Undetectable tsh post thyroid cancer

[TTandnowhyper]

Hi....

Acting to get some I sight because I'm not gettin much at home in Australia.

I'm nine months post op for stage 2 pappilary thyroid ca. Three months post RAI. the cancer was found by accident after removal of a branchial cyst... Lucky. During surgery my jugular vein was nicked and my hemoglobin dropped to 5 so I was in hospital for a while. Adjusting my meds was easy and up until July I am having problems getting the correct dose.
I was on 100 per day and feeling awesome. Then in July my Endo upped it to 150 per day.. I asked her not to as I don't feel well on a higher dose.. Well well well it's been a nightmare since. She keeps telling me my tsh needs to be undetectable so cancer doesn't return.... I get that, but am finding it really difficult.

I have ended up in hospital a few times with a number of symptoms ranging from heart palps, extremely hot even though my temp is fine grrrrr sweating, nauses, dizziness, blurred vision etc. I was even on a drip for dehydration??

At that point my tsh was <0.01..... My recent bloods are
Tsh 0.03.       Ref 0.50-4.0
Ft3 4.8.                 3.5-6.5
Ft4 20.3.                10.0-19.0

When the Endo called me telling me she will bring forward my appointment she said I need to have an undetectable tsh and I'm scared she will up my dose again and I will feel bad again. I'm on 100 now and I can just manage.

Any thoughts???


This discussion is related to Post Thyroid Cancer Follow-up Procedures.

[TTandnowhyper]

Thanks for that.. Can't seem to access it. Can get on lab tests online but there is an error with the link.

Apparently because I have thalasemia my iron seems fine grrrr

Thanks again.

[gimel]

Have a look at the chart in this link and I think you'll see that your first priority should be getting the doctor to diagnose and fix your iron issues.  

http://labtestsonline.org/understanding/analytes/ferritin/tab/test

[TTandnowhyper]

Hello,
Hoping I could ask your thoughts on some tests.
I'm kind of on the way to getting better, just can't shake off the tiredness, dizzy and irritable/anxiety feeling. I have never had anxiety before so its more annoying bc I'm not sure if it goes away.

Iron 18.2.               ref 9.0-26.0
Transferrin 2.01    ref 2.10-3.80
Saturation 36        ref 13-51
Ferritin 140.          ref 10-120
Comment: ferritin values above the reference range together with a low level of transferrin may be seen with inflammation, liver disease and also increased iron stores.

Vitamin D 75
Ref vitamin d sufficiency >75
Sub-optimal level 60-75
Vitamin d insufficiency 20-60
Vitamin d deficiency <20
Comment borderline vitamin d level.

I see a new Endo in early march so hope he helps. When you use the public system here you see different endos in the clinic each time you see them so seeing someone private and having one person dealing with my case hopefully helps.

I feel I need an increase as I'm so tired a lot yet need a decrease bc the anxiety and shakes.

Thanks

[gimel]

I meant to add, that if you want to be really cautious, then start with the 1/4 grain, and take only half of one of the 75 mcg tablets of T4 on one day in the week.  

[gimel]

There is available info that says that Free T3 suppresses TSH even more than Free T4.  I think you need more T3, and less T4, so that is why I was suggesting that you try 63 mcg of T4 daily by skipping one of the 75 mcg daily doses and adding 1/2 grain of Armour.  That gives the equivalent of approx. 81 mcg total, which is the level you said seemed best for you.  But that is only my opinion, you and the doctor need to agree.

[TTandnowhyper]

Just doing some extra research for myself... Wow, it's amazing at all the different types of combos. I found and Australian website that even talks about slow release T3 meds which release slowly over 24 hours.

I think now my Endo reduced my Thyroxine to 75, I will ask my doctor if I can start on 1/4 grain of Armour first. I may be wrong with my calculations but if I do this I will be just under 100???

I'm sorry to keep asking you so much but I really want to get this under control. Some days I'm great and other are just a nightmare.  I'm scared/worried to try the 1/2 grain and go hyperion again. My Endo will re check in 3 months.

He kept saying "your TSH needs to be suppressed" and when I said, well previously on a low dose, anything under 80 my TSH rises and you just increase meds again. He didn't really care lol

So on 75 and 1/4 I'm hoping this will keep TSH down and improve symptoms.