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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Post Hemi-Thyroidectomy Hypothyroidism
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.
Post Hemi-Thyroidectomy Hypothyroidism
by 2wheelermom, Apr 19, 2007 12:00AM
I had a hemi-thyroidectomy 8 weeks ago for the removal of what turned out to be a benign adenoma. I was euthyroid before the surgery (TSH = 1.5) and was told I should be euthyroid afterwards. For the weeks after the surgery I felt generally fine, except I'm a cyclist (recreational) and noticed it was getting harder and harder to pedal the 60+ miles I was used to on my normal weekend rides. I also noticed pain in my quads just going up stairs and it was getting worse over time. At my 6 week post-surgery follow-up appt I learned my TSH was 68(!) and my FT4 was 0.3. I was put on 75 mcg (I think that's the unit) of Synthroid, which I've been on for 2 weeks now.
I was wondering whether I could've been placing too much demand and strain on my half thyroid after surgery by working out/cycling and whether that could account for the high TSH, or whether I've probably always been functioning on half a thryoid and, as luck would have it, that's the half that was taken out. Is it possible that if it's the former I could actually recover from this and become euthryoid again on half a thyroid over time without Synthroid? Also, how long will it take for the TSH to drop to normal? Should I stop working out? Sorry for the overload of questions - I just discovered this terrific site. This just all seems so bizarre to me.
I was wondering whether I could've been placing too much demand and strain on my half thyroid after surgery by working out/cycling and whether that could account for the high TSH, or whether I've probably always been functioning on half a thryoid and, as luck would have it, that's the half that was taken out. Is it possible that if it's the former I could actually recover from this and become euthryoid again on half a thyroid over time without Synthroid? Also, how long will it take for the TSH to drop to normal? Should I stop working out? Sorry for the overload of questions - I just discovered this terrific site. This just all seems so bizarre to me.
Doctor's Answer
by Mark Lupo, M.D., Apr 20, 2007 12:00AM
, Apr 20, 2007 12:00AM
Not the cycling - this appears to be a true hypothyroidism and not likely a transient compensation after a hemi-thyroidectomy. I imagine you have positive thyroid antibodies (hashimotos).
Alternatively - You could also have had a palpation thyroiditis (during surgery) which is transient hyper followed by hypo and this is the hypo phase -- in this case you would recover usually (assuming the antibodies are negative).
So, would take the synthroid for now to normalize TSH, give it 3 months then try to cut the dose in half with the intent to see if you can do without the med. However, if the antibodies are positive -- best to stay on the med.
Alternatively - You could also have had a palpation thyroiditis (during surgery) which is transient hyper followed by hypo and this is the hypo phase -- in this case you would recover usually (assuming the antibodies are negative).
So, would take the synthroid for now to normalize TSH, give it 3 months then try to cut the dose in half with the intent to see if you can do without the med. However, if the antibodies are positive -- best to stay on the med.
