TSH suppression for thyroid cancer on NDT?

March 13, 2012

Hi Folks

In brief, I'm back! I was here a year or so ago with Graves - Tess saved my

bacon! It turns out that my totally incompetent endo missed that I had severe

hashitoxicosis, intermittant T3 toxicity, and thyroid cancer - not just Graves

(not that Graves is a picnic!). I finally saw a brilliant endo surgeon who took

one look at me and whipped me in as an emergency case. He saved my life. Turns

out I've been sick since I was 17 and dangerously so for the last 10 years!!

Total thyroidectomy in late Dec - there was no other choice, my thyroid was

fibrosed, inflamed, destroyed and I had malignant nodules. I have no doubts at

all that this was the right action. I'm very grateful to my surgeon. I'm on T4

only - 175mcg for total TSH suppression and I'm due a radioiodine remnant

ablation in April (which I'm pretty much decided to do, but have some misgivings

about).

I feel radically better already! The problem is I don't feel completely well on

T4 - my surgeon is a lovely, lovely, lovely man and has got me sorting out my

diet, done an exclusion diet and off gluten, sugar, caffeine, and dairy. He's

checked all my hormones (oestrogen a tiny bit low) and has done adrenal tests,

and checked ferritin (v low, I'm using floradix to get it back up), Vit d was v

low but is now normal - take daily supplement. B12 was normal, my calcium is a

tiny bit low but normal, but it was in my boots by the time of surgery in Dec -

had constant pins and needles! He's a very good clincian, and I'm not moaning.

He just doesn't do NDT.

I'm taking all the right vits and minerals for conversion and absorption etc.

But the weight isn't budging. I feel tired. I'm constipated. I've jsut

started taking my temp and it's low. Also at 175mcg I feel shaky and toxic, but

150mcg isn't enough.

Anyway, my TSH is now suppressed but my FT3 is still only 4.4 (3.5 - 6.5)and my

FT4 only 15 (9-24. I'm still three stone overweight (endo had me on carbimazole

for two years and I gained over 50lbs). I'm considering either doing a T4 / NDT

combo or switching to NDT. However it's imperative that I keep my TSH

suppressed.

Can someone explain equivalences to me? The conversion charts say that 15mg NDT

= 25mcg T4. Or One Grain = 100mcg T4. But looking at the actual contents it

seems that 60mg (one grain)= 38mcg T4? So would my 175mcg anti-cancer dose of

T4 = 2 grains, or 4.5 grains?

Also, any mileage in combining T4 and NDT (e.g. 75mcg T4 and equivalent 100mcg

NDT?).

Help appreciated.

Thanks

x

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