u/Antenler

In December 2024, I had a total thyroidectomy for thyroid cancer, followed by radioactive iodine (RAI) about 6 weeks later.

After surgery, I developed several symptoms, including erectile dysfunction, brain fog, air hunger, low energy, and generally feeling like I wasn’t myself. I also temporarily went back on Ritalin with my doctor’s approval because I already had an ADHD diagnosis and had used it years ago.

During this period I saw multiple doctors, but none of them solved my problems. Eventually I started researching the medical literature myself and used AI as a tool to better understand thyroid hormone replacement.

My endocrinologist initially prescribed 12.5 mcg of T3 once every morning. It didn’t help. Then we tried adding another 12.5 mcg in the evening, which actually made me feel worse.

What finally worked for me was:

• T4: 150 mcg daily
• T3: 5 mcg three times a day, approximately every 6 hours

I also take my first T4 and T3 dose as a “pre-wake” dose, usually 2-4 hours before I actually get up (when I wake up to use the bathroom). I learned this approach from Paul Robinson’s CT3M protocol.

With this schedule, my FT3 stays in the mid-to-upper part of the reference range, FT4 stays around the middle of the reference range, and my TSH is usually between 0.2 and 0.6.

For ED, I also underwent ESWT and exosome therapy. In addition, I take:

• Cialis 5 mg daily
• L-citrulline 3 g daily
• Pycnogenol 60 mg daily
• Panax ginseng 3 g daily (cycled: 2 months on, 1 month off)

Today, my ED is completely gone. In fact, my sexual function is better than it was even before surgery. I regularly have sex two or even three times a day.

Before surgery, I needed 100 mg sildenafil to get reliable results. Now, daily 5 mg Cialis works extremely well. I could probably stop taking it, but since I’m sexually active almost every day, I prefer to continue it.

My air hunger has completely disappeared. I no longer breathe through my mouth. My brain fog is gone, and my energy levels are excellent.

Interestingly, even before my thyroidectomy my thyroid labs were considered “normal” (TSH around 1.5-2.0), yet I still had chronic air hunger and often breathed through my mouth. Those symptoms are now completely gone as well.

I currently weigh 106 kg, so I may need to adjust my T4 dose if I lose a significant amount of weight.

I’m sharing my experience because I know many thyroidectomy patients struggle despite having “normal” lab values. This isn’t medical advice—it’s simply what ended up working for me after a long period of trial, error, and discussion with my doctors.

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I read many post in this sub and I almost decided royals updated turquoise color is the best. And they have correct animal as horse. But interior plaque is wrong and they don’t have the correct one. For speedy p9 turquoise it should be ah24 but my seller told me factory doesn’t have this.
So which factory have the correct stamp ? What is your experiences?