Undetectable tsh post thyroid cancer

[TTandnowhyper]

Hi....

Acting to get some I sight because I'm not gettin much at home in Australia.

I'm nine months post op for stage 2 pappilary thyroid ca. Three months post RAI. the cancer was found by accident after removal of a branchial cyst... Lucky. During surgery my jugular vein was nicked and my hemoglobin dropped to 5 so I was in hospital for a while. Adjusting my meds was easy and up until July I am having problems getting the correct dose.
I was on 100 per day and feeling awesome. Then in July my Endo upped it to 150 per day.. I asked her not to as I don't feel well on a higher dose.. Well well well it's been a nightmare since. She keeps telling me my tsh needs to be undetectable so cancer doesn't return.... I get that, but am finding it really difficult.

I have ended up in hospital a few times with a number of symptoms ranging from heart palps, extremely hot even though my temp is fine grrrrr sweating, nauses, dizziness, blurred vision etc. I was even on a drip for dehydration??

At that point my tsh was <0.01..... My recent bloods are
Tsh 0.03.       Ref 0.50-4.0
Ft3 4.8.                 3.5-6.5
Ft4 20.3.                10.0-19.0

When the Endo called me telling me she will bring forward my appointment she said I need to have an undetectable tsh and I'm scared she will up my dose again and I will feel bad again. I'm on 100 now and I can just manage.

Any thoughts???


This discussion is related to Post Thyroid Cancer Follow-up Procedures.

[TTandnowhyper]

So currently I'm on 100 Monday to Saturday and 50 on a Sunday which works out to be 92 mcg per day. By adding the Armour I would be adding roughly 19 mcg of t4 making that roughly 110 per day and 4 1/2 of t3 per day? Because I can't really handle 100 or slightly above, you suggest I reduce my daily intake of t4 to around 75 per day?? Equalling roughly to 90 mcg of t4 per day??
If i drop my 50 on a Sunday and only take 100 Monday to Saturday that equals to 85 pet day and with the armour added mybt4 would be just under 100..... ??? Hope at made sense lol
Thankyou heaps for helping out. I see her gain in 4-5 weeks but will go n earlier if I need. I see my Endo in a week also and I think I'll just ask tell her I will drop Sundays intake... She will not be happy because the head professor of the clinic where I go hates the idea of armour. He wrote a whole article on it on the net.... Oh well lol

[gimel]

Great news about the new doctor, that will prescribe Armour Thyroid med.   I do have a concern that with your prior increase in T4 to 100 mcg, you seemed to have a reaction.  If it was strictly due to the T4, then your current change to add a half grain of Armour will be adding about 19 mcg of T4, along with about 4 1/2 mcg of T3.  If not discussed already, you might want to mention your prior experience with the higher level of T4, and ask the doctor about reducing it by about the same amount as being added with the Armour.  And yes, it should keep your TSH down.  If the next round of tests show TSH not quite low enough to satisfy the doctor, then I would request an increase  in the Armour and a equivalent decrease in the T4 med.  

[TTandnowhyper]

So I went to the doctor today... A new one and she has prescribed me ARMOUR woohoo. She wrote a letter to my Endo who i see Monday week and seems to know what's going on.
I did want to ask though, I know armour is a t4 and t3 med?? She has still kept me on my dose of thyroxine aswell as armour. Half a grain daily so far. I don't get the dosages yet but I'll ask at the chemist. By adding more t4, will that have side effects of too much??? Also can this keep my TSH down?

Thank you so much... I'm so,excited to start them next week.

[TTandnowhyper]

Thanks for that... That's what I thought. Here in Austalia, the doctors, endos I have seen quickly dismiss the idea of t3.
They shut it down very quickly even though I have supportive evidence to show them. My Endo keeps telling me that me feeling dizzy, lightheaded and hard to concerrntrate are not thyroid related. I think it is... The rest of my tests are fine.
I have an appointment with a new GP who I found through a chemist someone on the forum suggested and was told she has helped people with combination meds. I'm sooooo hoping she wil find something to change the way things are.

[gimel]

I don't have much new to offer.  I don't think you need an increase in your T4 med.  I still think you need to talk your doctor into reducing your T4 med and substitute some T3 med, to reduce your Free T4 level and increase your Free T3 level.  Tell him that T3 has been shown to affect TSH levels more than T4, so those changes should achieve what both of you want.  And by the way, I don't really think that the difference between .13 and essentially zero TSH is significant enough to keep increasing your T4 med, in view of your symptoms.  

If you symptoms are not related to the excessive level of T4, then the only other thing that comes to mind is that I would want to see a 24 hour saliva, or urine, cortisol test done, so that you can see the levels at different times of day.

[TTandnowhyper]

Thankyou