HypoThryoid Symptoms After Lobectomy

[grgmals]

Hi Dr. Lupo,

I am a 34 year old male.  I have had a left thyroid lobectomy with isthmusectomy for a 3cm thyroid nodule.  The nodule was Hot as diagnosed from being Hyperthyroid and via thyroid scan.  The surgery in Sept. The biopsy report of the specimen showed Chronic Thryoiditis. I tested positive for TGaB and TSI before surgery and TGab since the surgery. Since the surgery I have been struggling with joint pain, muscle aches, hair loss, and some sinus/ear pressure issues.  

Lab Results

November - TSH was 2.6 (range .3-4.5)- I was dealing with being cold, low body temperature, joint pain, muscle aches, fatigue.
End of December - TSH was 2.0 (.3 - 4.5) Free T4 .9  (.6 - 1.2)
Recent Lab March 5th  - TSH was 1.4 (.3-4.5) Free T4 - .8  (.6 - 1.2)
In the recent lab work I also had B-12 test which was normal
CK test which was 133 (Range 30-194)
C- Reactive - Normal
Potassium - 4.1  (Range 3.4-5.2)
TGaB         - 11.2 - Abnormal

My endocrinologist is saying that no medication is warranted at this time. I have had a neurologic workup that came back clean except they did find carpal tunnel in my hand which is a new one for me. The neurologist did MRI's of brain and spine as well as Lyme testing.

Some of the symptoms I was dealing with have subsided (cold temperature, hair loss has slowed). The ones that remain are the muscle and joint aches and a low tolerance for exercise.  My appetite is very spotty, some days I will not eat much at all and have to almost force myself to eat. Also my diastolic BP has risen from what normally was 90 to now 100-110.

My question is could the FreeT4 being on the lower end of normal cause some of these symptoms?  When I was hyper I felt great for a period of time and my TSH was .4 (.3 - 4.5 range)

[Mark Lupo, M.D.]

The thyroid levels appear normal with no indication for treatment at this time.  
Would continue to monitor as often symptoms stabilize several months after correcting hyperthyroidism.  Flonase should not impact these levels.

[grgmals]

Thank You Dr. Lupo,

The service you provide here is excellent.

One last question, are muscle aches and joint issues usually the last to go after thyroid levels stabilize? It seems like those are the ones that are hanging around.

Thanks again.

[grgmals]

I am also on 100mcg of Flonase per day.  Not sure if that would effect any of the most recent blood tests

[grgmals]

One more point to add.

My dr also tested some adrenal function with a Metanephrine and Normetanephrine test and they came back normal.