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TSH levels prior to surgery
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TSH levels prior to surgery

Hi just wondering can answer this question.  This past month a small nodule was found and then biopsied.  It tested positive for papillary malignacy and Hurthles cell. My TSH level is 10.7 and my dr put me on .50 levo.  Meant with surgeon who had to review my case with ans endo.  The endo said I needed to up my levo to.75 for at least one week before scheduleling surgery.  I haven't talked to any Drs other than surgeon on the phone. Can anyone tell me why they have to bring down TSH levels before surgery?
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Avatar_m_tn
If they were doing a Total thyroidectomy They would want to get some T4 into your system, since after surgery you would have no thyroid to produce hormone other than the replacement medication taken after, so they would not want your levels to start with a deficicit. Are they doing a Total Thyroidectomy or partial?   FTB4
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Avatar_n_tn
I think total on my ultrasound there was also a couple enlarged lymph which they did not biopsy  even though the nodule is small because it has two types of cancer cells and I'm already on meds because of high TSH  I hope they take the whole thing out. Would you agree?  T4 is missing if TSH is elevated?   I haven't been to endo yet and my dr didn't even want to do the ultrasound and when that came back as highly suspicious for neoplasm he didn't think the FNB recommended by radiologist was necessary.  I had to insist on it. Needless to say I will be looking for a new dr when this over.  All my info has come from sites like this. So thanks so much for any input
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Avatar_n_tn
Sorry forgot to ask ....  do you think they will have to do another TSH test before I can have surgery.  
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Avatar_m_tn
In order for you to understand what they do I have to explain how the thyroid works, first of all TSH is not a thyroid hormone, it is a hormone produced by the Pituitary Gland in the brain, Your Thyroid Produces a hormone called T4, your body or your liver converts the T4 that does not get carried away by protein, this si called Free T4, then after conversion it is known as T3, and more is carried away by protein, what remains is Free T3, T3 is the actual hormone used by the bodies cells and what your body needs to function. So when the T3 levels drop, the pituitary gland acts like a sensor, it detects this T3 drop and sends another hormone to the Thyroid to "Bump" or stimulate it to produce more T4, This is called the TSH "Tyroid Stimulating Hormone"  So when the T3 drops the TSH rises.
So, like you said when the T4 is missing or low the TSH go's up. So Yes, if they have detected Cancer then the best procedure would be to revove and do a Total Thyroidectomy, and that would ex[lain why they would want the TSH down, But like I explained above, your MD should be doing Free T3 and Free T4, not just TSH, But the motive for either would be to make sure the hormone levels are up prior to removal, this way you would have a reserve, they don't usually start medication or replacement hormone until at least six weeks after the TT.   Best Wishes FTB4
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