Is It Safe To Be On 125 Mg Of Synthroid After Surgery For Thyroid Cancer?

Posted on Thu, 12 Mar 2015

Question: I am freaking! I have been having some real issues with my doctor. I have been on nature thyroid. alternating 1.75 1.5 gr. when i reached that does my levels were at the desired range. I am post papillary CA. The next thing my md did was to demand a reduction in the medication
. We fought for several months and I went to another MD. After much negotiation I have just started Synthroid 125 mcg. I am scared because it is to difficult to change medications. I was on synthroid for years before. That is why I am going back on it.

Answered by Dr. Shehzad Topiwala (3 hours later)

Brief Answer:
Thyroid dose

Detailed Answer:
Guidelines from expert thyroid associations have always recommended levothyroxine as the mainstay of treatment of 'hypothyroidism'.

Synthroid is a brand name of levothyroxine. In general, adhering to the same brand helps ensure steady blood levels.

Nature thyroid is not deemed appropriate.

If your papillary cancer was more than 5 year ago, and your endocrinologist has evaluated you to have no evidence of cancer then you are presumed cured and can aim for target TSH levels as for others with hypothyroidism (but with no cancer history).

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (1 hour later)

I want to believe you. I really do...but there is a problem. Whenever my TSH goes above one my neck in the thyroid bed turns red. When the TSH went to 5 a couple of years ago the thyroid area actually started looking black. One other problem I have is that my thyroglobulin goes up when my TSH goes up. The other issue that I have to deal with is that I have increased hoarsness with an elevated TSH. These are the concerns I have. The endocrinologist that I saw yesterday seems to agree with wanting the TSH to remain low. Any thoughts on these symptoms? I am wondering if my TSH has been supressed for so many years that my body now needs it to be low. I had the CA treated in 1995.

Answered by Dr. Shehzad Topiwala (9 hours later)

Brief Answer:
Follow up

Detailed Answer:
I follow what you are saying.

The rise in thyroglobulin needs to be explored. It is only thyroid tissue that makes thyroglobulin. So if you have had a total thyroid removal, then there should be no thyroglobulin in your blood.
If you had less than complete thyroid removal, then there is no value in measuring thyroglobulin.

So the TSH target will be determined by the cancer status. You have to be careful about the effects of excess levothyroxine dose on your bones.

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar