# Second thyroid surgery



## MeredithRX (Dec 14, 2012)

Five years ago, I had a right hemithyroidectomy for a follicular adenoma that turned out to be benign. My hormone levels TSH/T3/T4 were all normal before the surgery, and they remained so afterward. I've never had to take any Synthroid or other replacement therapy. The surgery was straightforward and very easy. I was back at work in 2 days and had no lingering problems at all.

I've now noticed (and we've now confirmed) that my left lobe is now growing some lovely adenomas too. I'm almost entirely certain that they will turn out to be the same cold, follicular adenomas I had last time. I'm not as scared about the cancer possibility as I was last time and am not in the huge rush to head to surgery that I was last time, but I know it will need to be done. Sooner rather than later most likely. My hormone levels are still normal (as of yesterday).

My biggest concern is dealing with the total replacement of hormone after the surgery. I've never had to supplement before and having to replace 100% all of a sudden intimidates me. My doctors discuss it as if it's not even an issue and I do realize that it's definitely doable. I'm just seriously concerned about the time it'll take to get back to normal functionality! Will there be a huge crash after the surgery? How do you deal with that? How long does it normally take to titrate Synthroid/etc and start feeling normal?

I also have Multiple Sclerosis and just cannot bear the though of any added fatigue or depression or any type of hypo-symptoms!

Encouragement is needed! I know that I need to have the surgery, and I'm not concerned about the surgery itself after the good experience last time, but I really need to wrap my mind around what happens next. Thanks!


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## joplin1975 (Jul 21, 2011)

I'm sorry you are facing this...surgery is never fun!

I think you should be fine provided you are started on a decent amount of synthroid, usually something between 100 to 125 mcgs. As long as you are started on enough and provided you convert t4 to t3 well, you shouldn't be overly fatigued. If you don't convert, you'll have to look at other medications other than synthroid...but synthroid is the standard medication to try first.

You'll need labs evey six to eight weeks while you titrate and you sometimes do need patience while getting the dose right, but any unpleasantness you experience should be minimal. You might be tired or feel fatigued, but it's usually managable. Just take good care of yourself. Eat well, stay hydrated, get lots of sleep, etc.

I don't find taking a pill every day onerous...it's just become part of my daily routine.


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## MeredithRX (Dec 14, 2012)

I'm not so worried about taking a pill everyday. I have to take injections everyday for my MS. It can't be worse than that! *laugh*

I just dread the time it'll take to get back to some version of normal.

Thanks for the response!


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## MeredithRX (Dec 14, 2012)

Also, my doctor gave me some low-dose Synthroid to take now. He said there is a slight chance that it could cause a reduction in the size of nodules, but that in any case it couldn't hurt anything as we move through this process.

I have the RI Uptake scan scheduled for Monday morning and I assume I'll move to the FNA Biopsy after that (if I remember correctly from last time).

Is there any reason at all why I should avoid the use of Synthroid now? Will it skew any results that I'll need between now and the potential surgery? Will it help to take between now and surgery? (Not really to shrink anything, but will it help in transitioning to the post-op dose?)


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## webster2 (May 19, 2011)

I had a right side done 20 years before the left side was removed. Replacement hasn't been too difficult once the correct medication was found. Best wishes to you!


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## joplin1975 (Jul 21, 2011)

They wanted me to take synthroid before surgery too, but I couldn't tolerate it (too much TSI), so I only took it for a handful of days and then stopped. I don't think it changed any thing one way or the other.


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## Andros (Aug 26, 2009)

MeredithRX said:


> Five years ago, I had a right hemithyroidectomy for a follicular adenoma that turned out to be benign. My hormone levels TSH/T3/T4 were all normal before the surgery, and they remained so afterward. I've never had to take any Synthroid or other replacement therapy. The surgery was straightforward and very easy. I was back at work in 2 days and had no lingering problems at all.
> 
> I've now noticed (and we've now confirmed) that my left lobe is now growing some lovely adenomas too. I'm almost entirely certain that they will turn out to be the same cold, follicular adenomas I had last time. I'm not as scared about the cancer possibility as I was last time and am not in the huge rush to head to surgery that I was last time, but I know it will need to be done. Sooner rather than later most likely. My hormone levels are still normal (as of yesterday).
> 
> ...


I hope you share your concerns with your doctor as your doctor and leave orders to start you on Thyroxine replacement before you even leave the hospital.

It does take time to titrate. At least that is the case for the majority of us. Everyone is different so it is hard to narrow the field but do expect some months.

Sure hope these are non-cancerous as well!


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## Octavia (Aug 1, 2011)

Given that you have MS, I would recommend working a little harder than most people might work to avoid surgery, simply because you're doing well with half a thyroid, and the surgery could disrupt your system's delicate balance. Of course, you'll want to get a biopsy, but if you and your doctor are pretty certain you're dealing with the same cold, follicular adenomas you had last time, it might be worth it to take a wait and see approach.

Having said that though, if you do end up needing to get your remaining thyroid lobe removed, the key is to start out on a decent dose of Synthroid pretty quickly after surgery (I started mine the next day). Depending on your size, 125 mcg might be a good plact to start. As long as you start on a good dose, you should not take a nosedive into hypo-land. My doc started me at 125, and I didn't miss a beat.

Best wishes.


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