I had the right side of my thyroid removed in my early 20s i am 54 now. I have been experiencing some symptoms for the past 2 years but my test all come back within the normal range until this last one. My tsh levels were low .43 my t4 free was 1.3. I have never taken any thyroid medicine. What does this mean? Should i see an Endo ?
Hello Mona:
I am an RN -nurse and I live in the USA. I am also the same age as you. I got Hashimoto's when I was 27.
What symptoms do you have. (Low thyroid), Hypothyroidism can have the following: Weight gain, no periods or heavy ones, fatigue, dry skin, low pulse, depression and or anxiety attacks, muscle aches, etc...there are more but these are most common.
Hyperthyroidism is too much, and you will see rapid loss of weight, fast heart rate, nervousness, bug eyes, etc... these are most common ones.
Normal TSH is 0.34 to 5.60 range in USA lab levels. T4 is low. If it goes low the Pit. Gland will try and send a signal to the thyroid to make more to tell the thyroid to get busy, but the thyroid can't always do that. your TSH (thyroid stimualting hormone) seems okay.
Blood values help to let the doctor know how your thyroid is functioning. Blood is just one way to see what is happening. Any symptoms of low hormone is another way to diagnose it. This is more of an indicator than just blood work.
However even if the blood levels are good, you can still experience problems as you age and go through menopause. It sounds like you have some symptoms but I don't know which ones, so please state your symptoms. It also sounds like the remaining part of your thyroid is working as you do not have any replacement hormone. As we age the thyroid could slow down, so if you are experiencing any of the above symptoms, then you should see an Endocrinologist.
I hope this helps, feel free to ask any questions. Shelly
Hi Mona, Yes .. you should definately see an endocrinologist. Your ft4 is ridiculously low .. I don't know what the range is there where you live but that figure would be at the bottom of any range I've ever heard of.
I've heard so many stories like yours where half the thyroid gland is removed and the patient is not given any medication to make up for the loss. They are left to struggle on, gaining weight, being offered blood pressure medication, cholesterol medication, diabeties medication and anti-depressants. I had half of my thyroid removed almost thirty years ago and was put on 100mcg Oroxine immediately. I have had no weight or health problems since.
TSH is unreliable .. but doctors rely on it to the detriment of the patient. Your tsh is indicating that you may be hyperthyroid but your ft4 is saying that you are hypothyroid. Which of these conditions do your symptoms match? With half of your thyroid gone I doubt it is hyperthyroid.
Be your own advocate and learn all you can about thyroid conditions so that you can have a say in the management of your treatment.
Hi Shelly,
i too am from the USA, I experience symptoms of both hypo & hyper am not sure where to start. I am being treated for mildly high blood pressure, my cholesterol is also just over the high range, i have ridges in my fingernails, have lost most of the hair on my arms and legs, my ears ring all the time, constipation most of the time, had to have my gall bladder removed because it quit working, i snore, grind my teeth, only sleep between 4 and 6 hours a night, have heart palpations, sometimes my hands shake.. with all that being said part of these don't happen everyday. And some of these can be attributed to menopause. I am having with my short term memory (not sure if that is a symptom), the skin on my hands, forearms, shins, and feet are very dry.
Hi Sketchy,
i experience signs of both at different times. The more prominent are constipation, dry skin, ringing in my ears, high blood pressure, ridges in my fingernails, loss of hair on legs and forearms. My Dr. wants to check my levels in 6 mths. I have already had my gall bladder removed because it quit working (not sure if it is connected ) i also have heart palpations randomly.. i am so confused and just dont know when to seek an Endo. By the way the ranges at the,lab that for tf4 0.8 - 2.2 (mine 1.3)
Tsh .47 - 4.68. (mine .43) .... i am so confused.. 
Hi Mona,
The best advice I can give is for you to arrange an appointment with an Endocrinologist as soon as possible so that all the necessary thyroid tests can be done. Gp's do not know much about managing thyroid conditions and can leave you dragging on with unpleasant symptoms for months or years while they play around with TSH readings.
TSH is unreliable especially if you have had abdominal surgery .. it seems to change the blood work readings. Mine changed after surgery and the TSH almost dropped to zero but I was quite well. The GP insisted in reducing my medication saying I must be hyperthyroid (I was'nt) .. and I became very unwell within six months. Your symptoms sound like hypothyroid. Palpatations can happen with hyper. and hypo.
My TSH is almost zero. I refuse to let GP's change my meds and make me ill again. Always get copies of your thyroid blood tests so that you can keep track yourself.
Hello Mona:
Yes, hair loss is a symptom of a low thyroid (Hypothyroid), also nails that don't grow or break deep down. Also constipation is a symptom of low thyroid. Also memory and confusion is a sign. and dry skin.
I go by symptoms more since blood work can change from week to week. However in USA, your TSH is just an indicator and can be not the true picture since symptoms speak louder, if you know what I mean.
Normal T4 is between 4.5 and 11.2 but like I said, you seem to have many of the low symptoms.
Forget the blood work for now, keep a log of your symptoms and bring it with you as it will help let the Endocrinologist know. You may need thyroid replacement meds. There are many on the market. Some are Synthoid, Armour Thyroid, thyrolar and Cytomel.
You may be swinging back and forth between hypo and hyper, and it takes the gland time to settle down and to see if it can make enough hormone for your body.
So see an Endocrinologist - have your GP refer you. I hope this helps. be well, Shelly
Hi Shelly,
i see where most who have had a partial thyroidectomy have taken meds soon after. Have you taken meds? I was never put on any kind of meds. Just wondering if thats normal.
Hi again Mona,
Just wanted to say .. It was about thirty years ago when I had half of my thyroid removed and at that time I was told that after the removal I would be given 100mcg Oroxine and that would supply my body with my complete thyroid needs for the rest of my life and the remaining half would go to sleep. The general rule of thumb is 1.6mcg thyroxine per kilo of body weight and I weighed just under 60 kilo so I was given 100mcg which I am still on today. Since that time I notice that there seems to be a 'wait and see' approach when half the thyroid is removed and I don't think it's a good idea at all. As I have come into contact with people who have not been given medication and have struggled on for years with hypothyroid symptoms and massive weight gain because their GP's keep looking only at the TSH to guide them .. (TSH is unreliable).
You must see an Endocrinologist and explain your symptoms and have all the necessary blood tests done. You must stand up for yourself and learn all you can so that you will be able to converse with doctors about your condition. Get copies of all your blood tests.
Hi Sketchy,
yes weight gain has been a problem!! I have bouts of depression.. my ears ring and have soon after the surgery.. loss of sex drive .. high blood pressure.. just recently somewhat high cholesterol. . Constipation... more than average hair loss.. dark circles around my eyes.. sleep 4 to 5 hrs a night then tired in a couple hours want to go back to bed.. concentration is hard for me.. many more symptoms.. however at my age they consider alot of them to be menopause. . I am contacting my GP today to get a referral to see an Endocrologist. Thank you very much for all your knowledge and advise you dont know how very much it has helped ..
Hello Mona:
I have Hashimoto's Thyroid Disease but I have not had my thyroid removed. Since I have low thyroid (HYPO), I am on meds for it.
The ones who have a partial thyroidectomy do start meds soon after because of the HYPO symptoms. In some people, the remaining part of the thyroid can compensate and in some it sadly can't.
You most likely will need hormone replacement and it will help reduce your symptoms once your thyroid level is back in normal range.
I hope this helps, Be well Shelly
After very long discussion with my Dr he finally agreed to refer me to an Endocrinologist. July 9th.. YEAH .. Thank you for all your help..
YAY- good job!
Hi Sketchy,
I went to my Endo appointment and they took 5 vials of blood. She examined my neck and eventually did an ultrasound of my remaining thyroid because she felt nodules. My concern is she didn't want to see me again for 4 months then i am to have blood taken a week before i go see her. I guess my question is, is this normal. I have not heard or seen how my blood work was. And should i ask for a faxed copy of it?
Hi Mona, It's good that you went to see the Endo because they know the correct tests to be done for thyroid problems. The important thing is that you get a copy of your test results because 'you' need to know what they are so that you have the knowledge to plot your way to better health. Always get copies of the tests! It's your right to have them and you need to understand them. When you get them post the results with the ranges here so that people can give advice. However, it's just occurred to me that you may not get to see those results until you see her again in 4 months when she will compare the first lot of tests with the second ones. I would have thought she would have made an appointment to see you in a few weeks to discuss the results of the first tests and the ultrasound? So you have only seen her the one time when she ordered the tests?
Yes thats right.. i go and have another blood test for tsh only 1 week before i see her in November.. i called them today to have them fax me a copy of my tests.
Mona, I find it very strange that your Endo would make you wait four months before she would even give you her initial thoughts based on the first blood tests. If something appeared not right with those tests I would hope that she would call you to come in for a consultation.
Although we here in the forum advised you to see an Endo to get the right things tested they are notoriously bad at dealing with thyroid patients. Many of us have been mucked about or had symptoms completely ignored by Endo's. It's such a shame because they should posess all the knowledge to help us and we wait patiently for weeks or months to see them only to be sent away and told there is nothing wrong. They stick rigidly to TSH (which is rubbish) and will not even give consideration to Ft4 or Ft3 which are just about to drop out of the range. They are driven by ranges and will not budge beyond them regardless of symptoms.
This is why it's so important that you get a copy of those results so that you can begin to understand for yourself what your thyroid is doing and you can compare them against any future tests that you have done. Also need the ultrasound results.
Anyway, for now lets just see what those blood test results show.
I just received the copies of my blood tests. I dont know much about them, but here they are.
tsh. .50
T4 free. 1.2
T3 total. 102
Thuroglobulin antibodies <1
Thyroid peroxidase antibodies <1
I would appreciate any feed back.
Hello Mona:
I am an RN (Nurse) and live in the USA. USA lab values are similar to UK's so here goes. TSH normal is 0.34 -5.60. Your TSH is within the so called normal. However, symptoms of low thyroid could show through even if it is so-called normal. It is just an indicator tool. T4 free: Normal is: 0.7-1.9 and you fall into the normal again.
If you feel low symptoms, such as: Weight gain, sleepy, low energy, mood swings or confusion, please call your Endo or GP and let them know.
Sometimes our blood is good, but we feel crappy. Blood work is an indicator and symptoms are also important to consider. The more you complain and if needed document symptoms by a log or have another doctor record it, will be helpful.
Make sure your minerals are okay, as people with thyroid problems have low calcium and iron and B -12 and having the proper levels will help. Also have Vit D level checked - ask your GP to order it. I hope this helps. Be well. Shelly
Hi Mona,
It's good that you managed to get your test results. When you post results in future can you please post the 'ranges' alongside them. I am in Australia and the ranges for these tests are very different here.
When I look up US ranges I get confused as there are variations in the ranges showing on the net.
Can you give us your Free T3 results with the ranges please?