General Medicine

» free2ridejones - In need of understanding

In response to In need of understanding posted by free2ridejones:

Hi Elaine

Just thought I would let you know my TSH reseptor results are still not through but will post as soon as I get them.

Thanks Margo

-- posted by free2ridejones

» Elaine Moore - My Graves Numbers

In response to My Graves Numbers posted by kaicee118:
Hi,
Yes, your positive TPO antibody result and your borderline TSI result confirm that you have Graves' disease. Based on your levels and your minimally elevated uptake it would be considered mild.
Another fact is that symptoms of hyperthyroidism in Graves disease generally develop when TSI reaches 125% activity. This is how this test result cutoff was decided on. Levels higher than what's seen in the normal population but below the cutoff are common in mild GD and also early GD. Both of these factors are associated with a good chance for achieving remission.
The uptake is usually closer to 65% in mild to moderate hyperthyroidism, with levels above 90% in severe hyperthyroidism. This is just a general guideline since this test is influenced by many factors, including a false decrease with a high iodine diet or exposure to iodine contrast dyes, meds containing iodine etc.
Thyroiditis is a term that means thyroid inflammation. The autoimmune hypothyroid disorder Hashimoto's thyroiditis is an example.
But thyroiditis associated with hyperthyroidism is usually transient and caused by estrogen influences during the postpartum period (postpartum thyroiditis), or infectious, for instance bacterial thyroiditis occurring after sinus infections or surgery or viral thyroiditis occurring after a viral infection. In thyroiditis pain is common and the uptake is low. Although these types of thyroiditis aren't autoimmune in origin they're associated with inflammation and this can cause a slight increase in TPO and/or thyroglobulin antibodies. Best, Elaine

» Elaine Moore - In need of understanding

In response to In need of understanding posted by free2ridejones:
Thanks Margo,
You might also want to read my reply to Kaicee since it explains how the results for stimulating TSH receptor antibodies (also known as thyroid stimulating immunoglobulins or TSI) aren't always clear-cut. I'll watch for your results. Take care, Elaine

» kaicee118 - My Graves Numbers

In response to My Graves Numbers posted by daisyelaine:
Thank you, Elaine. It's wonderful to receive such detailed information that's so specific to my individual case.

I have three further questions for you:

1. If Graves Disease burns itself out, runs its course, etc, why do so many people with Graves have RAI treatment or surgery? Is that just for very severe cases?

2. I don't think I mentioned that I also have symptoms - tremors (in my hands, arms and thighs when I'm standing too long), heat intolerance, palpatations and a "heart pounding" feeling, and body aches (sometimes severe). Is this normal considering my numbers, or should I look for another cause?

3. With regard to stress - a close friend of mine died suddenly two weeks ago. For the past week, the above symptoms have been very bad. Stress almost always exacerbates autoimmune disease - right?

Thanks again,

Karen

-- posted by kaicee118

» Elaine Moore - My Graves Numbers

In response to My Graves Numbers posted by kaicee118:
Hi Karen,
Doctors in the United States have been influenced by early endocrinologists who patented aggressive radioactive treatments at a time when the autoimmune nature of Graves' disease wasn't known.

Prior to the discovery of radioiodine most patients in the U.S. were treated with strong solutions of potassium iodide until they achieved remission and more severe cases were treated with surgery. Radioiodine is still recommended in the U.S. because of a notion that hypothyroidism is preferable to hyperthyroidism, and because it's the least expensive treatment over time. Insurance companies don't think of long-term consequences.

In most countries worldwide patients are treated with anti-thyroid drugs. It's only in the U.S. that RAI is recommended over other treatments, although the use of RAI for GD has declined over recent years.

Thyroid hormone is very potent and even slight increases in your levels can cause the symptoms you mention. Palpitations are generally considered harmless although they can be worrisome to the patient. Body aches aren't common although if you have muscle weakness they can occur. You can also have many nutrient deficiencies associated with hypothyroidism. Symptoms related to nutrient deficiencies don't automatically resolve when thyroid hormone levels are corrected.
You may need supplements to restore nutrient levels. Muscle weakness is associated with B vitamin deficiencies. Overall, hyperthyroidism causes deficiencies of essential fatty acids, particularly omega-3 oils and fat soluble vitamins like vitamins A, D, K, and E.

Stress, especially the stress associated with bereavement, is a well known trigger for Graves' disease. Symptoms typically worsen during periods of stress. And as you mentioned, this is a common factor in nearly all autoimmune diseases.
Best, Elaine

» free2ridejones - In need of understanding

In response to In need of understanding posted by daisyelaine:

Hi Elaine

Finally some results. I am hoping these are the right ones.

Thyroid Stimulating Immunoglobulin

1.0 U/L range (0.0-1.0)

Not sure if I should be expecting anymore or if this is it. I also had tested
Vit D 48 nmol/L range (50-150)
Urine Iodine .74 umol/L I fit into their description of Mild deficiency (0.40-0.80 umol/L)

So am I still hypo? What do I do now? I have just started taking a similar product to Armour that we have in NZ but only on 45mg so far as my doctor wnats to be sure I am hypo before increasing, well I was to be on 30mg but I bumped it up myself, so far no changes. Also on one drop of lugols.

Thanks for your help

Margo

-- posted by free2ridejones

» kaicee118 - My Graves Numbers

In response to My Graves Numbers posted by daisyelaine:

Thank you, Elaine. I have one more question (at least for now:-)). If my muscles are weak from this disease (which I assume they are because of the tremor), is it beneficial to try to strengthen them (light weights at the gym, etc), or is it better to rest? I haven't really done much physical activity in the past several months because I haven't felt well. Any time I have tried some moderate activity, I get shaky. Thanks in advance.

-- posted by kaicee118

» free2ridejones - In need of understanding

In response to In need of understanding posted by free2ridejones:

Whoops I mad a mistake. The TSI should read 1.0 U/L range 0.0-1.0 sorry.

One other thing I have noticed over the last couple of months is cartilage at about my adams apple is starting to pop out. It's hard and kind of pointy. When I swallow it goes up and down.

Thanks Margo

-- posted by free2ridejones

» Elaine Moore - In need of understanding

In response to In need of understanding posted by free2ridejones:
Hi Margo,
It sounds like you have some thyroid enlargement or goiter. Goiter can occur in both hyperthyroidism and hypothyroidism. Your TSI of 1.0 would be considered normal or right below the level where symptoms of hyperthyroidism occur, but this depends too on whether you have blocking TSH receptor antibodies. People with Graves' disease who move into hypothyroidism typically have higher levels of blocking antibodies. These antibodies prevent both TSI and TSH from stimulating thyroid cells to produce more hormone.

With the 1 drop of Lugol's and the very small dose of replacement hormone your thyroid hormone levels may be too low for you. Even 90 mg of Armour (1 grain) is considered a very low dose. It will be interesting to see what your next set of thyroid hormone levels, FT4 and FT3, look like. I suspect they'll be low. Best, Elaine

» free2ridejones - In need of understanding

In response to In need of understanding posted by daisyelaine:

Thanks Elaine

My doc did ask for TSH receptors and that is all that has come back, may be there is more to come. Do you think I am still hypo? I don't want to be taking the wrong medication. Also I see when I correct my mistake I still got it wrong (must be something wrong with my keyboard!) TSI should read less than 1.0 U/L (not 1.0) (it won't type in the less than sign) range (0.0-1.0) hopefully I have it right this time. Sorry about the confusion.

Thanks Margo

-- posted by free2ridejones