General Medicine

» cowlover614 - Help need input

Hi Elaine, I really need some input. I have really been having trouble. The Endo still has me on snythroid 37.5. My hair is still falling out my eyes have been protruding out more, I have been choking on food and sometimes feel like I can't swollow. Now on going headaches and just really feeling bad. He said wait eight weeks for labs it's been a little over four and I have decided to go next week because I feel the way I keep bouncing that is to long. Also he doesn't want to see me till November. Any ideas why in the world I would still be on snythroid? I thought those are for when you are Hypo or am I wrong? I feel like I did only worse before when I was hyper and they started me on the ATD. none of this is making sinse to me.I have just about had it with this doctor crap he says give him a chance. I'm at the point that I think he doesn't know what he is doing. I do go August 8 to the Graves specialist. I hope he can tell me something. If my eyes weren't so bad I could take the hyper, hypo thing. Shirl

-- posted by cowlover614

» Elaine Moore - Help need input

In response to Help need input posted by cowlover614:
Hi Shirl,
If I recall you started out hyper and then were put on too high of a dose of meds. This caused hypothyroidism and then you seem to have also moved into hypothryoidism on your own. This happens if you have thyroiditis rather than Graves' disease.
Eye symptoms can occur in both hyperT and hypoT and when they're caused by thyroid levels that are off, the symptoms persist until the blood levels are corrected.
You're only a low dose of thyroid replacement hormone. It seems your doctor was conservative since you were hyper before. But you should be having labs now to tell if this dose is too low or if somehow you moved back into hyperT, which can happen in thryoiditis.
I suspect you're hypothyroid still and the dose is too low. Most of the symptoms you're mentioning are from hypoT. Can you call the office and mention your symptoms and see if they'll call in an order for lab tests.
Or if you already have an order, you could get your labs now. Let us know what you do and what your labs are. Best, Elaine

» cowlover614 - Help need input

In response to Help need input posted by daisyelaine:

Hi Elaine, I started out hypo then they gave me to much meds and made me hyper. Then they gave me ATD which made me hypo. Then they put me back on snythroid 75mgs. July he cut my dose to 37.5 said I was back to hyper. Here are July's labs again. TSH L0.03(A) [0.50-6.00) FT4 1.8 [0.7-1.8] FT3 499H [230-420] TSI 282H [=125]. I don't understand why he still has me on snythroid if I am hyper. I try to call and can't get anywhere. He said labs in 8 weeks and he would see me in Nov.My eye symtoms have got worse not any better and I just feel awful. Waking up with what feels like a fever but when I take it I'm around 97.5. I just don't understand any of this.Help Shirl

-- posted by cowlover614

» Elaine Moore - Help need input

In response to Help need input posted by cowlover614:
Hi,
Your doctor might not realize that you can fluctuate from hypo to hyper and back. He might think that once hypo, you stay there.
Since your lab tests were borderline in July while on 75 mcg, he may think that cutting the dose in half will bring your levels in line.
But if you're once again moving back into hyperthyroidism then your levels can continue to rise on their own. I agree that it would probably be best to stop replacement hormone and see where you stand without meds at all. Then if you are hyperthryoid you could start on anti-thyroid drugs.
Since your dose of replacement hormone is low, labs that you have now would be helpful. If you're still hyperthyroid on a low dose of meds this would show that your hyperthyroidism isn't related to the meds.
If you're still hypothyroid then your thyroid hormone levels should have fallen by now from the dose reduction. I hope you can get your lab tests soon to help figure this out. Best, Elaine

» nurseheatherone - Newly diagnosed with Graves Disease

Hi there, I am 26 years old and after having high BP/cholesterol, having a very irregular menstrual cycle, acne and gaining 30 lbs over 4 years I was just diagnosed with GD. Since I was hoping to start trying to have children in about a year from now my Endo is treating me with Tapazole for 6 months and then would like to do RAI. I have a sensitivity to beta blockers ( weight gain, high triglycerides and lightheadedness, I also take lisinopril 10 mg) so she said that would be the best treatment plan. I am just wondering if this is the treatment of choice in women in my situation. I have just started to become more symptomatic with palpitaions and anxiety and I am anxious to get this disease under control. I did read somewhere that taking ADD medications could contribute to GD. I took Adderall since I was about 11 years old and I didnt start gaining weight and having other symptoms until a few months after I stopped the medications. Also, I am a nurse in L&D and recently switched to a more low stress job on a regular schedule and that was when I finally noticed my irregular or light periods and went to the Dr. I also in very afraid of not taking a beta blocker and getting RAI, I have heard of the possibility of Thyroid storm and Graves eye disease. Wondering if it is worth it to risk the side effects of beta blockers to reduce symtoms and help reduce possible risks of RAI.
Sorry so many questions, I am just trying to adjust and find some answers
Heather

-- posted by nurseheatherone

» Elaine Moore - Newly diagnosed with Graves Disease

In response to Newly diagnosed with Graves Disease posted by nurseheatherone:
Hi Heather,
Tapazole will lower your thyroid hormone levels and this will reduce your symptoms. It takes about 6 weeks to see the full effects of the Tap at which time the dose is lowered. It takes 6 weeks for the stored hormone in your gland to get used up. After this you just need enough Tap to reduce the production of new hormone.
Most people on meds achieve remission within a few years although during pregnancy PTU is recommended over Tapazole since it's less likely to cross the placental membrane. On a low maintenance dose you could use either of the ATDs.
Beta blockers are usually used early on in hyperthyroidism to reduce symptoms until the meds kick in. A low dose like 25 mg atenolol as needed might be enough to reduce palpitations, which are usually considered annoying but harmless.
Most everyone with Graves' disease has an initial hypothyroid phase that's usually mild and not diagnosed although some people have overt hypothyroidism for years before moving into Graves' disease. This initial hypo phase could account for your weight gain.

There are some reports of amphetamine and related sympathomimetic amines triggering GD, and amphetamine mildly elevates T4. However, there's no real proof if this is a trigger. The same connection has been made with diets. It's thought that the common link may be the hypothyroid phase which could cause some people to use diet pills or strenuous exercise or diets to help with weight loss.

It's difficult to pinpoint with certainty what may have caused your GD but you'd have to have a genetic predisposition. And usually several factors contribute with the most common ones being excess dietary iodine in fast/processed foods, stress (especially of bereavement and events like weddings), cigarette smoke, aspartame in NutraSweet, low selenium levels, etc.

You might want to read the article I wrote on Carnitine. This supplement is very effective in reducing the symptoms of hyperthryoidism and also helps lower levels. It could work in place of beta blockers to relieve your symptoms. Best, Elaine

» tdove52 - Newly diagnosed with Graves Disease

In response to Newly diagnosed with Graves Disease posted by daisyelaine:

Hi Elaine,

In your response to "newly diagnosed" are you suggesting that strenuous exercise can trigger GD in someone who may be hypothyroid and is susceptible? If yes, can you pint me to any research that supports this? Thanks.

-- posted by tdove52

» u25000 - Elaine: Post Rai Hypo Lt4 and PREG

In response to Elaine: Post Rai Hypo Lt4 and PREG posted by daisyelaine:
YOU HAVE BEEN SO HELPFUL THIS PAST YEAR
I reported to you recently that I was very newly preg finally.
This is thanks to FSH injections. The last day of injections 7/7 I had labs done which indicated the following:
(on synthroid 100 since 5/6)
TSH .04 (.03-5.5)
FT3 3.2 (1.9-3.9)
FT4 1.73(.76-1.7)
It appears those #s are great; except for tsh which RE said was too low. What does this mean? Isn't it correct that Tsh is an inactive signal whose purpose is convey the condition of thyroid, but I don't have a thyroid so shouldn't be considered, right (as you've mentioned in articles)? Well as I understood ft3 is the best indicator of the active hormone, mine seemed great,finally. However, FT4 has been slightly elevated; but thats an inactive hormone which is "stored" as the body need more hormone to convert to t3 right? So that elevation shouldn't matter either. Yet I've read that TSH and FT4 are the primary for Graves.
Anyway, I told you after the 7/7 labs I freaked out, and chose to stop lt4 altogether for 1 whole 7 days, before taking 88mcg per RE request. Well last week 7/31 I asked for post preg labs and they only ordered TSH which was .71. So I ordered my own labs and did those 8/6 the results are as follows:
(7/8-7/15 no lt4; 7/16-8/5 88mcg) LabCorp p/healthchkusa
TSH .9 (.5-1.2)
FT3 1.34 (.27-4.2)
FT4 2 (2.3-4.2)
Days after I had stopped I had noticed palpitations, but I didn't know if they were related to the FSH injections I was taking. So I didn't consider an issue. I have seemed more lethargic the past few weeks, but could be pregnancy. I have easy numbness in the extremites when I sit on them for a bit, but I've never really compared. My hair does seem to be changing again.
Most importantly, I was so ready for this preg to not be affected by my thyroid and very quickly it seems, no thanks to Graves inept Docs, I may be facing complications considering the obvious labs. And of course, it will be easy for them to blame age. Do you have any more advice? What time frame is this lab indicative of, I hear 4 weeks ago? I took the lab before I took the Lt4 as you said before. How long after LT4 should you have a lab done, hour, hours? Should I ORDER another lab next week? Should I IMMED increase back to 100 or higher- considering yours and Shomons info suggesting 40-50% increase upon preg? YOUR TIME IN REPLY GREATLY APPRECIATED!

-- posted by u25000

» u25000 - ADDEND:Elaine: Post Rai Hypo Lt4 and PREG

In response to Elaine: Post Rai Hypo Lt4 and PREG posted by u25000:
FORGIVE ME THE LABS FOR 8/6 ARE AS FOLLOWS (NOT AS PREV)
TSH 1.34 (.27-4.2)
FT3 2. (2.3-4.2) LOW
FT4 .9 ( .5-1.2)
AND I SHOULD MENTION AS YOU CONSIDER THESE #'S AND THE STOP PERIOD (MY FAILURE;believing would help body catch up faster to 88 dose) THAT EMBRYO SHOULD HAVE IMPLANTED ABOUT 7/16 (THE 2ND DAY I RESTARTED LT4)BASED ON OVULATION INDUCTION DATE 7/9. ALSO THIS LAB DID SOME FOR ME IN APRIL WHICH WERE SIMILAR RANGES TO WHAT I'M USED TO; THIS TIME ARE DIFFERENT #'S; I WORRY OF THEIR RELIABILITY, SINCE THEIR INDEPENDENT. I HEARD THAT LABCORP DRAWING CENTERS ARE OFTEN REDONE BY OTHER CENTERS-WHICH MIGHT EXPLAIN WHY A RECENTLY OPENED OFFICE HAS ALREADY CLOSED NEARBY; NOT TO SAY THERE REALLY IS A PROBLEM W/MY NUMBERS.

-- posted by u25000

» erimay - Newly diagnosed with Graves Disease

In response to Newly diagnosed with Graves Disease posted by nurseheatherone:

I was also just diagnosed with GD. I felt lightheaded w/ the beta blocker (toprolol), but after I cut in half, it stopped. My endo told me to take PTU, and that in approximately 4 months I can start trying to conceive, but I can't stop taking PTU pregnant or nursing. Also, I have read that the RAI can harm the fetus no matter how long after you wait, and that it can pass problems on to children's children. I sympathize with the symptoms, I have ridiculous ones myself. Good Luck!

-- posted by erimay