General Medicine

» Elaine Moore - Mixed up Help!!!!!

In response to Mixed up Help!!!!! posted by cowlover614:
Hi,
Forgot to mention that you can take flaxseed oil along with other meds. Flaxseed oil contains essential omega-3 oils that are deficient in our diets and they're particularly deficient in people with autoimmune thyroid disorders. They're known to help restore eye moisture, and for this reason they help TED, which is often characterized by dryness. The dryness, by the way, is what causes tearing as your eyes try to correct the dryness.

» Elaine Moore - Mixed up Help!!!!!

In response to Mixed up Help!!!!! posted by cybee:
The concentrated oil, either as an oil or capsules, is a convenient way of adding flaxseed oil. Ground flaxseed also contain lignans and are a good source of fiber. The seeds are better if you can manage to eat enough of them. I use both flaxseed oil capsules and ground flaxseed on salads and I also take fish oil capsules. Most people benefit from both fish oil and flaxseed oil.

» cowlover614 - Mixed up Help!!!!!

In response to Mixed up Help!!!!! posted by daisyelaine:

Well forget my daughter's doctor! She said if your hyper it's better to stay with a Endo. She said sometimes it's just better to abate the thyroid. Guess it's back to looking again! I just don't know where. These doctors are something else. Elaine do people who have Graves take thyroid meds or do they just do the ATD? Shirl

-- posted by cowlover614

» Elaine Moore - Mixed up Help!!!!!

In response to Mixed up Help!!!!! posted by cowlover614:
Hi Shirl,
Most people take ATDs, either methimazole or PTU. These meds will lower thyroid hormone levels and mildly suppress the immune system. Some people also use block and replace therapy. With this approach, as soon as FT4 falls into range using an ATD, levothyroxine or Armour thyroid replacement hormone is added instead of the usual protocol, which is to lower the ATD dose.
There are studies showing that Block and Replace Therapy offers a higher remission rate and studies showing that it has a lower rate.

The block and replace approach has the advantage of providing stable thyroid hormone levels while slowing the gland down. The gland is sort of put to sleep and this helps reduce thyroid antibody production. The original studies using B&R are pretty impressive, and used correctly most people do well with it. Best, Elaine

» trinity2 - just which disorder is it????

Hi,
I'm a 43 year old female who was diagnosed with Hashimotos disease in December 2006 and put onto 900mcg of thyroxine a week (TSH was 3.5 & Anti-Throglobulin was 130 U/ml). My blood test results from March 4th 2007 are as follows (I'm in australia so I'll include the normal range here):

TSH 0.05 - (normal range 0.40-4.00)
free thyroxine 70pmol/L (normal 10-20)
free T3 16.6pmol/L (normal 2.8-6.8)
Anti-Throglobulin Ab 250 U/ml (normal60)

I was short of breath, amazingly high heart rate, trembling, frequent bowel movements,pins and needles in feet, tightness in chest and feeeling even more horrible than I had in 2006. Local doc puts me on Deralin until I can get to see endo. So endo then decides i now have Graves Disease....and puts me on carbimazole - 30mg a day which i started 1 week ago. endo also sends me off to have a nuclear thyroid scan which shows an uptake of 0.47% - normal being 1.1%-4%. The doc analysing the results suggests subacute thyroiditis......what is going on??I feel dreadful and ring endo cause after doing research am worried about continuing carbimazole if it is in fact subacute thyroiditis. he says stay on it because he doesn't really know what's going on.
can you shed ant light here?? any feedback is greatly appreciated
thanks,
trinity

-- posted by trinity2

» Elaine Moore - just which disorder is it????

In response to just which disorder is it???? posted by trinity2:
Hi,
Thanks for including your reference ranges with the labs since, as you suspected, they're different than levels in the U.S.

The carbimazole won't hurt you no matter what the disorder since it'll help lower your thyroid hormone levels. But, you'll need to have labs in at least 2-3 weeks to make sure your levels aren't falling too low.

It's true that the uptake is low in thyroiditis and high in hyperthyroidism, but since you were on replacement hormone, your uptake results aren't reliable. Your thyroglobulin antibody level isn't as high as the levels seen in Hashimoto's and it corresponds more with the levels seen in Graves' disease. However, studies show that low levels of thyroid antibodies often occur in thyroiditis.

The best way to find out if you have Graves' disease would be a blood test for thyroid stimulating immunoglobulins (TSI). These antibodies, which are the cause of hyperthyroidism in Graves' disease, won't be positive in thyroiditis. There are other clues with blood tests. For instance the erythrocyte sedimentation rate (ESR or sed rate) is usually high in thyroiditis and low in Graves' disease.

Clues also help. For instance, thyroiditis occurs in about 6 percent of all women within the postpartum period or one year after termination of pregnancy, which is usually childbirth.
Viral or bacterial thyroiditis usually occurs after respiratory or sinus infections or sinus surgery.

Both thyroiditis and Graves' disease cause an initial period of hypothyroidism. In thyroiditis it lasts around 2 months and in Graves' disease it can last from a few weeks to many years. In thyroiditis the hypoT is followed by a similar period of hyperthyroidism which can resolve on its own or be followed by another cycle of hypothyroidism.

So the carbimazole won't hurt you if it's not used longer than needed although ATDs aren't generally used since the hyperthyroidism resolves quickly. And if there's an infectious process going on, you'd want to treat the infection. Also, anti-inflammatory meds are helpful for reducing any associated pain. Pain is more likely to occur in thyroiditis and rarely occurs in Graves' disease.

Of course, now I'm curious as to which disorder it turns out you have. If you've had a child within the last year I'd bet on postpartum thyroiditis. Best, Elaine

» cowlover614 - Mixed up Help!!!!!

In response to Mixed up Help!!!!! posted by daisyelaine:

Thanks Elaine, I have to figure something out soon. I have enough meds for about another week. No refills so I might call my PC doctor go in and just tell her I don't want the scan. Maybe I can get her to do labs and I don't understand why an MD can't order an ultrasound. This is just crazy! Is it they just don't want to full with it? Or they are just afraid of us people who are hyper. Also do you get rashes I have one spot on my knee and one on my stomach seems like they come and go really strange. Maybe meds or hyper reaction or I think I had read something about rashes related to graves. Thanks Shirl

-- posted by cowlover614

» Princess2007 - Results from Latest Blood Test

Hi Elaine
I would really appreciate your advice on my latest blood results which are below. I have been prescribed 5mg twice a day of Carbimazole but would really prefer to hold off on medication until I really need to take it, and keep going with the diet and lifestyle changes I've been making over the last two months when I first relapsed after about 2 years in remission. I'm thinking that at this stage it probably is necessary to take the medication and combine the natural healing with it. If I start on the medication again though I'm just wondering as well how long would I need to keep taking it for? The consultant today was suggesting perhaps 12 months.
The ranges that are used are
TSH (0.4 to 4.0)
Free T4 (10.3 to 24.5)
Total T3 (1.1 to 2.
The most recent results are
TSH 0.02
Free T4 30.8
Total T3 4.30
The ones 6 weeks before were
TSH 0.02
Free T4 25.5
Total T3 3.23
Thanks in advance

-- posted by Princess2007

» Elaine Moore - Results from Latest Blood Test

In response to Results from Latest Blood Test posted by Princess2007:
Hi,
Since your levels rose even with dietary changes, I'd start the meds now. As soon as FT4 falls into the reference range you'll be able to reduce your dose. And over time you'll reduce it again. Once you're keeping your levels in range with a very low dose like 2.5 mg carb daily, you could see if you're able to keep your levels in control and achieve remission using natural means alone.
With levels that are rising, it's a good idea to use meds to get them in control before your symptoms escalatate. We're all different. After a relapse, most people manage to achieve remission again using ATDs. And using a low dose for a longer period is associated with a higher remission rate. For this reason, arbitrary time frames like a year or 18 months on meds aren't used as protocols but more as guidelines. So you'd want to test the waters before stopping meds, reducing the dose slowly and making sure the dose is so low it's really negligible when you do stop it. Best, Elaine

» Elaine Moore - Mixed up Help!!!!!

In response to Mixed up Help!!!!! posted by cowlover614:
Hi Shirl,
Your doctor can order an ultrasound. I had one a few weeks ago. Thyroid ultrasounds are routinely used to see if you have nodules either as a cause of hyperthryoidism or nodules occurring along with Graves' disease. You have a right to request a method that doesn't expose you to radioiodine if your doctor is trying to diagnose or rule out nodules.
Rashes are common in GD. We often have food or allergic reactions that cause rashes. You might want to read these articles, Rashes and Hives in Autoimmune Diseases and
Skin Changes in Autoimmune Disease. Best, Elaine

If these links don't work do a search on rashes autoimmune disease on this web site.