TSH levels after Total Throidectomy

[aussie mum]

Hi Everyone,
I'm not sure where else I could ask this question so I hope it's ok to ask here.

I had a total thyroidectomy in September and was put on 150mg Thyroxine straight away.
I have just had my first routine blood test to check my levels and it said:
TSH - 0.08 (way under the normal range)
FT4 - 19 (upper end of normal)
FT3 - Cant remember the number but within the normal range.

My Gp wants me to reduce the Thyroxine to 125mg as my TSH is so out of range, but I was wondering whether the TSH is relevant at all now that I don't have a Thyroid. My train of thought is that as my T4 is good (due to the medication), there is no need for the TSH hormone to be released. Hence the low number.  Is that the way it works?

I am feeling ok on this dose, but have already gained a few pounds. I am heavy enough as it is, and the thought of more weight gain is depressing.

Any advice would be greatly appreciated.
Thanks
Aussie Mum

[Carebear]

Hi Aussie Mum,

I know what you mean about the TSH.  The thyroid stimulating hormone (TSH) is a hormone produced by the pituitary gland that signals the thyroid to produce its hormone.  Because it's in the low range, it's telling your thyroid that you have too much hormone.

My thyroid was destroyed, not removed like yours, but my TSH is still the measurement my docs go by to see if my thyroid medication needs adjusting.

You don't want the TSH to be too low because this can reduce your bone density, as well as make you hyperactive.

[engy]

I also do not have a thyroid (5 years gone now).

I look more at free T4 & free T3 but I do still check my TSH. If my TSH looked like yours I would have serious anxiety. If you feel okay maybe you can take the 125 four days a week & 150 the other three? My doctor does bloodwork but also allows me to adjust up or down based on symptoms too. Ask your doctor if that would be okay & do another blood check in 4 weeks maybe?

Good luck, I was hoping it would be easier to maintain my levels after I had to have my thyroid removed but that hasn't been the case for me.

Carie

[aussie mum]

Thanks for the advice.

Carebear, I had no idea of the osteoporosis link.
 
Engy, I thought I was feeling ok, but on reflection, I do have Hyper symptoms even though I have gained weight, so I am now less apprehensive about reducing the dose. I will be having followup blood tests before Christmas so time will tell.

[Carebear]

Hi Aussie Mum,

I reread my earlier post, and I just wanted to clarify it (brain fog ).

What I meant to say was that if your dose of thyroid hormones is too high, this can cause a loss of bone density.  I didn't want to give anyone the impression that being hyperthyroid without taking meds would harm your bones.

Anyway, I think you made the right decision.  You should be being even better by the middle of December. 

[irish]

Aussiemom, The confusing thing about the TSH test is that the higher the number the more HYPO thryoid you are and the higher the dose of medication needs to be. Where I get my blood work done the "normal range" is .04 through 3.5. Your number of .08 if below the normal or putting in into the more hyper area. I have found that I do better when I am above the 1.0 but I have a hard time getting the doctors to listen to me.

When the number is low then you are HYPER and your dose needs to be decreased. It sound like you doc has got things under control. Never worry about lowering a dose or raising the dose the one number. I have been on everything from .112, 125., 137, and 150 and have had to change back and forth a lot. It is strange how this can happen. I would bet that your body is going to be a little bit that way as it adjusts to being without the thyroid gland.

I would think that eventually you will be able to be on one dose without changing so much. Out bodies are so fine tuned to all these hormones, etc that I find it hard to figure out. I don't really know if the tsh put out by the body has the ability to be stored in other tissues to be called upon to be used later. You will be able to educate us on that point by in a short period of time.

There is something else that I am mulling over in my head also. It seems like I have been having a lot of tremoring inside my body the past few years and I keep thinking it is from my TSH that is below the 1.0 level. After starting the Plaquenil and finding that I am starting to feel some better and also noticing that I am not tremoring lately I am thinking this. What if the tremoring was a reaction of my body to the amount of inflammatory  response that was going on. Was the inflammation causing my body to "stress"? My psychologist wanted to increase my medication for depression and I have refused repeatedly as I felt that something was going on that was physical. Time will tell. Irish

[engy]

Irish, my tremors stopped completely after starting plaquenil!

Glad plaquenil helping!

Carie

[aussie mum]

Thanks Irish, I was hoping you would post. I have so much to learn and must have patience.

Don't worry Carebear, I knew what you meant, maybe brainfog is a new language that we all understand