
What Should Be Done If I Have Low Hemoglobin And High TSH Levels Even After Eight Months Of Thyroidectomy?

Thanks for the query
Thanks again, for your elaborate and descriptive history, which is very helpful in decision making. I also appreciate your act of meditation during this time.
From the description given by you few things are very clear:
1. Elevated TSH – Hypothyroidism, depression, lethargy, weakness, etc.
2. Loss of parathyroids- Hypocalcaemia, tingling sensation of the palms, muscle weakness, etc.
3. PCOD – Leading to Obesity
The doctors who did the thyroid surgery have taken a right decision and you have got relief from that (my periods are more normal since surgery, that and being able to breathe better have been the benefit of surgery).
Post surgery you have developed hypothyroidism and hypocalcaemia as there is no thyroid and parathyroids to release any thyroid hormones and calcium. This has to be replenished with supplements. The dosage of these supplements will be adjusted according to the TSH and Serum Calcium titers.
An important feature of PCOD as well as hypothyroidism is weight gain. Even with the best of the diet management and exercises it is difficult to control obesity. Apart from this you are also taking Metformin for PCOD. Metformin can cause weakness because it will reduce sugar levels in the body.
Most of the symptoms that you are experiencing are because of the above mentioned reasons. I would suggest you to stop worrying; just because your maternal aunt died of colonic cancer does not necessarily mean that you will also suffer from those problems and die. You need to understand that there are hormonal imbalances in your body and you have to fight them.
A team of good Endocrinologist, Dietician and a Clinical psychologist can help you in leading a better quality of life.
Hope I have answered your query; I will be available to answer your follow up queries.


The problem is you are telling me what I already know. I understand that.
I am not worried so much about having colon cancer.
I am not currently taking metformin.
I stopped taking it months before surgery because the disgusting maple syrup smell it gave my urine and it did not help my gi.
since I started taking synthroid from taking cytomel .25 post surgery the dosages of synthroid have been increase from 100, 125, to now last week to 150mcg
at first it was just strong urine scent like urea. but now the scent my urine for the last 2 months is that same sickly sweet maple syrup odor. and now for the last month even that odor is changing to something different not just sweet but musty moldy its weird.
The reason why my aunt died was the colon cancer resulted from anti rejection medication due to having 2 liver transplants. the high steroids she had to take cause the colon cancer. and the liver disease she had was congenital, my grand mother told me its something she inherited from my grand mother but my grand mother never told me the name of the disease and she died 2 days before TD.
they have found liver cysts in me which have been considered benign. when i asked about them i was told its fairly common finding in adult ct's. i know several other relatives and even my brother have had problems with liver enzyme levels over the years. when i was younger before i had the blood clot in my arm i noticed when doctors were treating my endometriosis with birth control pills i always had right side pain. they always ignored it when i mention it. i guess lab work never really showed any problems. which iknow its good when the lab work doesn't show a problem. but it seems to me i am one of those people that labwork does not always show my issues. and i do not think the doctors can just rely on that in my situation but because they are trained that way thats how they are doing things. I think they need to take a different approach. My biochemical pathways seem altered and not as honest or straight forward as the standard. Medical standards are based on a normal healthy white male as the baseline in most western medicine. Not even a normal healthy white female.
This is not a question of even race because i am a hybrid race, multi racial background. Its a question of gender. and more than a question of gender its a question of me being unique and having unique rare problems that other people do not have.
I understand i have hormonal imbalances its a struggle just to put 2 words together and think.
but my gut feeling is something else is amiss. i do not want to feel that way. But time and experience has shown me ignoring this is just going to hurt me more financially down the line. i just want to be certain some other evil tumor is not going to pop up and make my life worse. what is the statistical odds of having 2 very rare, hard to detect tumors, in unusual areas that resulted and caused organ and structural damage to the body? what could be the biological or biochemical process thats underlying thats creating these hidden body monsters? what can be done to screen and detect other hidden illness so if i need treatment it can be done now while i am not working? Please understand i do not want to be more sick. But the fact i am feeling more sick and not progessing in recovery as i should makes me think there is more to this than just hormones. I have read about Multiple Myelomas, and have wondered is it possible that i am experiencing this. esp due to the long standing hormonal problems. another thing i forgot to mention is in 2007 (a lot happened that year) they also found a lump in myright breast and both right and left breasts were experiencing bleeding. they were going to schedule me to have surgery but i ended up having the emergency surgery for the ovarian cyst instead. By the time they were looking at the breast again and did followup mammograms the lump was no longer visible i have had occasional breast pain but not the bleeding and self exam and other exams have not shown anything. My mother currently has breast cancer and has had multiple breast cysts and tumors removed since her 40s. Her doctors suggested she go on tamoxifen but she is not taking that because the risk of CVA. they are not treating her other wise. The ultimate cause of my grandmother's death last august was CVA. high bp runs in the family in my mother;s case polycystic kidney's and renal failure are becoming the cause of her high BP. Now she is having thyroid nodule issues and pituitary cyst both are being monitored. her thyroid is starting to enlarge since last year. Like I said what happened to me is rare. In my family most of the women or men had thyroid problems in their later years.
My youngest brother had a goiter when he went through puberty then it went a way. now he is having more problems and will have to have surgery possibly similar to mine. That is something, he reminded me of recently because i had forgotten that had happened.
Its also possible its cancer with him, he smokes so it also could be a factor. I do not smoke nor have i ever smoked. he is 4 years younger than me.
i just recently found out another cousin is having thyroid issues, also maternal she and I are the same generation.
so it seems suddenly my generation is suddenly in the last 3 years all started having severe thyroid problems and at younger age than my grandmother's generation. My mother and her other siblings did not get thyroid problems but one of their cousins did.
I see a illness cluster happening. I do not know what to do about it.
I will be entering my 40s next march. I do not want more medical health drama. I want to prevent illness not have more Reactions to illness in my life and in my care.
What else can be done to Prevent/ stem/ reduce, ameliorate my conditions and try to avoid just the wait and see and then by the time something is seen its devastating to my life and my finances. Rather than just wait i want to actively find and get rid of any possible future problems. Life should not be about being sick i should have happiness. but unfortunately the majority of my life i have been nothing but sick. and i think a lot of it could have been avoided if they had detected the problems instead of giving me panaceas.
Please rethink and please help.
Welcome back
I am extremely sorry for the psychological turmoil you are undergoing because of the things happening with you and around you. I have gone through your query in detail and I would like to post convincing answers to the best of my knowledge and ability.
1. Regarding the odor of urine after taking Synthroid.
Although there are no established research articles quoting the change in odor of the urine after consuming L-thyroxine, few patients who took L-thyroxine did complain of a change in the odor of the urine ( WWW.WWWW.WW which is considered normal.
2. Post surgery the dosages of Synthroid have been increased from 100, 125, to now last week to 150mcg
In your previous post you have mentioned that you are taking calcium supplements also. In that case, do you take the calcium supplements 4 hours after taking Synthroid? Calcium taken along with Synthroid or soon after taking Synthroid can actually lead to decrease absorption of the Synthroid requiring higher doses of Synthroid. If so, please do discuss with your doctor regarding this.
3. “Medical standards are based on a normal healthy white male as the baseline in most western medicine. Not even a normal healthy white female”.
This is absolutely untrue and this is mere misconception. The clinical trials are always made irrespective of gender/race/color/built, etc. In some conditions warranting separate values, the clinical trials are sub classified either according to the age or sex. The Laboratory Values hence made are acceptable worldwide with very minimal variations. Doctors in Asia do follow the same Laboratory Values as prescribed by the FDA and there are hardly any discrepancies encountered
( WWW.WWWW.WW WWW.WWWW.WW WWW.WWWW.WW .
4. What is the statistical odd of having 2 very rare, hard to detect tumors, in unusual areas that resulted and caused organ and structural damage to the body?
This is indeed a difficult question to answer as the incidence depends upon various factors such as ethnicity, food habits, environment, sex, age, predisposing factors, etc. According to a study done in Europe it is around 6 per 1lakh population per year
( WWW.WWWW.WW http://www.springerlink.com/content/n172u7870v8hr053/).
5. What could be the biological or biochemical process thats underlying thats creating these hidden body monsters?
Here again, various factors are to be taken in account, such as genetic mutation (change in the composition of the cells or chromosomes) in the cells, food and habits, environment, etc. All these cause mutation in the normal cells leading to abnormal and uncontrolled proliferation of the mutated cells.
6. What can be done to screen and detect other hidden illness so if I need treatment it can be done now while I am not working?
Cancers are detected by various modes:
a. Tissue biopsy
b. Tumor markers
c. Radiological features, etc.
Yes, you can consult a good Medical Oncologist either in person or through various websites offering cancer related services (http://www.mdanderson.org/) and get the screening tests done for the tumor markers ( WWW.WWWW.WW uk/understanding/analytes/tumor_markers/glance-3.html).
In this post I have given the links along with the answers for your further reference.
Wish you Good Health
Regards
Dr. Naveen Kumar

Answered by

Dr. Dr. Naveen Kumar Nanjasetty
Otolaryngologist / ENT Specialist
Practicing since :2001
Answered : 2545 Questions
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