Thyroxin Dose After Thyroidectomy for Papillary Cancer

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Question

Following a complete thyroidectomy 18mo ago (papillary CA) I am now on 250ug thyroxine. Key question is: If I am exercising more, (trying to run 7kms, 3x/w) should I be raising my thyroxine dose. I would imagine that under normal circumstances, metabolic needs would rise hence a greater need for thyroxine.Compared to pre-thyroidectomy running, I now need 2-4 days recovery time after a run – previously running every 2nd day. If I don’t run, my energy levels are certainly better. When I do run, there is a definite accumulated lag time in my recovering energy, and subsequently need to take 7-10 days off exercise. I am 6″2′, weighing 94kg.

Appreciate your thoughts.

Dr. Christopher Hume-Phillips

Response

Your dose of T4 may be making you hyperthyroid, and possibly more so than needed. Hyperthyroidism certainly could affect your running. Check the TSH. Then discuss with your MD the desired level. This could be “well suppressed” (+/- 0.1uU/ml), or more likely, as in most patients thought to be cured, 0.5-1uU/ml. It is a decision that is based on all of the facts in the circumstances.

L De Groot,MD