Worsening symptoms...menopause vs. complications of thyroid cancer

Posted by glickteig @glickteig, Dec 11, 2024

I was first diagnosed with Papillary Thyroid Cancer (T3a) in April 2016. I underwent a complete thyroidectomy & neck dissection followed by 2 courses of I131.
Initially I lost my voice for 6 weeks, but gradually it came back. Almost immediately following surgery I experienced shortness of breath (SOB) and acid reflux. After several visits to (2) ENT doctors and (2) pulmonologists with scopes and lung function tests, it was determined my right vocal cord is paralyzed in closed position making it hard for me to breathe. Okay...I just huff and puff a little more.
Over the past 8 years other symptoms are getting worse including extreme fatigue, night-time migraines, elevated night-time blood pressure, weight gain, achy joints, cholesterol, blood sugars, etc. TSH lab work done every year and providers insist my Synthroid dosage is what it should be. They attribute my worsening symptoms to menopause. When I ask if there is something we can do to correct these problems providers are all reluctant to prescribe anything due to my history of thyroid cancer. All they recommend is I talk with a dietician which I have done twice.
I keep a food diary and they say I eat healthy, but health problems are interfering with my life. They say symptoms are hormone related but they will not prescribe any HRT. I am feeling so frustrated and tired of the run-around. I want to be able to enjoy life, but just don't have the energy. Also am alarmed at my high blood sugars and high cholesterol and SOB. I do not want to have a stroke on top of everything. Anyone have any advice?

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In rereading your reply .. are you insinuating that thyroid cancer is caused by high cholesterol or BP?
Thyroid cancer is caused by high radiation Xrays, as a Radiologist, cancer in your thymus.
I know that 4 years prior I had two xrays taken by a Chiropractor. I had to open my mouth I told my surgeon. Then I asked who checks her xray machine? I got no answer. Then I questioned our Power Board but no. My father died of Lymphoma diagnosed by a post-mortem aged 83.
That is why I want the thynus identified. It's big in a child but shrinks as we get older as only required as a young child to maintain immunity of childhood illnesses.
Every year after sending a reminder to my surgeon I ring Radiography Department if there is an appointment made. I was done in our base hospital. In Feb 2020 4 months after Stroke. The Endocrinologist tried postponing it to 6 months but as I said surgeon and anaesthetist team over rode said a.s.a.p.
There are a lot of risks in RAI yteatment. Were you given these?
Another hot, muggy day with nlue skies in NZ. Cheri JOY

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No, I am not insinuating my cancer was caused by either BP or high cholesterol. I had neither until post thyroidectomy.
I work in radiation oncology and radiology for the past 36 years and understand the thyroid is highly susceptible to radiation exposure. I accept my cancer was likely a hazard of the job. It is all the issues I have had since my surgery that frustrates me.

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@glickteig

Yes, I don't understand the provider's reasoning either. This last appointment my husband went with and was very outspoken about trying to adjust Synthroid dosages, but she dismissed it and was trying to tie my symptoms to other conditions (menopause, nutrition, etc.).
I have a follow-up appointment next week with her and am definitely asking for a referral to an endocrinologist or thyroid cancer specialist. Thank you.

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I find it very concerning when a doctor wants to tie issues to areas which cannot be proven (menopause, nutrition), when a change in medication or dose, will cause a reaction which can prove the association of thyroid and/or medication to the symptoms you are having. I had one doctor tell me to wait 6 months to “give the medication a chance” when I was on a high dose of Synthroid…. I asked her if she would wait 6 months dealing with constant leg cramps, headaches, nausea and extreme fatigue to see if a medication worked? My new Endocrinologist discontinued the medication and the symptoms went away within days!! I do not miss the leg cramps!!! Unfortunately, after a little while the symptoms of Hypthyroidism started, so I had to try a new medication, but that showed me that the symptoms are related to the medication and dosage and not just “aging.” The dosage of Levoxyl is about a quarter of the dosage the previous Endocrinologist had me taking of Synthroid (and she was talking about raising it!).
Since you had a total thyroidectomy you cannot just stop your medication, however asking to increase the dose to see if it helps with the side effects while lowering your TSH even more, might work. Maybe you can use the old “Let’s just try it and see approach,” with the doctor.
I am fortunate that I do not need referrals for doctors; I can just go. However if your doctor will not give you a referral, maybe you can tell her you want a second opinion….from what I understand, they have to grant second opinions. You might also try calling your insurance company and ask about seeing a cancer specialist…they might not require a referral since you want to prevent regrowth and that will save the insurance company money. Definitely keep trying!!
Good luck!

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@koh

I find it very concerning when a doctor wants to tie issues to areas which cannot be proven (menopause, nutrition), when a change in medication or dose, will cause a reaction which can prove the association of thyroid and/or medication to the symptoms you are having. I had one doctor tell me to wait 6 months to “give the medication a chance” when I was on a high dose of Synthroid…. I asked her if she would wait 6 months dealing with constant leg cramps, headaches, nausea and extreme fatigue to see if a medication worked? My new Endocrinologist discontinued the medication and the symptoms went away within days!! I do not miss the leg cramps!!! Unfortunately, after a little while the symptoms of Hypthyroidism started, so I had to try a new medication, but that showed me that the symptoms are related to the medication and dosage and not just “aging.” The dosage of Levoxyl is about a quarter of the dosage the previous Endocrinologist had me taking of Synthroid (and she was talking about raising it!).
Since you had a total thyroidectomy you cannot just stop your medication, however asking to increase the dose to see if it helps with the side effects while lowering your TSH even more, might work. Maybe you can use the old “Let’s just try it and see approach,” with the doctor.
I am fortunate that I do not need referrals for doctors; I can just go. However if your doctor will not give you a referral, maybe you can tell her you want a second opinion….from what I understand, they have to grant second opinions. You might also try calling your insurance company and ask about seeing a cancer specialist…they might not require a referral since you want to prevent regrowth and that will save the insurance company money. Definitely keep trying!!
Good luck!

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Agreed...will ask my provider one more time to adjust Synthroid and if she says no, I will be seeking a second opinion.

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Hi,
After having a total hysterectomy at 46 and HRT following this (10 yrs) and an abrupt stop when I received a breast cancer diagnosis, I realize now how little many doctors know about HRT and how important it is. I too had thyroid cancer (medullary) and a neck resection as well. Not one Dr was willing to put me back on HRT! You need to be your own advocate and go armed with HRT facts. Perhaps search for a Dr that is willing to let you try some of the newest HRT. Research tells use that hormone therapy is not ALWAYS bad for cancer survivors. It makes me angry when they are dismissive. Best of luck… you deserve better. 💕

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Thanks for the encouragement....hope you are doing well with your post surgical treatment.
Healthcare requires us to be our own advocates...I am doing some research now.
Best of luck to you as well.

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Hi
I went through a hysterectomy and talked into it by my surgeon who was repairing my indirect ingroinal hernia.
I was very ill after as blood transfusion and infections took their toll.
I could not do the pelvic exercises at the time and later was too late.
Within 2 years after an ovary was removed I went into post post menopause at 40.
In UK I tried the patches but an instant itch and redness stopped those. The cream brought me out in ecema behind the legs.
Them I went for an implant of estrogen yearly for the next 6 years in UK.
Years later my Locum said to use estrogen cream with your finger. Put a little on. Daily or how you feel.
I had thyroid cancer too. Papillary. Removed with 12 lymph nodes with 2 affected. This year 4th I have had 5 tests inconclusive of cancer ? as three areas have calcified. On 6 monthly CT scans.
Some research shows that oestrogen and cancer are connected. But they are missing the point that sometimes it should be the choice of the patient rather than what the medical proclaims to be a risk.
I refused RAI treatment and suppression of TSH after my thyroidectomy. My choice and I was low risk. I refused radiation after the breast surgery with no return.
Fight for your right. But do think about OVESTIN CREAM as an alternative. I use it sparingly as I have been told that it can interfere with my thyroid synthroid med.
Do take care.
For Dr to prescribe OVESTIN Cream should not be a problem.
Cherio JOY
And in 2005 a carcinoma in the milk duct in Right Breast.

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Hi again
Synthroid my thyroxin.
Your TSH should be monitored regularly. Along with T3 and if low take 2 brazil nuts a day. The T4 shows if you
are taking too much - over 22 or not under. But during adjustment to your TSH - what your surgeon in my case wants you at. Mine is about 2. But research shows 1.7 better - at low normal.
Research Gary Clayman's direction. He is No.1 surgeon USA on thyroid cancer.
I had a general surgeon who was very careful with me .. I had the voice box examined prior to the thyrodectomy.
1 hour before op and after 1.5 saline drips I had a thick blue dye put in. This would show where lymphs nodes were compared with veins etc. Reading Clayman's book. Atlas Head and Neck .. shows every single operation so I read about mine after. The surgeon has to clip back this and that to have them out of the way. There are lots of things which can get in the way.
Voice changed - I'm a Soprano singer. It took about 3.1/2months to settle my voice.
The dye was most important.
It was the Stroke earlier with AF and Day 4th diagnosed with Thyroid Cancer which was Papillary.
So thyroid cancer caused the irregular heart beat which a clot from it caused the stroke.
Normal TSH is 0 .5 - 4.2. I see they have now changed here to 0.25.
Below this is hyper and you need less thyroxine. Above 4.2 you are hypo and need more thyroxine.
I changed to Synthroid as it is more dependable to stay at your level. It is weight sensitive. I changed to the 50s as they are white and I'm allergic to sulphites and it seems aluminium in the yellow ones.
I work with my surgeon. My Endocrinologist was 'pushy' to say the least. After the stroke she put me on Metoprolol when I said NO it will make me breathless and it did. But with no followup I remained on it for 1 year 5 mths. It did not control my H/R. No Beta blocker contrilled my H/Rate but CCBs did.
Cherio Tuckie. (JOY)

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Thank you for sharing your experiences. I am seeking a second opinion re: my thyroid cancer and rising TSH.

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@glickteig

Agreed...will ask my provider one more time to adjust Synthroid and if she says no, I will be seeking a second opinion.

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@glickteig, if you are considering a second opinion at Mayo Clinic, you can self-refer. Here's the link to get started http://mayocl.in/1mtmR63

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