Should T3 and T4 levels be monitored post thyroidectomy for effective nmangement

Posted on Fri, 12 Jun 2015 in Thyroid Problem and Hormonal Problems
Question: I am post thyroidectomy at age 24. Now I'm 72. My tush levels are consistently too low...tho the dose has been weaned gradually for 2 years. It is being monitored by tosh only. Would it be better if my doc used t3 or 4 to monitor?
Answered by Dr. Shehzad Topiwala 1 hour later
Brief Answer:

Detailed Answer:
I follow your point.

However, the vast majority of thyroid experts worldwide use levo thyroxine ( of which synthroid is one brand name) for the treatment of an under-active thyroid ('hypothyroidism')

Scientific guidelines have consistently recommended the use of levo thyroxine for this purpose and discouraged the practice of using armor thyroid,because of the unfavorable side effects tat can occur with armor.

When I see someone like you in my practice, I would judiciously adjust the dose of synthroid over the course of several weeks to arrive a stable dose that keeps your TSH in the range of 1 to 2, with Free T4 levels above the mid-normal range (but well under the upper limit of the normal range for that lab).
This is typically not every difficult for an endocrinologist to achieve.

Regarding your question as to whether or not T3 /T4 need to be checked, I would say I follow only TSH and Free T4, as is the most common practice globally.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Shehzad Topiwala 12 hours later
I've been followed by many endocrinologists since age 12. Will review this with mine now. It was even more frustrating on levothyroxin, though.
I'll follow up.
Answered by Dr. Shehzad Topiwala 5 hours later
Brief Answer:
Follow up

Detailed Answer:
Best wishes.

I just noticed a minor typographical error above in my first response.

" typically not every difficult for an endocrinologist to achieve.' was supposed to read
' typically not very difficult for an endocrinologist to achieve.'

I am sure you figured that
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Shehzad Topiwala


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