia and fears magnified. Since the surgery all of it has gone away except the insomnia (but I believe that is mostly from my fears.) I have fears of having eye problems even though the only bother I have with my eyes is slight twitching at times and dry/ uncomfortable feeling at times which could be from 8 months of sleep deprivation (Graves & having an infant plus 3 other boys!). But, I can't shake the fear all the same as I know eye problems can happen at any time. I'm trying not to worry, but it's hard. I tend to worry about stuff. If I could get regular sleep, I think I'd feel a whole lot better. Hopefully that will come at some point. Trying to be positive, but I so much want to be my normal, healthy, energetic self again. Patience and trust and faith that things will be well is what I need to work on. Thanks again all!
Alexis


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