choking on liquids after thyroidectomy

Your thyroid is a butterfly-shaped gland located in the front of your neck. thyroid, levothyroxine, thyroidectomy, liquid levothyroxine, levothyroxine dose. J Clin Med. Scerrino et al. I'm glad to know I'm not the only one. 2009 Dec;146(6):1174-81. doi: 10.1016/j.surg.2009.09.010. I'm 6 weeks post surgery. Hopefully you'll find some explanation! The Annual International Thyroid Cancer Survivors' Conference and Regional Workshops, Download our free Low-Iodine Cookbook (PDF), Rally for Research and Thyroid Cancer Research Grants. It's more strained. 2023 Jan 11;8(1):140-149. doi: 10.1002/lio2.1009. It can be quite painful but I think it is a common side effect from the surgery. Pain not bad. Thyroid cancer rates have increased at least 3-fold across the last few decades, 1,2 with over 63 000 incident cases diagnosed annually. I was diagnosed with a large tumor - a follicular neoplasm - on Feb. 19th after a biopsy was done. We found no correlation between dysphagia and patients' age, the specimen volume, and patients' body mass index (Spearman's rank correlation coefficient = 0.1, each). I've been to my local GP who has sent me for tests after tests as she really couldn't work out what the problem was. However, you also have to consider the role ofthe thyroid's calcitoninand the parathyroid's parathormone in calcium ion use as well; calcitonin moves serum calcium into the bones, parathormone moves it out of them. If you have a large goiter or a large cancerous . Theclubswinger230462 The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. The https:// ensures that you are connecting to the Furthermore, Jin et al. Do you have any tips on this? Optimizing Levothyroxine Dose Adjustment After Thyroidectomy With a Decision Tree. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. As reported by Del Duca et al. FOIA It has worked really well for me. Individually-tailored thyroxine requirement in the same patients before and after thyroidectomy: a longitudinal study, Levothyroxine replacement dosage determination after thyroidectomy. When I would choke the only option was to bring it up and when it did I noticed most of it was mucus. I had the same results. Pirola I, Daffini L, Gandossi E, Lombardi D, Formenti A, Castellano M, et al. Good luck to everyone - I hope you find a solution to your problems that makes you feel healthy and well again! This is because post-surgical consequences often include a sore throat and such foods might enhance the level of discomfort. Administration of the optimal dose of levothyroxine (LT4) is crucial to restore euthyroidism after total thyroidectomy. My doctor told me after the surgery that I have a "hole" in my throat now and to give it a good year before it completely heals. I think it may have to do with everything in that area getting used to the added scar tissue. 3 The primary treatment modality for thyroid cancer is total thyroidectomy. The authors underlined the effectiveness of liquid LT4 over the tablet formulation to achieve the proper TSH levels in patients treated with total thyroidectomy for thyroid cancer. It has helped but some days I still seem to choke. Concomitant ingestion of calcium supplements, ferrous sulfate, proton-pump inhibitors, bile acid sequestrants, and sucralfate can also influence LT4 absorption and/or metabolism (6, 7). In 2014, Di Donna et al. I totally forgot about my swallowing issues and choked badly enough that I had to stop and pull off the road. Finally, in 2019, Al Dhahiri et al. 2022 Sep 19;11(18):5486. doi: 10.3390/jcm11185486. Nonetheless, these schemes are of great utility to start the replacement therapy approaching the best dosage, but keeping in mind that changes during follow-up can be necessary according to the TSH values that are to be reached in every case. Twenty articles were selected for inclusion in the review. More recently, however, increasing attention has also been paid to the formulation of LT4. [Intraoperative avoidance and recognition of recurrent laryngeal nerve palsy in thyroid surgery]. I feel like the muscle in my throat is very weak. The tape will fall off after a few weeks. Wanda's arrival to Temple's Voice, Airway & Swallowing Center was long overdue, she says. Giandalia A, Russo GT, Romeo EL, Alibrandi A, Villari P, Mirto AA, et al. I was terrified to eat, especially alone, for fear of choking and now I am able to eat without worry. Any input on my situation is appreciated. Since you can breathe and swallow without any problems, it's unlikely there's anything obstructing your throat. I never eat chips and meat of any kind seems to stick in my throat and cause the spasm frequently. In a recent study, soft gel capsule and liquid formulations given during breakfast were compared for their effects on thyroid hormone profile. During your surgery, your surgeon will examine your whole thyroid gland and remove the parts that have cancer. These papers addressing the liquid form report some promising results also in patients who have undergone thyroidectomy (12, 13). Do not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. I dont have trouble swallowing but its not as natural as it used to be. For some reason I do not remember anything from when I was 14!!! The aim of this study was to investigate temporal ultrasound measurements of the hyoid bone displacement during swallowing following thyroidectomy in women and to relate these measures to age, clinical outcomes, and upper digestive airway symptoms. Predicting thyroxine requirements following total thyroidectomy. In particular, the rate of patients in the hypothyroid range was significantly higher in the solid form LT4 group (13.5%) compared with the liquid LT4 group (1.8%). Table 1 But for some reason every once in awhile I choke on liquids, and when I do this big air bubble blocks my air way and is nearly impossible to get out it seems. American Thyroid Association (ATA) guidelines help in determining the class of risk in patients, mainly represented by the presence of distant metastases, and the response to the initial treatment. After my second thyroidAfter my second thyroid surgery I noticed I was having to "cough" to clear my throat a lot. Oh dear..hoping this gets better..endo said to see the surgeon since its a surgical issueApril 13th I will see him! The experimental group consisted of 300 patients (202 females and 98 males) who underwent thyroidectomy . This site needs JavaScript to work properly. - would appreciate reply. But I'd still love a perfect steak meal right now! Similarly, Cappelli et al. I still have the chocking sensation but it is because I've just had my fourth neck dissection and the scar tissue build up is quite bad. Their analysis showed BSA as an independent predictor of the LT4 dose. Some gastrointestinal conditions and their treatments can contribute to suboptimal LT4 performance by altering gastric acidity and thereby reducing the bioavailability of LT4. Hi all, And if the parathyroid glands were removed along w/ the thyroid, that needs to be dealt w/ via therapeutic medication too. I've been drinking lots of fluid but it hurts to cough with my throat being so sore. After a thyroidectomy, some people experience symptoms of low calcium such as burning, tingling, or numbness in their hands, feet, or around the mouth. before surgery i had this weird cough like if i was smoking, after surgery i still have the same cough! Furthermore, Jin et al. HHS Vulnerability Disclosure, Help 10 months on I have had swallowing problems to extent that sometimes I choke and vomit. official website and that any information you provide is encrypted This might imply a long-term treatment with LT4 to the extent that in these patients it is even more important to individualize the therapy to balance accurately its supposed benefits against the potential risk of adverse effects during follow-up. My endo made me seem like he had never heard of it. On the other hand, when the formula proposed by Elfenbein et al. I have a total thyroidectomy three weeks ago. I also noticed a slight inflammation that I'm assuming is normal for the trauma to the area of the neck that was worked on. The most common ones that lead to the necessity of LT4 dose adjustments include lack of compliance, changes in LT4 formulation, dosage errors, increased serum levels of T4-binding globulin, body mass changes, and dietary habits. I got my thyroid gland removed about a month ago (through RAI), and I've been noticing that it is difficult swallowing. undefined will no longer be visible to you including posts, replies, and photos. Hello everyone! It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Thyroid Hormone Profile in Patients Ingesting Soft Gel Capsule or Liquid Levothyroxine Formulations with Breakfast. I finally found an ENT doctor who listened to me & suggested seeing a swallowing specialist. It feels like there is always a lump of mucous in my throat. (32) studied 103 patients who had undergone total thyroidectomy for benign diseases. May 4, 2015 7:40 PM. If you want to confirm this, have a look at the scientific evidence in my paper in the following link. How long till the sore throat goes away? Have questions about navigating your Inspire support community or need assistance from one of our Inspire Moderators? As far as my understanding goes, this is due to the lowered levels of thyroxine, resulting in a lowered basal metabolic rate and therefore lowered response to stimuli; it also results in the skin being dry and, if thyroxine levels are excessively low, mental deficits can result. Talk to your doctor. I had a second surgeryI had a second surgery mid-July and noticed a cough. Results. Carhill AA, Litofsky DR, Ross DS, Jonklaas J, Cooper DS, Brierley JD, et al. When i eventually got to normal fluids i found i could control my swallow with hot drinks. I had my thyroid removed about 10 days ago. Another important issue is the possible necessity of a suppressive thyroid hormone treatment in those patients who have undergone a total thyroidectomy for a differentiated thyroid cancer (DTC). Only eight of these studies also contained a proposal to work out a scheme for the prediction of the LT4 requirement after thyroidectomy. (16) and Jin et al. 2022 Sep 13;2022:1118745. doi: 10.1155/2022/1118745. (31) performed a prospective randomized study in 2016 of 155 patients who had undergone total thyroidectomy and evaluated the patients mood state and their self-perception of mental well-being during a follow-up period of 2 months. They reported that moderate thyroid hormone suppressive therapy, with TSH maintained in subnormal to normal levels, was associated with an improvement of overall survival and disease-free survival across all stages of DTC and that aggressive thyroid hormone suppressive therapy (TSH maintained undetectable-subnormal) showed no additional survival benefit (25). Hi clemclem, can you tell us if your thyroid was ablated by RAI or did you undergo a thyroidectomy followed by RAI? . using inhalers to help my breathing 4 times a day. After a while, it goes away. The optimal dosing scheme for levothyroxine after thyroidectomy: A comprehensive comparison and evaluation. Bookshelf This hurts! On the other hand, overt and subclinical hypothyroidism have both been associated with unfavorable changes in several metabolic parameters, including lipid profile and glucose control, as well as with higher blood pressure and insulin resistance, all conditions that may amplify the cardiovascular disease risk in type 2 diabetes. I also had issues with choking on liquids & foods after my TT in 2013. The authors concluded that the liquid form of LT4 can be administered directly through the nasogastric tube without the need for an empty stomach and is more easily managed by a nurse. The chin tuck technique is something that is taught to stroke victims that have swallowing problems. laying down is also difficult. I hope you find a doctor who will take you seriously. POST THYROIDECTOMYJust had total thyroidectomy on 9/18/09. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer, Optimization of thyroxine replacement therapy after total or near-total thyroidectomy for benign thyroid disease. Coughing up thick yellow mucous - difficulat to bring up , don't seem to be able to get a strong cough. Thyroidectomy is the most commonly performed surgical procedure on endocrine glands and its effect on swallowing is common, following both complicated and uncomplicated surgery [1,2,3].Swallowing disorders after a recurrent laryngeal nerve injury are expected, because of the movement dysfunction caused on the larynx, and the damage of the superior laryngeal nerve can affect the sensory . First, Ojomo et al. Cappelli C, Pirola I, Gandossi E, Cristiano A, Daffini L, Agosti B, et al. The authors reported that the TSH level was lower with the liquid LT4 compared with tablet LT4 form, concluding that liquid LT4 is resistant to the sequestration by calcium or iron. Is that normal? We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Influence of high-normal serum TSH levels on major cardiovascular risk factors and Visceral Adiposity Index in euthyroid type 2 diabetic subjects. We offer this Site AS IS and without any warranties. In addition to the liquid LT4, another new formulation of LT4 is represented by the soft gel capsule. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). Sahli Z, Canner JK, Najjar O, Schneider EB, Prescott JD, Russell JO, Tufano RP, Zeiger MA, Mathur A. Laryngoscope. (2) introduced age as a factor to be considered along with body weight to calculate the proper LT4 dose. I was told that coughing is healthy. Methods: We reviewed the current literature available on MEDLINE database, concerning the swallowing disorders appearing after the thyroidectomy. voice loss and swallowing problems after C3-6 Fusion. I choke on liquids even my own spit. PMC I found breathing through them helps a lot. Weight Gain and Asthenia Following Thyroidectomy: Current Knowledge from Literature Review. Pat the area dry. Thyroidectomy and weight gain - Good stories only PLEASE!! Could not breath on my own. I had a Crycopharengeal Myotomy in 2014. This procedure could be a hemi (one lobe) or total (both lobes) of the thyroid. Nevertheless, due to the complexity of calculating the dose, finding a practical and clinically relevant prediction model is yet of limited efficiency. The authors developed two different and very complex formulas (one polynomial and one linear) for predicting the LT4 dose after thyroidectomy, with a rate of correct estimation of 65.8 and 51.3%, respectively. I mentioned it to my surgeon at a follow up appointment since he also deals in sinuses and allergies, he looked at me like I was crazy. I cough and choke when I try to swallow them. Ojomo KA, Schneider DF, Reiher AE, Lai N, Schaefer S, Chen H, et al. In case of comorbidities or advanced age, the low- and intermediate-risk categories should both maintain TSH levels between 0.5 and 2 mU/L (24). The liquid formulation is supposed to overcome the food and beverages interference with absorption of LT4 tablets. 7 years on I'm mostly tube free but when i get a throat infection i need 24 - 36 hours of NG tube fluids to keep me out of hospital and the same if i get a bug - the vomiting sends my swallowing out of sync. The coughing has just stopped. I've been using my breathing machine (airlife) to keep my lungs working at capaciy. Introduction: Oral L-thyroxine liquid versus tablet in patients submitted to total thyroidectomy for thyroid cancer (without malabsorption): A prospective study. In some cases, this surgery causes permanent problems with chewing, speaking, or swallowing. I would like, then, in this week's entry to share with you an update I sent to friends and family last Saturday about what life was like for me in those hours before and after surgery. Nevertheless, long-term treatment with LT4 should be individualized and weighed against the potential risk of adverse effects, and patients who require suppressive therapy should be appropriately selected (8). Furthermore, some gastrointestinal conditions and their treatments can contribute to suboptimal LT4 performance by altering gastric acidity and thereby reducing its bioavailability, particularly in the solid form. Use of this online service is subject to the disclaimer and the terms and conditions. According to the most recent Italian Consensus on Diagnosis and Treatment of DTC, after the initial therapy, patients included in the ATA high-risk category should be maintained at TSH suppression below 0.1 mU/L, unless contraindicated by comorbidities or advanced age (shift the target to 0.10.5 mU/L). Wish it weren't Have the stuck a camera up your nose and down your throat to check your breathing tube is still a good size? If you want to get notified by every reply to your post, please register. (25) in 2015 analyzed a registry of 4,941 patients with DTC who had undergone a total thyroidectomy or near-total thyroidectomy with a median follow-up of 6 years. over a year ago. A study by Peirce et al. They also created a model that takes into consideration only BSA as a unique parameter, competent to predict 64.5% of the corrected dose. I had thyroid surgery in December 2018. I had my thyroid removed about 10 days ago. I'm not noticing it now. What Are The Symptoms and Causes of Heartburn. It's definitely not convenient - I'm unable to go out to dinner with family and friends as I need to be close to the bathroom when I eat - my husbands wonderful and knows what I'm going through, so helps me to keep things "discreet"if we have to go to these family functions. In particular, Benvenga et al. It's been about 24 hours and while I have had a relatively easy recovery, I'm starting to get. An inadequate level of thyroid hormone levels in these patients can be due to several factors. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. Unauthorized use of these marks is strictly prohibited. Moreover, no body weight changes were observed among the whole population enrolled. Al-Dhahri SF, Al-Angari SS, Alharbi J, AlEssa M. Optimal levothyroxine dose in post-total thyroidectomy patients: a prediction model for initial dose titration. If you have a drainage bulb, empty it 2 times a day. I have the same problem,i had tt 2015 and had a RAI treatmrnt after 2 months,those months swallowing is normal,but after a year i had a swollen salivary gland,from then on till now i have a sallowing problem i could not eat steak or any meat,had been to the ENT and they said they cant see any abnormality,i don't know what will be the next test for me,i hope it will back to normal soon .. have read the commits on here you guys scare me. Data were collected and scrutinized from the PubMed database using combinations of the following search terms: levothyroxine, dosing, thyroidectomy, differentiated thyroid cancer, and liquid levothyroxine. Inadequate dosage may result in hypothyroidism or hyperthyroidism, both involving serious sequelae at several different levels. Needless to say, Wing Bowl will not be a future endeavor of mine. So I had a partial thyroidectomy about 7 months ago. No more eating on the bike. Epub 2022 Apr 19. "Following a thyroidectomy in 2004, I was choking all the time," she recalls. It is how we ensure our lungs are clear after surgery. Federal government websites often end in .gov or .mil. I've lost over 20kgs and kept it off! Anyone undergone completion thyroidectomy?? Mine seems to have gotten better, that or people just stopped asking because they are used to it too. The sample was divided into an experimental group (EG) of 20 women who underwent thyroidectomy (mean age = 49.55 years 15.14) and a control . Every doctor I mentioned it to thought I was crazy. Health care providers perform thyroidectomy to treat thyroid disorders. TSH Variability of Patients Affected by Differentiated Thyroid Cancer Treated with Levothyroxine Liquid Solution or Tablet Form. I had my thyroid removed in July 2011. Depends on the possible causes of the difficulty swallowing (related to nerve damage or appearing after uncomplicated thyroidectomy), different types of diagnostic procedures could be used to study patient discomfort, as well as intraoperative nerve monitoring, fiber optic laryngoscopy, endoscopy, pH monitoring, esophageal . Epub 2018 Sep 7. You may have some trouble chewing and swallowing after you go home. Your thyroid surgery options may include the partial removal of the thyroid (also called a thyroid lobectomy or hemithyroidectomy), a total thyroidectomy, or a total thyroidectomy with lymph node removal. It's possible there could be some swelling associated with the healing process. Initially I had a collagen injection on the right vocal cord which helped. I began with milkshakes - they had to be freezing cold for me to have full control over my swallow and one mouthful would take 5-7 swallows. Conclusion: 5ml 2x/day (1 teaspoon). National Library of Medicine Chen SS, Zaborek NA, Doubleday AR, Schaefer SC, Long KL, Pitt SC, et al. This is suspicious for malignancy. Horrible feeling like I was suffocating - did ekg/stata cxr said no hematoma all tests fine . The liquid form in two presentationsa soft gel capsule and as an oral solutionrecently became available for LT4 replacement therapy (10). i imagine continuing to seek an explanation from varying specialists is tiring and w/out positive result probably feels worthless at timesbut i think it's important to continue to seek the answers. Thyroidectomy-related Swallowing Difficulties: Review of the Literature. I just had RAI 5 days ago due to reoccurred Thyroid Cancer. over a year ago. Laryngoscope Investig Otolaryngol. The LT4 dose required for achieving normal TSH values did not differ between tablets and the soft gel capsule formulation. I understand how scary this is for you. When I do get it out, my air way closes so tight I can barely breathe in at all so I just keep choking. You might also have to take supplements after thyroidectomy to balance your calcium levels. FOIA I still can't eat solid food and voice very hoarse. The scar itself and right below it (in the dip in my throat) are so tight, it's terribly uncomfortable. over a year ago. Afterward, Di Donna et al. The diagnostic procedures described can help to identify the mechanisms involved in swallowing disorders, with the aim to choose the best therapeutic option. There's also little adjustments like eating more slowly. eCollection 2023 Feb. Melfa G, Siragusa G, Cocorullo G, Guzzino M, Raspanti C, Albanese L, Mazzola S, Richiusa P, Orlando G, Scerrino G. J Clin Med. Anxiety can also cause this feeling, even if you don't "feel" particularly anxious it's similar to the feeling we get when we're sad and about to cry. At first I took it as prescribed, but then I started only taking it at nightit really worked. contued as i was taken to general floor. These complaints are usually related to superior and inferior laryngeal nerves dysfunction, but these can appear even after uncomplicated surgical procedure. best dr to see is an ENT wishing you well, after my surgery i ended up in ICU. Maybe I'll have answers for many of you too..hoping! Before an over night stay turned into a 6 day stay, Neily (18) included patients who had undergone total thyroidectomy or lobectomy, making their data not homogeneous. Food seems to go so far down my throat and then get 'stuck''. I ended up with swallowing difficulties after my TT, and that's what I do now. 8600 Rockville Pike Symptoms after thyroid surgery may include dysphagia, dysphonia, aspiration, choking, and even dyspnea (10) (11) (12)(13). I had a complete Thyroidectomy nearly 3 years ago (2 days before you to be exact!). Nevertheless, when retrospectively applied by other authors, the rate of patients being reported to be euthyroid at the first postsurgery follow-up was amendable, ranging between 23 and 53.2% (19, 21). ThyCa: Thyroid Cancer Survivors' Association, Inc. the contents by NLM or the National Institutes of Health. These schemes take into consideration a combination of the following parameters: body weight, age, body surface area (BSA), iron supplementation, mineral supplementation, preoperative TSH concentration, sex, or body mass index (BMI). Main proposed schemes for the prediction of LT4 requirement after total thyroidectomy. who developed a Poisson regression formula that takes into account seven factors: four of them were found in previous proposed schemes (actual body weight, BMI, age, sex), whereas the remaining three additional factors were preoperative TSH, vitamin-mineral supplementation, and iron supplementation (21). Italian consensus on diagnosis and treatment of differentiated thyroid cancer: joint statements of six Italian societies. It's not painful, but it's almost like something "clicks" into place when I swallow liquids. My recovery is going well, however, I'm having tingling in my fingers & hands. I had a total thyroidectomy on Feb. 27th, and although the first few days after surgery were a little rough, I have made steady improvement since then. Department of Surgical, Medical, Molecular and Critical Pathology, University of Pisa, Pisa, Italy, Edited by: Bernadette Biondi, University of Naples Federico II, Italy, Reviewed by: Salvatore Benvenga, University of Messina, Italy; Marco Centanni, Sapienza University of Rome, Italy, This article was submitted to Thyroid Endocrinology, a section of the journal Frontiers in Endocrinology. I had my voice intact when I awoke in recovery, because the larynx nerves were stimulated during the procedure, and except for some slight difficulty swallowing ( I am now 5 1/2 weeks post . Twenty articles were selected for inclusion in the review. (28). Copyright 2017 IJS Publishing Group Ltd. Results: Only articles written in English were included. Spicy Food. I think it is called esophageal spasm and mine started after the surgery. I remember the first long bike ride I did after my TT, and I tried to eat an energy bar while riding. The site is secure. Comparison between liquid and tablet levothyroxine formulations in patients treated through enteral feeding tube. I had a really productive cough. Thus, before LT4 therapy is administered, it is of paramount importance to consider, along with the risk of persistent or recurrent disease and the response to the initial treatment, whether poor general health status and comorbidities (in particular, bone and cardiac diseases) contraindicate TSH suppression (14). Thyroidectomy is a safe procedure that is commonly performed for both benign and malignant thyroid diseases. Chirurg. After trying to be as self aware as possible I noticed that the mucus in the area he had noticed would only release in two ways 1) gargling with one of the alcohol based listerine products (I tried the alcohol free and it didn't work as well) 2) eating, within the first few bites the mucus would loosen and go down and clog and require forced removal. All authors contributed to the article and approved the submitted version. It lasted two or three weeks. Even this formula, when applied retrospectively, did not lead to better results. The use of tablets, compared with treatment with the LT4 liquid formulation, resulted in a higher number of DTC patients with TSH values out of range for the ATA risk score (15.7 vs. 3.9%) during 24 months of follow-up. 1 Complications occur in only about 3%-5% of patients after thyroidectomy, with tracheal perforation occurring in approximately 0.06% of cases. Lesson learned. I drank a lot of fluids, it made it easier. greyzak. Many times I'd wake up from a sound sleep coughing, gaging, and eventually vomiting. Bethesda, MD 20894, Web Policies Long-Term Outcomes Following Therapy in Differentiated Thyroid Carcinoma: NTCTCS Registry Analysis 1987-2012. This review examined the literature involving hypothyroid patients who underwent a total or near-total thyroidectomy to understand the problems they generally encounter with their replacement therapy. On the basis of their study, they claimed that patients with mildly suppressed TSH levels were closer to the euthyroid status and suggested that these finding were directly applicable to the management of patients who underwent total thyroidectomy for DTC or benign thyroid disease (26).

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