General Medicine

» cowlover614 - July5 labs

Hi Elaine here are my new labs from July 5th, Any ideas about what they say. FT3 499H (230-420) FT4 1.8 (0.7-1.8) TSH L0.03A (0.50-6.00) TSI 282H % baseline (=125). My hair is really falling out bad is it because of these levels? I'm taking 37.5 snythroid. The endo's office talked like I have Graves but don't you have to be hyper to have graves. I am really tired and have been very depressed but I don't know if it is stress or my thyroid? Shirl

-- posted by cowlover614

» cowlover614 - kinda scared

Elaine I am worried about my antibodies being so high. My dad died of Non Hodgkins Lympohoma. Which I know is cancer. Does that diease stem from autoimmune disorders? This sure scares me. Shirl

-- posted by cowlover614

» Elaine Moore - July5 labs

In response to July5 labs posted by cowlover614:
Hi,
Your TSI level confirms that you have Graves' disease. TSI are autoantibodies that stimulate the thyroid gland and order the thyroid cells to produce more thyroid hormone.
The initial stage of GD usually causes an episode of hypothryoidism, and you're likely now moving from this hypo phase into the hyper phase.

Your actual thyroid hormone levels show FT3 being slightly elevated and FT4 at the high end of the range. Once you stop the Synthroid these levels may be normal or they may be on the rise, requiring your to start anti-thyroid meds like PTU or Tapazole to lower your levels.

The hair loss could still be from the hypo phase or it could be occurring because of your levels being slightly elevated. Once your levels improve and return to the normal range, hair loss should stop. Best, Elaine

» Elaine Moore - kinda scared

In response to kinda scared posted by cowlover614:
Hi,
Graves' disease is usually a self-limited disorder, and the overactivity of B lymphocytes that causes autoantibody production winds down. In lymphomas, the B cell activity is much more intense and persists for longer periods. Some autoimmune disorders, such as myasthenia gravis, do pose a higher risk for lymphoma but Graves' disease doesn't usually do so. Best, Elaine

» u25000 - RAI induced HypO-on Lt4-but elevated

thanks for the previous responses.
New Question: I have not heard of anyone stopping meds for a few days due to overage of dose.
Is there an absolute negative to this idea you can share.
I've been over medicated since March while gradually reducing dose. 75 was not doing much (low range ft4 1.13 (.80-1.8) after 2 mths (dec-feb; GP was happy w/that til next year) so I increased on 2/23 to 75 + 1/2 tablet=112mcg (also I errored by trying 150 for 5 days on 3/2) and a test on 3/13 showed ft4 1.52 ,tsh .02, Doc expressed concern-too much, so then I waited another 4 weeks for the 112 dose to show its true effect and found still low on 4/12 ft4 1.77, tsh .011(onlinelabs). I then started dose 75 + 1/4tab=93.5 on 4/20 and requested an rx starting 5/6 for 100mcg, however I failed to bother testing until 7/7 and my tsh.04, ft3 3.2(1.9-3.9),ft4 1.73(.76-1.70) so I stopped (onmyown)for one week and restarted new rx for 88mcg on 7/15; because doc had been concerned w/too much lt4 and osteoporosis,etc..Also I had been on selenium for last 3 months- I stopped after this last lab.
Please give me your advice on what I should do now and where I or Dr jumped the gun at any point. I think I should have another lab done this week-since TTC. thanks....bunches.

-- posted by u25000

» u25000 - PS: RAI induced HypO-on Lt4-but elevated

In response to RAI induced HypO-on Lt4-but elevated posted by u25000:
PS: Also I had been on clomid (estrogen receptor blocker to fool the pituitary to create more fsh,lh) March April May, and FSH shots (synthetic fsh) the week leading up to that last lab July. I just thought of this after posted. In case you can put something more together about my tsh being low. And if I'm correct a fetus doesn't rely on mothers thyroid hormones until 6 weeks of gestation so I may have time to correct if I'm insufficient. Also the Doc who is concerned w/low tsh is Rep Endo.

-- posted by u25000

» Elaine Moore - PS: RAI induced HypO-on Lt4-but elevated

In response to PS: RAI induced HypO-on Lt4-but elevated posted by u25000:
Hi,
The fetus is able to make its own hormone at around week 11, but before then your thyroid hormone is utilized for proper growth and maturation. Your levels aren't alarming, and TSH is often falsely decreased after RAI because of TSH receptor antibodies.
Your FT3 is fine and in some of your labs FT4 is slightly elevated. Are you taking your meds before you have your labs drawn? If so, this could cause a slight elevation.
The average dose of replacement hormone 1 year after RAI is 100 mcg. None of your doses seem unusually high. Because you're taking other hormones, you should probably be having an FT4 by dialysis assay to remove any interfering substances.
Your symptoms are also important in determining your optimal dose.
You shouldn't have to stop meds for a week because of a slight rise in FT4. The best advice I can give is to request the dialysis FT4 test and see where this level falls before you make any drastic changes to your levothyroxine dose. Best, Elaine

» u25000 - Elaine: Post Rai Hypo Lt4 and PREG

just found out I'm pregnant so I really need your experience to clarify last messages.
Started FSH injections 7/2, labs on 7/7; Synthroid 100 since 5/6 tsh .04 (.03-5.5), ft3 3.2 (1.9-3.9), ft4 1.73 (.76-1.70) those #'s were very close to 4/13 #'s Synthroid 75+1/2tab=112(so I requested 100mcg rather 75 or 88 as they orig wanted). So anyway RE resident said my levels were "high (hyper)" so of course first concern is too much lt4 can cause osteo, etc. So she suggested 75mcg; I told her I had been on 75 for 2 months w/low range levels so could I atleast go on 88 (since I had never been). She was agreeable. Now here's the problem, concerned that I had been over-dosed since I started 112 dose feb (a/2mths of lo range 75mcg), then down to 100(p/my request-after 4/13 labs) since 5/6. I chose to not take meds for one week the very week that I would ovulate 7/9 and potentially conceive (course I didn't have much faith; or also I was concerned that I would be too hyper as when m/c before), then I started the 88mcg after 1 week w/out Lt4. As it turned out, I conceived likely on 7/10, I reported preg to RE nurse 7/27-blood test confirmed Positive. Now I feel concerned after re-reading effects of preg early on, that I not only hurt myself w/that 1week w/out, but that I also should have stayed on 100 (as you said in earlier reply-hormones "estrogen" in particular may effect "tsh"). So today I will be requesting RE order "stat" labs post pregnancy, SO that I can up my dose immed.

-- posted by u25000

» Elaine Moore - Elaine: Post Rai Hypo Lt4 and PREG

In response to Elaine: Post Rai Hypo Lt4 and PREG posted by u25000:
Hi,
Congratulations on your pregnancy.
The 88 mcg dose sounds fine for now since you don't want your levels to be over the range. And during the week you were off meds you likely had adequate blood thyroid levels to take care of your body's needs.

As for post-pregnancy....you're going to need several blood levels and changes to your dose of replacement hormone before then. In early pregnancy, FT4 and FT3 are slightly elevated (you expect this) because the pregnancy hormone hCG acts like TSH and stimulates production of slightly more thyroid hormone.

But midway through pregnancy, as your hCG level falls and estrogen rises and your immune system slows down, your thyroid hormone levels fall. Most women need about 50% more thyroid replacement hormone than they've been on during the second half of pregnancy.

So all through pregnancy, your doctor will be keeping a close eye on your levels and perhaps lowering the dose early and and then increasing it later. Best, Elaine

» sherri07 - graves disease and diet

My mother in law has just been diagnosed with graves disease and we are looking for a health diet that may help her. We dont know much abouut graves so all info on this subject exspecially diets would be apperciated

-- posted by sherri07