General Medicine

» Elaine Moore - mixed up

In response to mixed up posted by cowlover614:
Hi,
It's a good idea to see an endo but if it takes a while before you can get an appointment, you might want to consider finding a new GP to help evaluate your condition sooner. Best, Elaine

» cybee - mixed up

In response to mixed up posted by cowlover614:

Hang in there, Elaine! Hopefully you will find someone helpful sooner rather than later! I have been dx with Graves Eyes but wonder if I am also getting the thyroid business too as I get so anxious over things and it is hard to control! Really don't like feeling like that! I am to have more labs within the next month which will tell us more! I understand your need to get to feeling normal again!!!!!! Won't that be wonderful...just hope it does not take too long!

-- posted by cybee

» cybee - mixed up

In response to mixed up posted by cowlover614:

OOPs! Meant to say hang in there, Shirl! (of course, Elaine, I always wish the best for you too! You have been so very helpful in such a good way! Wonderful advice! ). But...accidentally I wrote Elaine instead of Shirl in my last post! ha!

-- posted by cybee

» Elaine Moore - mixed up

In response to mixed up posted by cybee:
Hi Cybee,
Most people with thyroid eye disease end up developing an autoimmune thyroid condition, usually Graves' disease, within a year or two of the eye diagnosis. It's good that you're having your labs tested. Best, Elaine

» u25000 - Graves Rai induced Hypo,TTC

Please clarify what thyroid tests are adversely affected by Clomid? Totals? I only get free T's done. Are there other important labs affected that you are aware?
I understand p/your articles on Preg,that thyroid hormone fluctuate w/Graves (on atd)when your Preg, its not clear if the same goes for Graves a/RAI. I wouldn't think so since there is not a naturally produced hormone?
Curious if u know, I've read articles re: aspirin therapy when TTC for those w/thyroid ab's (on Lt4). What I find is they refer specifically to TPOab and Anti Thyroid Abs. Sometimes I hear Graves ABs (tsi) included and sometimes not. I'm trying to understand if those trials/studies pertain to me w/Graves.

Finally, I've heard more about pituitary tumors and adrenal insuff here than anywhere, can you tell me how these things are diagnosed. My OB or RE have never mentioned/tested directly.

-- posted by u25000

» cybee - mixed up

In response to mixed up posted by daisyelaine:

Yes, I just read your article re Graves Eyes. It noted those with Graves Eyes that do not go on to develop Graves shortly thereafter are euthroid (sp?) but that is a result of competing antibodies (?) (okay, so I don't have the article in front me now...and actually read it yesterday so may be confusing some facts.)..but that then one can have symptoms of both hypo and hyperthyroidism! yikes! That sounds unpleasant too (but it is self limiting?). I have lost 10 pounds since Jan and am so anxious about things...I suspect I will have Graves thyroid (after new labs..which I have not done yet), albeit I don't have tremors or other symptoms (but do have a subtle itchy rash..but that may be due to other things). I hope to get back to feeling normal..so almost hope there is a med..you think if it is Graves thyroid then I will go on just meds and maybe beta blocker ?

-- posted by cybee

» macurious - Graves Rai induced Hypo,TTC

In response to Graves Rai induced Hypo,TTC posted by u25000:

I can't answer your question about Clomid, but I can make a comment about TTC with Anti Thyroid Abs. I've heard of IViG being used for patients with Graves a/RAI. You can read more about it on www.repro-med.net but I don't know how effective it is (or even if it's necessary). I'm TTC and this treatment didn't work for me at all, so I'm not sure what to think at this point.

-- posted by macurious

» macurious - TPO - what does it really tell you?

I just heard that you want your TPO to be 35. What does it mean to be within that range? Is this information meaningful at all to a person with Graves after RAI? (My TPO is 10.)

(I've heard that this test is also called thyroid peroxidase (TPO) antibody (TPOAb) test, thyroid peroxidase autoantibody test, antimicrosomal antibody test and antithyroid microsomal antibody test.)

-- posted by macurious

» cynthia62 - bloodwork results using alternative treatment

Hi Elaine,
I have previously written a couple months ago. At that time, I started exploring alternative treatments for my Grave's and TED. I have been using acupuncture, massage, chiropractic, homeopathic and chinese herbs. I still take 20mg of tapazole once a day and a 10mg capsule of omeprizole(generic previcid) daily. I have just received results from some bloodwork that my Dr has ordered. They include:
Free T3 175.1
Free T4 1.48
TSH 0.01
Reverse T3 0.60 (range .18 units .51)I'm not sure what is
Thyroglobulin 14.0
Thyroproxidase 2660
I did not receive information regarding the normal range for these tests, but all are high with the exception of the TSH.
Can you please explain to me what these tests mean? And what each specifically checks? Does that make sense? At what point should I start decreasing my Tapazole?

I started taking coenzyme compositum, Heal-all, Galium-Heel and a chinese herb called phlegm transforming formula, when I started seeing this new Dr. I have noticed that since I started with this treatment: I have been sleeping better, I seem to have more patience and don't feel as anxious as I have in the past and my eyes do not seem to be bulging as bad. In fact, my sister mentioned to me that my eyes looked better than they did when I had seen her at a family gathering in March. The only symptom that I have noticed that is of concern is that my pulse rate has seemed to increase from my normal rate of 79-84 (resting) to 84-98 beats per minute. I mentioned this to my dr and he didn't seem too worried about it at this point. At what rate would you suggest I be concerned about the heart rate? I intend to pose this question to my Dr at my next appt thie Friday, but would appreciate your input. Thank you so much for your knowledge and support. It is greatly appreciated!
Cynthia :-)

-- posted by cynthia62

» Elaine Moore - Graves Rai induced Hypo,TTC

In response to Graves Rai induced Hypo,TTC posted by u25000:
Hi,
Clomid doesn't affect thyroid function tests. Because there can be changes in your sex hormone levels, you should be measured with free rather than total thyroid hormone levels. Since you are, these levels are reliable.
After RAI, TSH is often misleading since it's falsely decreased by TSH receptor antibodies, and these antibodies increase dramatically after RAI.
It's important to avoid hypothyroidism by ensuring that FT4 and FT3 levels are at least at mid-range, regardless of TSH. Infertility is much more likely to be associated with hypothyroidism than hyperthyroidism.
After RAI, our thyroid hormone levels fluctuate much more than when we're on ATDs. First, we still have some residual thyroid tissue that's being acted upon by both stimulating and blocking antibodies. Second, our needs for thyroid hormone are dependent on our diet, stress level, temperature, altitude, amount of exercise, general health, amount of sleep and other factors. Normally, our body produces different amounts of thyroid hormone to deal with these changes and the pituitary regulates our levels via TSH to keep these levels stable.
When we're on replacement hormone, these needs affect our levels. It's not practical to assume that one dose of thyroid hormone will meet our needs adequately. Fluctuations are very common. For instance, last summer the same dose of replacement hormone that keeps my FT3 around 3.5 in the winter caused my FT3 to rise to 7.1 (range 2.3-4.2).
TPO abs are associated with fertility problems and miscarriage so it's important to monitor them. TSH receptor antibodies cross the placental barrier and can cause fetal hypothyroidism and hyperthyroidsm. Most problems that occur in neonates are seen after RAI because the levels are so much higher. It's important to measure these levels in the first and third trimesters of pregnancy.
Our risk for pituitary tumors isn't particularly high but we're at risk for adrenal insufficiency if we have long-standing hypothyroidism or if the immune stimulation of RAI causes us to produce adrenal antibodies. A cortisol level is used to diagnose adrenal insufficiency. If a morning level is low, a stimulation test and tests for adrenal antibodies are run. Most people with thyroid disorders do not have adrenal insufficiency and taking cortisone when it's not needed is the primary cause of secondary adrenal insufficiency because of the disruption of the feedback mechanism.
Symptoms of adrenal insufficiency include marked weight loss, shakiness, and very low blood pressure.
Aspirin therapy isn't used for people with thyroid antibodies who are trying to conceive. It's used for people who have cardiolipin and other antibodies that cause blood to clot too fast. This is called antiphospholipid syndrome (APS) and it can occur in people with Graves' disease, lupus and other autoimmune disorders. Read my articles on APS and on autoimmune infertility for more info. Best to you, Elaine