Hyperthyroid/ Hashimoto's- Propofol for surgery

[Jlcjcp32]

Is it safe to use propofol for surgery when I have extreme hyper symptoms from Hashimoto's?  I have been so tired and fatigued due to a low tsh of .010 for the last 16 weeks since being overmedicated on synthroid. I have some tremors, insomnia, anxiety, panic attacks and extreme exhaustion.  Blood pressure and heart rate are normal.  I have an upcoming EGD and Colonoscopy as well as a possible gallbladder surgery in December.  I am concerned about feeling this way for so long and taking propofol for these procedures.  My symptoms are so bad that I have been in bed for 6 weeks because the symptoms are overbearing. Would anyone be willing to share their experiences?

[Barb135]

While thyroid issues can certainly contribute to some stomach issues (I get GERD really bad when hypo), the pain in your right side certainly sounds like a gall bladder issue.  I used to get "attacks", in which I would almost swear I was having a heart attack, only they would be on the right side vs left.  Tests showed that I had several gall stones and my gall bladder was removed in 2005; I've not had stomach pain since.

I would like to caution you about using TSH as a "guideline" for adjusting medication.  My TSH stays at < 0.01 all the time, so we have to look at the FT3 and FT4 in order to determine what's best.  Always insist on FT3 and FT4 *EVERY* time TSH is tested.

[Jlcjcp32]

Hi Thyroidhunter,

It has been 4 weeks since being overmedicated. The doctor took me off Synthroid temporarily because I had been hyper for 18 weeks and he believed I was overmedicated.  Before adjustment my TSH was .010 and after adjustment .018, but it has only been 4 weeks without synthroid medication.  I will go get TSH, Free T4 and Free T3 and antibodies again in 4 weeks to see where it is at.

I have had many stomach issues prior to experiencing thyroid problems at least extreme Hashi symptoms. I believe all these issues started after taking antibiotics or eating gluten causing leaky gut.  Anyways, after doing a CT scan it was revealed I have a 1.9 cm gallstone.  My GP sent me to a surgeon and my surgeon sent me to Gastro to rule other reasons that were causing my stomach issues before taking my gallbadder out.   Surgeon and Gastro said that sometimes gallstones are not always a problem.  So now I am off to do the scopes and biopsies etc tomorrow... I guess the next step is removal of gallbladder unless my thryorid is causing these stomach issues.  But with the pressure in my right side underneath my rib cage, I feel it could be my gallbladder.  You are right though, a second opinion would be wise.  Thanks for listening. :-)

[Jlcjcp32]

Thanks for your responses.  I started with hypo symptoms and a TSH of 5.05 and was given 50 mcg of Synthroid in May 2011.  I continued to have fatigue, brain fog, weight gain etc...  Then my next blood test, 8 weeks later, revealed my TSH only dropped to a 4.65 so the doctor decided to increase dosage up to 75 mcg due to my symptoms. Then, two weeks later she increased my dosage again to 88 mcg.  In addition, I also decided to go gluten and grain free.  From that point in time, my TSH dropped to .010 and my antibodies (TPO) increased from 39 to 435.  So strange. I was not happy with this Endocrinologist so 6 weeks ago, after having high anxiety, heart palps, insomnia, etc..I decided to switch to a new Endocrinologist and he told me that because I was consistently low for 18 weeks and experiencing HYPER symptoms to get off synthroid temporarily for 4 weeks so he can get a baseline of where my TSH actually is without any synthroid as well as to see if I was going through Hashitoxicosis (hypo/hyper cycle). He also stated that I could have been overmedicated.  It has helped tremendously to get off of synthroid because I am not experiencing as many "extreme" symptoms, but my TSH is .018 which is still low. T3 and Free T4 are back in range as they were above the range 12 weeks ago.  I will take another blood test in 6 weeks still without taking Synthroid.  I wonder if I have Graves and Hashi's, overmedicated, or Hashitoxicosis?  This disease is horrible, but I know I am going to get better and beat this.

[Jlcjcp32]

Hi Barb135,

Thanks for your response.  Yes, I talked to my Gastroenterologist and he said it would be fine despite my Hashi symptoms.  I relayed my symptoms to him and he still reassured me all would be well.  I am going in for EGD and colonoscopy tomorrow and will be give small dosage of propofol.  They doing these procedures to check out some of my stomach issues like bloating, flatulence, pain in upper and right side of stomach, etc...  They want to rule out everything else before they remove my gallbladder due to a 1.9 cm stone.  

[goolarra]

How long has it been since you were overmedicated on Synthroid?  Did your doctor lower your dose?  What was it before and after the adjustment?  Have your free T3, free T4 and TSH levels been retested since adjusting your dose?  After six weeks, your symptoms should have improved.  If they haven't, you most likely need a further adjustment.

Are the colonoscopy and EGD routine screening tests, or are they being used to diagnose symptoms?

Sorry for all the questions, but it seems you should not still be having hyper symptoms if your dose was adjusted adequately.

[ThyroidHunter]

It it's possible, speak with your doc about the degree of your symptoms to make sure he knows how serious they are.

You might also want to get a second opinion prior to surgery, most folks do. If you have been forced to bed for 6 weeks due to symptoms, you need a Doc who will TREAT your symptoms immediately, so a second opinion seems like a necessity after reading that.

Best in Health & Good Luck
ThyroidHunter

[Barb135]

You will need to talk to your doctor and the anesthesiologist(s) who will be doing the procedures.  Be sure to let them know what your symptoms are and how badly you've been feeling.