1/2 Thyroid Out/No Cancer/Now TSH High T4 Low

[stcygrl1214]

In September 2009 I just had the right half of a my thyroid out.  The other 1/2 stayed in.  I had a 1.9 centimeter nodule.  Which came back suspicious after 4 years of biopsies.  My endo decided it was time to see if it was cancerous once and for all.  The biopsy after surgery was cancer free.  So I had half removed for a nodule that you couldn't see and it was benign.  Ughh.  2 weeks after the surgery I had blood work done.   TSH and T4Free.  My TSH is 4.140 (High) and my T4Free is .96 (Low).  My doctor took me off of my synthroid which I was taking for 6 months prior to the surgery at 100 mcgrms.  So no synthroid.   He has me on 2000 mgms of calcium a day since my surgery.  No synthroid, and now look at my levels.   Thyroid still isnt functioning.  He wants me to go in 3 months for  another blood test, and still does not want me on synthroid just yet.   I also cannot sleep at all sincey my surgery.   What can I do to try to increase my good 1/2 thryoid to function normally.  Are these results very bad.   Does my body still need time to adjust?  Will it kick in?  What should I do?  I'm upset over my TSH level after surgery.  Should I remain on this much calcium after surgery?  Its been 3 weeks now.   Please help.  I'm upset with my recent bloodwork.  I was hoping to stay off synthroid forever.

[Mark Lupo, M.D.]

About 30% of patients become hypothyroid after removing half (one lobe).  These are usually patients with positive antibodies (autoimmune thyroid disease).  So would consider asking about your TPO antibody results.

Also, at this point after a lobectomy you should not need any supplemental calcium from a thyroid standpoint.

In addition, the TSH often rises the first several weeks after surgery, so there is a good chance things will normalize without thyroid meds.

[stcygrl1214]

Latest update:   I went to my endo for a post op. visit, he was appalled that my surgeon told me to stay off synthroid for three months.  He stated that the thyroid would not start working on its own, that it wasnt working before, so why would it when half of it was out?  And he immediately put me back on 100 mcg.s of synthroid.   One dr. says the complete opposite of the other.   I don't get this.   I just  got blood work done the other day because my endo wanted me back on synthroid for 4 weeks so he could see my levels.  What do you think? Thanks, Stacey

[stcygrl1214]

Dr. Lupo,

I appreciate you quick response and the precise answers.   I will give it more time to possibly stabilize.   I think you were right when you mentioned autoimmune thyroid disease.  After reading so much on thyroids before my surgery, I think I was in a panic thinking if I didn't get a good reading after surgery I was headed for Hasimotos disease or some type of ATD.    

I have a follow up with my endo on Thursday of this week .  It will now be three weeks after surgery.   I will mention to him that I would like my TPO Results.   This is important. And thanks for mentioning that.    Will keep you posted.   I think I was just alarmed.  And still need to me.   I was just hoping for the best thinking if they took half the lobe out with the nodule, my thyroid will start kicking in.   And voila! I'd be off synthroid.    That was my goal, next to ruling out cancer in all this in the first place.  Thinking - if I didn't have cancer, and got half the bad thyroid out, I'd be fine.   I will give it more time, but keep watching it and see what my endo has to say.  

My surgeon is the one who recommended no synthroid just yet, wait three months, then blood test, and an appointment in three months after with the surgeon.   He stated that if the blood work in three months were alarming, he would call me.  

I will post what my endo has to say on Thursday.  And Dr. Lupo, I appreciate your time and answer to my questions.   If I lived in Florida, it would be you I see!