Hypothyroidism is an expected sequela of total thyroidectomy.
Although, you are taking Synthroid, you are still experiencing symptoms of hypothyroidism (depression, inability to concentrate, fatigue, slurred speech, confusion, weight gain and difficulty losing some, etc.)
You should talk with your doctor about changing the dosage of Synthroid or switching on other brand of hormone or getting combination of T4 and T3 hormones.

How often do you visit your endocrinologist?

I had a thyroidectomy over a year ago now, Oct. 23, 2007. I still am trying to get my dosage right. I've been bounced around on different dosages of synthroid. Now I'm back to 100mg. See how that works. I'm feeling weak at times and having a hard time concentrating. I'm going to school right now, so it's hard. It's a long process for some and a long road. So hang in there and I hope you feel better soon.

I was diagnosed with papillary thyroid cancer (27yo), had my total thyroidectomy a little over a week ago (Jan. 27, 2009), and my doctor said that I would begin experiencing signs of hypothyroidism in about 3-5 days. It has been 9 days. Besides having a harder time remembering things everything is normal. I have really watched what I've been eating and have lost 2lbs. I'm just a little anxious for everything to start hitting like the tiredness and weight gain, because I get married in 3 months (hopefully the dress will still fit

I also had my entire thyroid removed because of cancer. It took more than a year to get my dosage right. Make sure you get regular blood tests and have your doctor adjust your medication. I personally found that a combination of T3 and T4 worked best for me (although the research is inconclusive).

Symptoms of both hypo and hyperthyroidism can be really difficult.

For Strickler: You shouldn't gain much weight in a short amount of time. Your doctor did give you thyroid medication, right? If so, you may not have any problem at all.

6 years ago I had cancer of the thyroid and it was completely removed. I am very tired every day, foggy and dizzy too. Is this what I should continue to expect the rest of my life? I take synthroid as well as cytomel. I have had clean ultrasounds every year and now I am told that I have multiple nodules and enlarged lymph node. Is this something that is common after 6 years? How worried should I be?

What is your TSH level? How often do you get it checked?

It took me a long time to come even close to a dose that worked for me. I kept asking myself and the doctors, "will I ever feel normal again." Some people find that they can just take their pill and go on with life. Other people (like us), are much more sensitive to small dose differences or tiny fluctuations in our medication.

I am also taking both Synthroid and Cytomel. Personally, I found that I can think much more clearly now that I'm on both. I couldn't concentrate before. I am a pretty articulate person, but I had trouble coming up with words to finish a sentence.

If your doctor is following the guidelines for cancer suppression, he or she wants your TSH to be less than 3 or maybe less than 2, depending on your risk for cancer recurrence. The lower your TSH, the lower your risk of cancer regrowth. Some people feel great between 1 and 2. For others this is too hyperthyroid, which can bring on symptoms, including fatigue, aches and pains, difficulty sleeping, anxiety, etc. In addition, prolonged hyperthyroidism can cause osteoporosis. Unfortunately, we as patients need to make the ultimate decision about what risks in one direction or the other we are willing to accept.

Also unfortunately, it looks as though you are having other on-going concerns with possible regrowth. I'm assuming you went through Radioactive Iodine therapy, right? Have they done any thyroglobulin tests in addition to the ultrasounds? This is a hormone secreted by any thyroid cells. If there are any present, they should secrete this hormone. My doctor says I need to have a thyroglobulin test every year for the rest of my life. So far, I've been clean. I haven't had an ultrasound since before my surgery, but there is probably a specific reason why you are having them done.

Have they done a biopsy on your nodules? If so, what did they say? Is the doctor taking a "wait and see" approach and going to send you for another ultrasound in six months or so? Or does he recommend surgery?

I don't know how worried you should be. The majority of thyroid cancers are very slow growing and treatable, even if they recur. What type did you have?

Sorry about the long post. I start talking about this stuff and I just can't stop. Please write back with more information concerning my questions and maybe we can be of more help.

I found it very helpful to read these posts. I had my total thyroidectomy last November (0 and am really struggling - especially since the RAI in March 09 (before that I was on T3 only which was up and down). The first week or so on 50mcg T4 I felt good - back to my pre cancer self (better than in years) but then got tired. So I was put up to 100, then 150mcg which was too much for me and I went hyper. Since then I have been down at 125, then 50 now 100 again. I've been mucking about with my own dosage which probably hasn't helped. But also I've had to find out for myself the fact that taking a multi vit with iron and calcium will interfere with absortion unless you wait 4 hrs between taking it and your T4. I hadn't.

I just feel all over the place, one day Ok, the next in a total fog. I currently struggle to wake after 10hrs of sleep and then hit a wall of tiredness at about 2pm. I have no energy to see people or do anything and I'm self employed so that's pretty stressful! This has to get better right? I have just requested to see an endo as I have not yet seen one just the cancer specialists and my GP who are not expert at this). I have probably read way too much online but I am concerned I may have low functioning adrenals as I had symptoms of that for years before the cancer. I read that that can affect the way you convert T4 to T3. And then I wonder if it's not working because I need the T3 too... Gahhhh it's so so so complicated. I'm hoping the endo will be willing to explore this properly. It's just so frustrating as I feel worried that the doctors won't investigate these things and I will never feel the way I know I can. Obviously having a low day but there we go. Has anyone has experience of getting their cortisol levels checked (to check for adrenal function)? Any help you can offer would be appreciated.
Thanks

You can take T3 and T4 together. It helped me a lot. Also, you shouldn't mess with your thyroid hormones yourself. It takes at least 3 months to adjust to a new dosage. If you change it yourself every time you feel bad, you're never going to get a consistent blood level for the doctor to test. There are dosages between 50, 100, and 150 that the doctor may prescribe. Remember that the doctor that treated your cancer may want to keep your TSH lower than the normal range in order to suppress future cancer growth (some want it below 2, others below 1). Make sure he consults with the endo about this.

Good luck.

Well, I had a total thyroidectomy with central neck dissection on 10/8/09. There were a few complications and surgery took way longer than they planned. My neck is still pretty swollen and stiff, my voice is not totally back, I am tired, achy in all my joints and not remembering things too well. I get emotional on the very low days and never really feel "normal" I am taking the levathroid and last blood test showed tsh of almost 5. I am scheduled for radioactive iodine on 11/18/09 and have been reading conflicting researches about side effects from that test. I am at the point where I do not trust any of the doctors. Their don't ask, don't tell attitude drives me crazy. I am very impatient and angry with the way they treat patients. Anyway, the lab tech told me to buy lemon drop candy and bring with me to the radioactive iodine procedure and to start sucking on the candies right away. However, I have read research that says that you should not start using the candies until 24 hours after radiation. Any thoughts?

Are you on the low iodine diet? Have you prepared your house so as to minimize the RAI exposure to others in your house (don't forget about the pets--they are at risk of thyroid damage if they come into contact with it, too) and so as to minimize clean-up afterward? Did you get a prescription for anti-nausea medication in case you feel sick (I definitely needed it)?

I started using the candies a few hours after I got home. Yes, I agree, there are conflicting reports about this. The study I think you're talking about has a few flaws (not being double-blinded, etc), but otherwise, it seems reputable. Personally, I think bringing the candy and starting on it right when you get the pill sounds a bit silly. It takes time for it to get to the salivary glands. If you feel tightness or pain or anything in your cheeks, I would start on the candy right away, but otherwise, you could probably wait 24 hours if you think that would be better for you.

As for the other stuff, don't worry about getting your TSH normal (or even feeling normal) until after you start on the Synthroid/levothyroxine. Cytomil/Levathroid work differently and so the dosage isn't going to be the same. It is going to take monitoring over several months to get your dosage right. Just don't let them throw your dosage up and down too much. Small changes can have a big effect. For example, if 100mcg is too low, starting you on 150 might be way too high. Ask to try 125 and see how that works, first. If it's close, but not quite there, try 137. And don't alter the dosage yourself. A lot of people really mess things up that way. And if your TSH is right, but you don't feel right, ask to try a combination of Levothroid and Levothyroxine (T3/T4 combo)--it worked for me. Also, I cannot stress enough how important it is to take your pill on an empty stomach at the same time every day. Follow the directions about how long you have to wait to take certain things, like iron, calcium, etc.

If you don't trust the doctor monitoring your thyroid cancer or your thyroid levels, that's not good. For one thing, you need to be able to ask questions and get a clear, honest answer. Personally, my ENT was great and even though I moved four hours away, I still go down to see him every 6 months because I trust him. You need to find an ENT or Endocrinologist experienced with treating thyroid cancer that you can trust. Otherwise, you will never feel secure.

Please feel free to write back if you have more questions. A lot of people on here have been through what you are going through and we are happy to help make it easier for others in any way we can. Best of luck to you.