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Dr. David
Dr. David, Other
Category: Endocrinology
Satisfied Customers: 45622
Experience:  Experienced physician, undergraduate studies at MIT, studied Engineering, qualified to answer your questions.
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If you have had a partial thyroidectomy could that trigger

Customer Question

If you have had a partial thyroidectomy for cancer could that trigger you to develop Hashimotos? My TPO antibodies are now high and I have serious brain fog.
JA: Have you seen a doctor about this yet? What medications are you taking? Anything else in your medical history you think the doctor should know?
Customer: I was on Tirosint and just changed to Armour with no improvement
JA: OK. Got it. I'm sending you to a secure page on JustAnswer so you can place the $5 fully-refundable deposit now. While you're filling out that form, I'll tell the Endocrinologist about your situation and then connect you two.
Submitted: 12 months ago.
Category: Endocrinology
Expert:  Dr. David replied 12 months ago.

This is Dr. David

a partial thyroidectomy would not trigger hashimotos which is an autoimmune condition where your body makes antibodies which attacks its own cells.

many conditions can cause brain fog.

what is your TSH levels? hashimotos can make it difficult to keep your thyroid levels normal since these TPO antibodies can flare up and down which can cause the remainder of your thyroid to make more or less thyroid hormone.

give your thyroid cancer surgery, your doctors could be giving you extra thyroid hormones to suppress your TSH levels down to less than 1.0 or less than 0.5 to decrease chances for your thyroid cancer to come back.

did you receive oral radioactive I-131 therapy after your thyroid cancer surgery to decrease the chances of your thyroid cancer coming back?

Customer: replied 12 months ago.
no radioactive iodine. TSH is around .5 it has fluctuated post pregnancy from 4.00 to now finally low again after increasing dose and to Armour. The brain fog started 3 months after surgery 6 years ago and continues to get worse.
T3 uptake = 32
T4= 5.4
Free T4 = 1.7
T3 reverse = 14
Thyroglobulin Antibodies= 1
TPO = 51
T3 total 196
T4 free = .9
T3 free = 5.1
Expert:  Dr. David replied 12 months ago.

do you have any other medical conditions which can cause brain fog?

excessive anxiety symptoms can cause brain fog

one option is to remove the rest of your thyroid surgically or with I-131 dosing so your hashimoto antibodies such as TPO antibodies will have no thyroid to inflame

and then go on thyroid hormone levels to keep your thyroid hormone levels steady.

armour also is very variable in how much thyroid hormone is in ease dose

this is a good article for you to read about armour

"So why do I and most other endocrinologists refuse to use desiccated thyroid?

There are a number of reasons. First and foremost, desiccated thyroid preparations have an unacceptable level of variability batch to batch, often resulting in unacceptable variation in thyroid-stimulating hormone. The current USP standards specify that the amounts of levothyroxine and liothyronine in each 65 mg of desiccated thyroid should be 38 mcg and 9 mcg; however, the actual amounts vary considerably. According to the American Society of Health-System Pharmacists “Big Red Book,” the mean concentrations of levothyroxine and liothyronine in each 60 mg of desiccated thyroid ranged from 8.8 mcg to 59 mcg and 7.9 mcg to 18 mcg, respectively."

Customer: replied 12 months ago.
I've only been on Armour for 2 months. Prior Tirosint and synthroid. So hashimotos is just treated with synthroid or radioactive iodine? no other Tx? I have no other thyroid symptoms except brain fog - no anxiety, depression, weight gain, temp good.
Expert:  Dr. David replied 12 months ago.

hashimotos is an autoimmune disorder which is difficult to control as your own body's immune system makes antibody levels which go up and down which can cause your thyroid hormone levels to go up and down.

to get rid of this up and down, surgery to remove the rest of the thyroid gland can work

or I-131 to destroy the thyroid gland.

you should talk to your endocrinologist about these options

are you seeing an endocrinologist?

Expert:  Dr. David replied 12 months ago.

let me know if you have other questions.

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you can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questions

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