Complete Thyroidectomy Nov.08

[jrilatos]

Im new to this forum, and THANK YOU. So much useful info, I havent even really started this journey of helping myself with these problems because until I visited this site, I thought I was going a little crazy, have always been a sound minded person, I am 33 years old, I had a complete thyroidectomy in Nov 08, I spent the following year just trying to feel normal, anxiety attacks, sleeplessness, the list goes on and on, the last blood test that I had done was in April and my Dr said that everything looked good, but after getting all my test from the lab myself they are not near where they were previous to surgery, I am currently on 137mcg of Synthroid, my Dr said that I was converting on my won and didnt need an additional medication that helped with that.
Let me just tell you my blood levels and you tell me if this is normal... I have since made an appointment with my family care Dr to see her instead of the surgeon that I have been seeing because she listens. What do I need to know before I go.. I really have so many questions but will just stop here for advise , then I will post again later...
So, PRE SURGERY here were my blood levels

Before Surgery (no medications)
TSH 1.23
Thyroid Peroxidaso 49

Before Surgery (50mcg Synthroid)
TSH 0.76
Thyroxine 9.9
T4 192

1 mo After Surgery: No meds yet
TSH 10.32
Thyroxine 9.1
T4 152

4 mo after surery (112mcg synthroid)
TSH 7.00
Thyroxine 10.1
T4 132

6 months after surg (137mcg Synthroid)
TSH 9.33
Thyroxine: 9.5
T4 150

8 months after surgery (137mcg Synthroid)
TSH 5.67
Thyroxine T3 12.0
T4 190

my last labs on 03/2010 137mcg Synthroid
TSH 4.44
T3 10.2
T4 180
I am feeling better than before obviously, but not myself completely yet. I am noticing I am starting to get leg and foot swelling, const., and the anxiety attacks sometimes still rip me out of a sleep, breathlessness , etc... If ANYONE has some input...PLease PLease Please comment...Any advise is welcome, or more questions if I havent devulged enough yet.. :) Thank to this site, really is a mind saver, Im not crazy..Im one of you. :)

[jrilatos]

Thank you so much for the response, I have in the past couple of weeks felt better than I have in a long time, learning to deal with the anxiety issues that present themselves sometimes in the night, not sure if that is related or not? Sometimes I wake up with a rapid heart rate right out of sleep, and less now than in the past year or so, it has become less frequent and I am hoping that this means that I am getting more stable... sometimes the out of the sleep wake up is pretty intese to the point I think that I might pass out with the rapid heart rate and cant catch my breath.... its a scary situation that I have learned to deal with, but have also seen a decline in its frequency...
I will read more into the forum to see about symptoms..its odd when Im not sure what would be a symptom..I feel better having found this site and hear that I am not alone in this! I will ask my doctor about the free T3 and Free T4, if I can get those figures I will also post them too!!! Again Huge thanks.. Nice to have found somewhere to go....
PS- Any pointers in asking my DR to test for those..is there anything I should know besides just plainly asking for this test... :)

[gimel]

Sorry about the delay in responding.  There is still something wrong about the reference range for the Triiodothyronine test.  The low end of the range should not be zero.  It should probably be more like 90, instead of zero.

Regardless, it appears that the Synthroid dosage you are taking has your total T4 and total T3 in the higher portion of their ranges.  This is indicative that you are clearly responding well to the meds.  It would be far better in the future if you got the doctor to test for the biologically active thyroid hormones free T3 and free T4, rather than the somewhat obsolete and much less informative, total T3 and total T4 tests run so far.  
Most important is the question of how you are feeling.  Do you have any thyroid related symptoms you have noticed?  Recommending any further testing at this point, besides FT3 and FT4, would depend on your assessment of how you feel.  I'm sure you've heard the old advice  "If it ain't broke, don't fix it".

[jrilatos]

Ok, So i have the actual lab reports and I will just write them as they are, hopefully they will make sense again I apologize for not getting them correctly before, I am new to all this lab stuff and it really is overwhelming at first! :)

Thyroid Testing Basic Chemistry (Pre Surgical/Before Any Meds)
10/24/2008
TSH 1.23 (Ref. 0.40-5.00 mIU/L)
Thyroid Peroxidaso 49  (0-60 U/mL)
Auto Antibody

Thyroid Testing 10/31/10 Pre Surgery w/ Meds 50mcg Synthroid
TSH 0.76 (Ref 0.40-5.00)
Thyroxine 9.9 (Ref 4.5-11.0)
Triiodothyronine 192H (Ref 0-187)

12/29/10 4 weeks After Surgery
TSH 10.32H (Ref 0.04-5.00)
Thyroxine 9.1 (Ref 4.5-11.0)
Triiodothyronine 152 (Ref 0-187)

03/31/10 Thyroid Testing 100mcg Synthroid
TSH 7.00H (Ref 0.40-5.00)
Thyroxine 10.1 (Ref 4.5-11.0)
Triiodothyronine 132 (Ref 0-187)

05/18/10 Thyroid Testing 112mcg Synthroid
TSH 9.33H Ref 0.04-5.00
Thyroxine 9.5 Ref 4.5-11.0
Triiodothyronine 150 Ref 0-187

06/18/2009
TSH 5.67H
Thyroxine 12.0H
Triiodothyronine 190H

The next results were given to me over the phone:
TSH 4.44
Thyroxine 10.2
Triiodothyronine 180
(I really hope that this helps and makes more sense, the values are exaclty as written on the reports and the names of the tests are as written)
Am I missing a test? OR should there be something else I should ask for?? Thank you a ton for replying! :)

[jrilatos]

No Problem, I dont take you as being difficult. I have never read these report before, so I will just write it as said on the report, It could be that I am thinking that T4 is something else... I am at work right now, but will repost as soon as I get home! Again Thank you for listening!

[gimel]

Sorry, but I'm having difficulty understanding the lab numbers.  You show Thyroxine in several places, along with T4.  Thyroxine is T4.  Then 8 months after surgery you show Thyroxine T3.  Then you  list a range for T4 of 0-187.  That can't be correct.    Would you please go back and double check how the results are shown on the lab report and confirm the report?  

The range shown for Thyroxine is consistent with a total T4 test.  So I also don't understand the listing for another  T4 test.

Not trying to be difficult, just cautious about interpreting the numbers.  

[jrilatos]

~Thanks gimel, I do have the lab results with me here and will add the refrence amounts as well, Thank you for your reply! :)

Before Surgery (no medications)
TSH 1.23  (0.40-5.00)
Thyroid Peroxidaso 49 (0-60)

Before Surgery (50mcg Synthroid)
TSH 0.76  (0.40-5.00)
Thyroxine 9.9 (4.5-11.0)
T4 192  (0-187)

1 mo After Surgery: No meds yet
TSH 10.32 (0.40-5.00)
Thyroxine 9.1 (4.5-11.0)
T4 152  (0-187)

4 mo after surery (112mcg synthroid)
TSH 7.00 (0.40-5.00)
Thyroxine 10.1  (4.5-11.0)
T4 132  (0-187)

6 months after surg (137mcg Synthroid)
TSH 9.33  (0.40-5.00)
Thyroxine: 9.5  (4.5-11.0)
T4 150 (0-187)

8 months after surgery (137mcg Synthroid)
TSH 5.67  (0.40-5.00)
Thyroxine T3 12.0 (4.5-11.0)
T4 190 (0-187)

my last labs on 03/2010 137mcg Synthroid
TSH 4.44 (0.40-5.00)
T3 10.2 (4.5-11.0)
T4 180 (0-187)
The trend is that they are getting better, but from my pre-surgery levels, I hope to get back into the 1.0 level, is this obtainable? Again I want to thank you guys so much for this forum, I feel so much better already having found this site.. I have an appt later next week to see my FP.

[gimel]

Let's start with getting you to post the reference ranges for those lab results.  Since lab results can vary from lab to lab, they can each use a slightly different reference range, and it is important to know where results fall within the ranges.  Just being within the low end of a range doesn't guarantee "normal" results.  If you don't have a copy of the lab report with the reference ranges, it is a good idea to always get copies and write on there how you were feeling at the time and your meds dosage.  These copies then become important references for future treatment.

[ChitChatNine]

Hi,

Welcome to our Community!   I'm sure others will stop by with some advice but I wanted to welcome you and hope you feel better soon.  Nothing worse than not feeling right on our meds!!!!

C~