# Post TT Surgery - Does the brain fog go away/memory improve?



## rmunoz (Jan 26, 2014)

I'm 5 days post TT surgery as a result of Graves disease. The Graves symptom most troublesome to me is the brain fog, cognitive decline, and short term memory loss. I can still feel it now. Has anybody had experience with these symptoms and when did these symptoms go away if they did? Does it improve? I'm tempted to go see my doctor for an antidepressant and yet I think I should wait a little while to let things settle out because I know the half-life is a week or two for thyroid hormone to decline.


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## jenny v (May 6, 2012)

I'll be flat out honest, 5 days post TT is nothing. I had a thyroid dump after surgery (the surgeon had to wrestle with my thyroid to get it out) and it took at least 3-4 weeks for all of that excess hormone to get out of my system. Pace yourself and see how you do in 2-3 weeks. Have you started on thyroid replacement medication yet?


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## Lovlkn (Dec 20, 2009)

rmunoz said:


> I'm 5 days post TT surgery as a result of Graves disease. The Graves symptom most troublesome to me is the brain fog, cognitive decline, and short term memory loss. I can still feel it now. Has anybody had experience with these symptoms and when did these symptoms go away if they did? Does it improve? I'm tempted to go see my doctor for an antidepressant and yet I think I should wait a little while to let things settle out because I know the half-life is a week or two for thyroid hormone to decline.


Do you have pre surgerical labs you can share with ranges?

Depending on where your levels were going in and how much thyroid hormone got dumped during your surgery - you may be in need of replacement medications such as Levothyroxine aka SYnthroid.

Once your hormones get into the mid to 3/4 of Free T-3 and Free t-4ranges your symptoms should improve. If not or in the mean time ask your doctor to check your Ferritin and Vit D levels as well as B-12.


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## rmunoz (Jan 26, 2014)

My prescription for .125 micros of levothyroxine is set up to start 2/6 which is 2 weeks after surgery date. I used to be Hashimoto's dominant hypothyroid for 15 years and was on .150 micros during that time up until the last year when I became Graves dominant hyperthyroid, so I have experience with the hypothyroid side of treatment with thyroid hormone supplement.

I figured it will take time. I guess I'm looking for some reassurance to relieve the hopelessness that I've been feeling for a while. I'm an engineer so cognitive thinking is important to my career and subsequent family stability. Fortunately, I work with a group who know who I once was and how I operated in the past (I've worked with them for over 5 years). They also know that I have a medical problem and have been very accommodating and sympathetic. I keep telling myself that my co-workers are waiting and hoping for me to mentally return soon. Everybody is different, but the Graves symptoms that affected me most were the brain fog, cognitive decline, memory loss, and loss of reading comprehension...the mental stuff.

Another thing that concerns me is that when I was hypothyroid, I had minor brain fog and was treated with Pristiq which helped. I stopped the Pristiq early last year before I was diagnosed with Graves because I wasn't sure if that was causing some of the problems. I figured at the time that starting from scratch was the way to go. When I did find out it was Graves, I didn't continue with the Pristiq and still haven't to this day. I'm hoping that the depression was really caused by the autoimmune thyroid disease and thyroid removal with subsequent levothyroxine treatment will be all that is required. However, I know that there is a high likelihood that the depression might not be caused by the autoimmune thyroid disease and I may need to be on an antidepressant when the thyroid hormone is stable.

Surgery went well other than me having a sore throat. I was told by the anesthesiologist that I have a "floppy" epiglottis that required me to be woken up during the surgery (which I can faintly remember) to force the breathing tube down into my windpipe...raw and sore throat is about the extent any surgery issues.

I guess all I can do is wait until the thyroid hormone is stable and go from there...just frustrating. Hopefully, I can get around to posting some of my lab work in the future.


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## Neska74 (May 3, 2013)

I know exactly what you are going through. I had a TT due to severe Graves on Nov. 28, 2012. So 14.5 months ago. The brain fog was horrible... the short term memory loss made me feel like I'm going insane. It's not like I would really forget to do things, I would actually do them and then forget that I did them... I'd start laundry and then seriously wonder who the hell was in my house and put the laundry in... it would get pretty bad... seriously thought I had to make an appointment to see a psychiatrist!

I started off at 150 mcg of synthroid and they eventually lowered it until the correct dose was found. 6 or 7 months after the surgery I started 88 mcg of syntrhoid as well as 10 mcg of cytomel (pure T3). I found that cytomel worked miracles for me. I started off with 5 mcg but I think it was June or so that my dr. finally put me on the dosage that I'm still on, as noted above (which worked best for me, after trial and error and weekly blood work..). I now feel great, but it does take time to figure out just what precise dosage works for you. I have to say that the brain fog for me lasted close to 4-5 months after the surgery. Not all days were bad, some were not that bad at all, then the fog would come back.

5 days after surgery is nothing...mind you it's been longer now that it's February, but do give it time, expect that you will not be 100% right after the surgery. Some people bounce back a lot faster and some don't - don't loose patience with yourself. I hope you have a great doctor who is listening to you - as my dr. put it - it's not always the test results that tell them how you feel - numbers can only show them so much - the rest has to come from you telling your doctor your symptoms and ups and downs.

Good luck.


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## Ginav (Jun 7, 2013)

I had my thyroid removed in November 2013 due to Graves. I had a lot of issues with mental decline before the surgery kind of like Neska74 described. I thought I was going crazy and did go to a psychologist who helped me to realize it was the symptoms of the Graves. I started on Armour and I have been slowly feeling better, including the mental decline, not perfect but I see improvement every day. This disease is nasty! I'm a financial counselor and I need my brain to work to. I remember telling my doctor that was the first thing he needed to fix I can't do without it plus I'm in Grad school and have been puttering along but it is getting easier and better. Unfortunately it is a journey not a destination! Hang in there it does get better! I'm happy to be able to tell you that. Gina


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## webster2 (May 19, 2011)

It does get better but it might take some time. I remember feeling like I was losing IQ points all of the time. I couldn't find the correct word when I was speaking. My memory was shot. It was scary. Give it some time and you will be amazed at how much better you will feel.


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## rmunoz (Jan 26, 2014)

Update -

3-1/2 weeks from the surgery and my cognitive abilities have improved. Brain fog has diminished and concentration is getting better and better every day. My confidence still needs some work. Those close to me have mentioned that I still need to improve looking at or into the eyes of the person that I'm speaking with. I think this has grown into a habit because I was more timid over the past year. I think it was a domino effect...losing the mental acuteness led to losing confidence which led to common habits of those without confidence.

On a relative scale, if my cognitive ability was 60% prior to surgery, I would say that I've just passed the 80% mark.

I thought I would update as a courtesy to help those that are seeking hope and/or inspiration. I think most of those who go through these issues inherently forget to follow up...it seems natural that if one doesnt have a problem anymore then they would be inclined to not post a follow up.

It is still a work in progress. Went to post-op and got a clean bill of health to continue follow up with my local endo.

If anybody has any questions, let me know.


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## joplin1975 (Jul 21, 2011)

Great news. It'll keep getting better -- the improvements might seem less dramatic, but they are there.


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## Lovlkn (Dec 20, 2009)

rmunoz,



> My prescription for .125 micros of levothyroxine is set up to start 2/6 which is 2 weeks after surgery date.


Two weeks is a loong time to go without replacement and a definite cause of the brain fog - I am glad you are feeling better.

You need to be sure you insist on Free T-4 and Free T03 labs every single time you have labs and also try not to take your replacement and have your labs about the same time to set a baseline for dosing.

It took me 3 endo's and around 4 GP's to get my set dose post op. I say this to encourage you to keep on keeping on and eventually you will end up with mid to 3/4 range frees and feel fantastic!


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