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Tiredness ,lethargy after partial thyroidectomy

I had a partial thyroidectomy to remove a large solitary non cancerous nodule just over 4 weeks ago. I am now becoming more tired and lethargic and am constantly yawning. I dont feel i have any energy. My thyroid function tests before and just after surgery were fine and are due to be checked again 6 weeks post op. I am not on any thyroid medication. I am hoping to go back to work on Monday but am worried i may not be able to cope as i get tired just pottering about the house! Is this normal?? Also my scar protrudes quite markedly and looks like a large adams apple although has healed fine has anyone else had this problem? Please help as i cant seem to find the answers!
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Avatar universal
In 2013 had a right thyroidectomy with a removal of a large non-cancerous follicular mass that 7cm×4.5cm×5cm. Took 4 hours on table some if which was to determine before closing having pathology to detetmine if there was any signs of cancer though biopsy was negative. The surgery went well the scar like yours protrude for a while but barely noticeable. Recent check up showed development of 4 nodules with complex vascular supply. Though They have grown a bit but not explore into the size of the last. I do suffer being lethargic though my TSH, T3, T4 and free T3 as well. Few months back has to have a CT-Scan with contrast and it lit my thyroid on fire cause of the iodine and since then had the problem of recurring tiredness, unable to sleep etc. Though thyroid levels are in normal range. Once you recovery and the problem persist would advise to get a consult for an endocrinologist. To follow you. Even Though your levels maybe normal they could be off to effect you. As well he may look as part of their speciality of there are any adrenal issue or your thyroid levels could be effecting adrenal glands which priduces the bodies steroids. As well as other body system in the endocrine system. Hope this helps.
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Avatar universal
I have no personal experience with your condition; however a search of the internet would show that many people find they do need thyroid med afterward.  From limited reading on the subject I think that you could expect to know within 6 weeks after surgery, and it is now almost 8 weeks post-op.  

The remaining half of your thyroid gland can produce more than before,  but just logically it seems unlikely that the remaining thyroid tissue could fully meet your needs by producing twice as much hormone as before.

To me it appears that your higher TSH level recently is an indication that your hypothalamus/pituitary system is trying to stimulate production of adequate levels of thyroid hormone, but it isn't happening.   The key question is whether your Endo knows about how you are feeling, but considers your current levels are already adequate, or whether he thinks your levels and symptoms will continue to improve and alleviate your symptoms.  

So I suggest that you ask your Endo that question.  If he erroneously thinks your test results are already adequate, then waiting until December will be a waste of time and you will need to go ahead and find a good thyroid doctor that will treat clinically, by testing and adjusting Free T4 and Free T3 levels as needed to relieve symptoms, without being influenced by resultant lab test results. Symptom relief should be all important, not just test results.  
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Avatar universal
Easy for your Endocrinologist to say, he doesn't have to live with your symptoms that are most likely due to inadequate levels of Free T4 and free T3, which are the biologically active thyroid hormones.

Your Free T4 is only at 20% of its range,  which is far too low, since the range is too broad, due to the erroneous assumptions used to calculate the ranges for FT4 and FT3.  Likewise your Free T3 is way too low, being only at 30% of its range.  In the words of an excellent thyroid doctor, "The free T3 is not as helpful in untreated persons as the free T4 because in the light of a rather low FT4 the body will convert more T4 to T3 to maintain thyroid effect as well as is possible. So the person with a rather low FT4 and high-in-range FT3 may still be hypothyroid. However, if the FT4 is below 1.3 and the FT3 is also rather low, say below 3.4 (range 2 to 4.4 at LabCorp) then its likely that hypothyroidism is the cause of a person's symptoms."

A good thyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms  without being influenced by resultant TSH levels.  Symptom relief should be all important, not just test results.  From your Endo's comments I highly doubt that he is willing to treat clinically, as described, so you will have to find a good thyroid doctor that will do so.  

Also, since hypothyroid patients are so frequently deficient in Vitamin D, B12 and ferritin, you need to get those tested and then supplement as needed to optimize.  D should be at least 50 ng/ml, B12 in the upper end of its range, and ferritin should be at least 100.

If you want to confirm all that I have said, have a look at this link.  I recommend reading at least the first two pages, and more, if you want to get into the discussion and scientific evidence for all that is recommended.

  http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf
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1 Comments
Thank you so much! I'll request all this blood work! So from your experience there's no chance the remaining half will eventually compensate?
Avatar universal
Hi Gimel not on any Meds yet. The endocrinologist who just checked me told me that "everything is ok" and to go for another check up in December... the range is TSH 0.35-5.50, t4 free 0.80-1.80 and t3 free 2.20-4.20. thanks! Jennifer
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Avatar universal
Hi everyone I had a partial thyroidectomy on March 8th this year. I was totally fine post-op but  for the past 3 weeks Ive been very fatigued (I wake up tired even after a good nights sleep and I cant stop yawning...). I went for blood work on April 21st and my TSH was 2.44 (prior to surgery it was never higher than 1.3), free T4 1.00 and free T3 2.8. The endocrinologist that saw me said I was perfectly fine and I should try to exercise more(?!) and to have another check-up non December. My question is: how long does it take for your body to adjust to only having half a thyroid? Is there any hope that Ill start feeling better on my own?
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1 Comments
Are you on any thyroid med since the partial thyroidectomy?  If so, what med and dosage?  Also what are the reference ranges shown on the lab report for the Free T4 and Free T3 results?
Avatar universal
That is far too long to have to wait for followup testing.  Most likely the remaining half of your thyroid gland is unable to produce enough thyroid hormone for your needs, thus the symptoms you are having.  I would call the doctor's office and tell them about the bad symptoms you are having and push to get in right away for tests.  You should insist on being tested for Free T4, Free T3 (not the same as Total T4 and Total T3), cortisol, Vitamin D, B12 and ferritin.  Even if you cannot see the doctor right away,push to get the tests done now.  Then you can post results and reference ranges shown on the lab report and we will be glad to help interpret and advise further about treatment.  
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I agree you were scheduled too far out for follow up.  I had PT left lobectomy Nov 14  for suspicious Hurthle cell cancer was scheduled for follow up with surgeon Nov 30 and was told to schedule with Endo one week after surgery date but only date available was same Nov 30. I was already on levothyroxine high dose so I'm sure it was more a question of the calcium and other lab
Avatar universal
I had the right half of my thyroid removed on 04/10/16 due to a Hurthle Cell Adenoma. I recovered fairly quickly from the surgery and my scar is healing nicely since I've been massaging it with a blend of oils: Bio Oil, Flexitol, thick Vit E oil and Frankinsence Oil. Over the past couple of weeks I've been experiencing sudden onsets of exhaustion during the day and extreme fatigue even after 12hrs sleep. I sometimes have no energy or motivation to do anything at all. I don't have my post- op check up til 28/11/16 and I'm not on medications. Coffee and vitamin supplements don't help either. Any suggestions?
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649848 tn?1534633700
COMMUNITY LEADER
It does take time after the surgery to begin feeling better; however, your symptoms sound like those of hypothyroidism, so if you could give us more information, we might be able to help you better...

Are you taking any replacement thyroid hormones?  If so, what medication, dosage and how long have you been taking it?  

What are your actual thyroid hormone levels?  Please post them along with the reference ranges from your lab report.  You doctor should be testing you for Free T3 and Free T4, as well as the pituitary hormone, TSH.

For what reason did you have the partial thyroidectomy?
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Avatar universal
I had an partial thyroidectomy on 14/01/2010 - I've tried to exercise and eat correctly - but I still have problems such as feeling tired. The days that I feel tired - I just try and make it through the day - those are the times when my moodswings are really bad - and I just  try and avoid people - just to spare their feelings, because of my sharp tongue and to keep my job intact!! :) The good news is - my scar is not that prominent and it has healed quite nicely. Wish I could show you my before and after pics!! :) I'm not on any medication because the doctor said that we should test whether the left side could take over the functions of the right side(the lobe I had removed).All in all - I think I am coping very well. The weight gain? Well , I havent lost any - but I've gained about 5kg since then. Hopefully the exercise and eating healthy routine will keep my weight stable. I also used bio oil and dermastine when the scar healed. It really looks fantastic. I first resembled someone that had been tripped by a washing line or a mug victim(everybody always wanted to know who slit my throat ;) ) - but today its just a thin line - which is not noticeable really until I tell you I had a partial thyroidectomy. So take care - and just take it one day at a time.
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1333978 tn?1275504805
I had partial thyroid removal one week ago today. Everyone made it sound like this surgery is no big deal, and for the most part things have gone well. I am SO stinking tired it;s frustrating! Thought it was the pain meds but havent had to take them for a couple of days so it's not that. I thought since just partial removal I wouldn't feel a big change...wrong!  Sounds like we all have the "tired" symptom, but It's good to know that it can get back to normal, I just have to be patient and see. Thank you for posting your experience.
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1 Comments
Hello had my partical thyroidectomy Sept 27,2016. Still feels like I have something tied around my neck. I'm always tired I did laundry for the first time yesterday and I felt dizzy and very tired. I have no sex drive, very depressed and I'm always hungry Anyone else have these symptoms
Avatar universal
I had a large goiter (the size of a softball) and half of my thyroid removed four weeks ago.  The goiter was benign.  I went back to work after 2 weeks.  Partially because people made it sound like the surgery was no big deal.  The first week or so until i had the bandages removed i was a little sore but generally felt ok.  Once i went back to work I began to have other "symptoms" and i have been trying to decide if i am crazy.  I am tired ALL of the time, constantly on the verge of tears, have slight muscle spasms all over but mainly in arms, and heart palpitations..  My doctor does not want to entertaint he thought of medication until my "body adusts"  in 3 months.   My appetite has not been much - but i am not losing weight either.  
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929504 tn?1332585934
I had a TT on 12-23-09 and I must say that after 19 days, I'm fine. I haven't started med's yet due to my surgeon wanting the pathology report and my labs in first. Pathology report was "benign" Thank God and I went for my labs yesterday (seems like they were taking all of my blood)....results will be in, n a few days. I noticed that after the surgery, my calcium dropped "alot" causing muscle spasms and tingling (all over), I was very tired but after 3 weeks, I feel good. I would check my "hemocrit" levels just to make sure that you are not anemic. As far as the scar, it's not that visible anymore and I also have a "adams apple" like appearance above the scar...and i'm sure that it's due to the "surgery", the area that was surgically cut and also not having a thyroid. My area is still numb but I have not problem with moving my neck around as usual. If you are really concerned, speak to your physician and ask what he/she thinks. God Bless You!~
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