# TSH still supressed 6 months after thyroidectomy



## kathlav (Mar 26, 2013)

Hi all,

I haven't posted in a while as things have so far been going well. I am now signed off from the ENT, and coming off calcium tablets after Christmas.

After seeing my endo in October he reduced my thyroxine to 100mcg per day from 125mcg 4 times a week and 100mcg 3 times a week. Begrudgingly I did so My FT4 was 21.9 (12-22).

I have just come back from seeing my endo today and after 3months on the reduced thyroxine my FT4 is 21.2 which is within range but on the high side, but I feel well in myself.
His concern is that my TSH is still supressed at 0.06 and with my FT4 still at the top end he wanted to reduce my thyroxine to 75mcg per day.

Personally I think that is a huge drop, whilst I feel well on this dose I don't want to risk reducing by such a large amount.

I was sure I read somewhere that even when the thyroid has been reduced relying on the TSH level was wrong!

Will having a supressed TSH do me any harm...if my FT4 is within range, my endo seemed to be worried about osteoporosis, After breaking my ankle badly 2 years ago with metal work in place etc, I am more concerned about putting on any extra weight effecting my dodgy ankle joint. With clothes on at the endo I weighed 75kg I am about 5ft 8".
The plan is to have bloods run in 6 months time and if my TSH is still supressed he will reduce my levo to 75Mcg per day.

Any advice would be much appreciated.


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## joplin1975 (Jul 21, 2011)

Why would he jump to 75mcgs per day instead of having you try 100mcgs everyday?

Suppression of TSH is not dangerous in and of itself, but it can be dangerous if your frees are high. Has he ever run free t3?


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## kathlav (Mar 26, 2013)

Hi Joplin,

Sorry, I don't think I was very clear in my post.....I have been on 100mcg for the last 3 month. Previous to that I had been on 100mcg mon, wed, fri, and 125mcg the other days of the week.

And previous to that I had been on 125mcg everyday, that was the dose I was put on immediately after my thyroidectomy.

No FT3 has not been run recently.

Many thanks for your reply


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## joplin1975 (Jul 21, 2011)

Oh! I'm sorry for my confusion.

I think I would push hard on that free t3 test. I would like to know how you are converting before dropping down too low...


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## kathlav (Mar 26, 2013)

Thanks Joplin,

Yes I will try, they are very reluctant to run FT3 here, the only time I have had mine done since being diagnosed, was just before and just after surgery!

Might get it done privately, but will wait till I get the rest of my bloods done in 6 months time.

In all honesty I was surprised when the 125mcg per day (I was initially put on)ended up being too much, for my body weight and height, I thought I would end up being on more, not less and at 75mcg a lot less!

Thanks again and have a great christmas


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## Lovlkn (Dec 20, 2009)

I also suggest you have a FT-3 run when your FT-4 is to give you the most accurate idea of where you are.

When in relation to your lab did you take your last levothyroxine dose?

Having too high of a FT-4 can cause a build up of reverse T3 as I understand. I've never had that test but the difficulty others have when adding T3 hormone or changing to a NDT seem related to having Reverse T3.

My TSH is always suppressed but my Free's are usually somewhere between 1/2-3/4 of the range so my doc is OK with it. I do have osteopenia and very close to osteoperosis which could have happened due to being hyper for many years, although it does seem to get worse as I age.


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## kathlav (Mar 26, 2013)

Hello Lovlkn,

I take my levo at 6.30 am, the blood test was taken at 1pm....... I try to keep it at the same time every draw, I work not far from the hospital I get my blood tests taken, and usually go up during my lunch break.

I recently had a bone density scan, and everything came back ok, so for the moment I feel confident that my graves has not had a negative effect on my bones and since my surgery I have had a bone profile blood test every time I have had thyroid panel, all has been ok.....in fact my endo just said to stop taking the calcium supplements after Christmas and a few days after I stop to get a bone profile done.

I have to say I shall be happy to have one less pill to take, Thanks for your input Lovlkn, this forum and members are always so helpful, wishing you and yours a merry Christmas.


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## jenny v (May 6, 2012)

You need to make sure your doctor isn't focused on TSH when dosing your meds. After a total thyroidectomy, TSH is relatively meaningless, so you have to focus on the Frees.


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## kathlav (Mar 26, 2013)

Thanks jenny,

Mulling it over , I have decided to come to a compromise........in anticipation of my TSH still being supressed and my FT4 still being on the high side when I see my endo in 6 months time.
I shall trial 75mcg Mon, wed, Fri and 100mcg the rest of the days. Hoping this will bring my FT4 to a more even keel and bring my TSH up a wee bit. Enough to appease my Endo anyway.

If I start feeling rubbish I will just go back to 100mcg per day.

After all How we feel should be the most important issue.

wishing you a merry Christmas

Kathy


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