General Medicine

» Elaine Moore - questionable graves disease please read!!

In response to questionable graves disease please read!! posted by kwild89:

Hi K,
Sorry to be slow in responding.
The total T4 test measures thyroxine that's linked to protein molecules. In this form, thyroid hormone is inactive. These binding proteins (that carry hormones in the blood) are increased by estrogens and certain medications.

So the T4 level can be elevated by either increased free thyroxine or increased binding proteins. Since women can have elevated estrogens, the T4 test is often falsely increased in women. Ever since labs developed tests to measure free T4 directly with the FT4 test, we've recommended that doctors order FT4 rather than T4 levels.

Most often, when the T4 is high and TSH is normal, it's because the T4 level is falsely elevated by binding proteins. To check this, most doctors would order an FT4 level.

Another possibility is that FT4/T4 levels have risen quickly and the pituitary gland, which secretes TSH, hasn't caught up with the change. Normally, as soon as your thyroid hormone levels start to rise, the pituitary slows down or stops secreting TSH in an effort to prevent hyperthyroidism. In this way TSH regulates thyroid hormone levels. Normally, TSH would tell thyroid cells to produce more thyroid hormone. But since you mention having symptoms for 3 months, it could be that you're noticing spikes of thyroid hormone elevation. The spikes would cause symptoms but not keep your levels elevated enough to see a TSH response.

One other (rare) possibility is that you're producing TSH antibodies, not TSH receptor antibodies. TSH antibodies falsely increase the TSH test result. There are tests available to test for these antibodies. We usually run them when the thyroid function tests aren't correlating the way they should. I hope this helps.

You can also write me at the spa discussions. I tend to get there more often. Best, Elaine

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» cybee - Selenium

Elaine,
I had a mild case of TED which now seems to be resolving and am currently taking 75 mgs of synthroid for hypothyroid. I had been taking 200 mg of selenium until I read about it possibly increasing the risk of diabetes...thus reduced it to 50 mg of selenium (by breaking the tablets into fourths). Should I continue taking selenium and if so, what amount do you advise! Thank you so much! This is a great site for much needed info!

-- posted by cybee

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» Elaine Moore - Selenium

In response to Selenium posted by cybee:

Hi Cybee,

I hope you were taking 200 mcg, not 200 mg of selenium. Studies in the last few years have found that selenium levels are often low in people with autoimmune thyroid disorders. Some of the major thyroid gurus like Dr. Wiersinga now list selenium deficiency as one of the triggers for autoimmune thyroid disease.
There are several types of selenium and ideally you'd be using a product that contains the 4 major forms of selenium. It could be the products that just have one form pose risk for diabetes although I haven't heard this. Check out http://www.lef.org/newshop/items/item005...
This is the perfect form of selenium.
And go to www.lef.org and do a search for selenium. You'll find several articles that explain how important selenium is. But since selenium is pretty inexpensive it pays to get the best product, and from my research this lef product is the best. Take care, Elaine

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» cybee - Selenium

In response to Selenium posted by daisyelaine:
Thank you for our reply, Elaine!
Yes, I guess the study that concerned me regarding selenium and diabetes is discussed on http://diabetes.webmd.com/news/20070709/... . i was taking selenium for the very reason that I read ( on this forum and elsewhere) that selenium deficiency was connected to thyroid autoimmunity (do studies reflect this is true with both hypo thyroid and Graves? ). I was in fact taking 200 mcg (ha! Oh, dear) of selenium for this very reason. I read about its other potential benefits too, but this study regarding diabetes made me wonder if I need only steer away from deficiency and hopefully since I am getting some selenium also in my diet, 50 mcg might be enough to avoid any diabetes risk? Well, that was my ponderment...and I always do appreciate your input!

-- posted by cybee

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» cybee - Selenium

In response to Selenium posted by daisyelaine:
I like the e-site to which you referred me as it is quite informative! Thank you! One thing I note is that it states selenium should not be taken with vitamin C and the selenium pills that I have been taking ( from selenium yeast..whatever that is! Does not differentiate what type of selenium otherwise) also contain 60 mgs of vit C! hmm! I wonder also which type of selenium removes heavy metals as that sounds good. Those do appear to be v. good selenium pills on that site!

As you can see by the article re diabetes and selenium, at this juncture it is still just a possible theory as the study was based upon a narrow group/type of participants (and further studies should be done to confirm/negate/clarify it).

-- posted by cybee

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» Elaine Moore - Selenium

In response to Selenium posted by cybee:

Hi,
The study is interesting and I can see why you'd be concerned. But with it not stating the type of selenium and the fact that the risk of type 2 diabetes increases with age, I'm not sure there's a real conclusion that can be made. There are many more studies showing a risk of heart and thyroid problems related to low selenium levels. The risk holds for both hyperthyroidism and hypothyroidism. Selenium is necessary for the production of the seleno enzyme needed to convert T4 into T3. Selenium and zinc are also used in the production of thyroid hormone.
I'm glad you liked the LEF website. I get most of my supplements there and usually stock up on things when they have their bi-annual sales. Best, Elaine

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» holly22 - Subclinical graves to hypo?

Hi Elaine -

My last test results indicated subclinical graves (TSI of 136 but normal FT3 and FT4). I am now having symptoms of being hypo which I will confirm next week (blood draw tomorrow). If that is the case what would make me go from normal levels to hypo?
Thanks! Holly

-- posted by holly22

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» princesssoft - Graves' Disease and Side Effects

In response to Graves' Disease and Side Effects posted by daisyelaine:

Hi Elaine

Just to let you know my thyroid level was checked on Monday, I got the results and they said the figures are now perfect (TSH, T3, T4). I'm now gradually being taken off the Propanolol but I'm still on 10mg Carbimazole.

Only problem now, i'm starting to experience the joint pain again, would this be because 10mg is too much?

Also, (i'm not sure how noticable this is), my left eye isn't opening fully, it's like the top of the lid is thicker, I don't know if that makes sense. My vision is perfect, my eyes aren't sore or red, but something is going on with that eye. I only seem to notice it when I have the joint pain though. Could it be thyroid related?

Any info appreciated
Anna

-- posted by princesssoft

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» Elaine Moore - Subclinical graves to hypo?

In response to Subclinical graves to hypo? posted by holly22:

Hi Holly,
If you begin producing more blocking TSH receptor antibodies than the stimulating variety (TSI) you'll move into hypothyroidism. Blocking TSH receptor antibodies block both TSH and TSI from reacting with the TSH receptor on thyroid cells. Thus, the signals for thyroid hormone production are blocked and thyroid hormone production declines. Best, Elaine

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» Elaine Moore - Graves' Disease and Side Effects

In response to Graves' Disease and Side Effects posted by princesssoft:

Hi Anna,
Joint pain is a sign of hypothyroidism, and it's likely that your 10 mg dose is too high for you. Hypothyroidism also causes periorbital edema, that is a swelling around the eye and eyelids. This could be what you're experiencing. Why don't you ask your doctor if you can lower your ATD dose.
Take care, Elaine

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