General Medicine

» eyeseelinda - Dizziness after 6 months in remission from Graves Disease

Hi Elaine and everyone, it's been a few weeks since I have posted q's, but I continue to read the daily posts from everyone. I have a question for you and the group. Now in remission from GD and six months off Methimazole I've continued to take 20mg Propranalol daily as directed by my endocrinologist. But in the last 7-10 days I've been very light headed, and in the past three days it's become much worse. I actually had someone drive me home from work today. I saw my family physician Tuesday morning and she seems to think the Propranalol may actually be overcorrecting my heart rate given my thyroid hormone levels are normal. As such, my heart may be beating too slowly, causing me to be dizzy. What do you think? Have you ever heard of this? Has anyone experienced similar symptoms while taking a beta-blocker?
The good news is that until now I've felt absolutely great (still do except when I stand up and move quickly), and even better news, the eye proptosis I experienced has resolved itself and you would never know I had eye complications over the past 18 months. So things are good except the recent bout of dizziness. I see my endocrinologist tomorrow at 11am. Thought I'd try and get your point of view beforehand. Many thanks!
P.S. I posted before, during & after eye photos at http://eyesee.typepad.com/hyperthyroid_g...
So for anyone experiencing eye proptosis and wondering if it ever "self corrects," yes, it can as it did for me.

-- posted by eyeseelinda

» dana65 - Clinical Thyroidology article

Hi Elaine . . . Just one more question, after all. Do you happen to know the issue of Clinical Throidology that had the poll of physicians saying they would follow a Wait and Watch approach in the case similar to mine? -- Dana

-- posted by dana65

» nurseheatherone - Newly diagnosed with Graves Disease

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

I did do the Nutrisystems diet for four months before my symptoms started I wonder if that had alot of iodine in it, most of the food was prepackaged and like chef boardee. I did lose 25 lbs from it but then gained 10 of it back in about 6 months and started getting acne and irregular periods right after I stopped eating the food on a regular basis.

I have already read half of your book, it is very helpful! I also see the naturopathic Dr. next week, I am a bit nervous about how my endo is going to feel when I have started a whole menu of new supplements in a month when I see her. And also when I tell her the RAI is a no-go for now:)
Thanks, Heather

-- posted by nurseheatherone

» Elaine Moore - Approach to Mild GD with Osteoporosis

In response to Approach to Mild GD with Osteoporosis posted by dana65:

Hi Dana,
I think I confused your TSI with Heather's.
Because you have enough TSI at 287 to cause hyperthyroidism but have a normal FT4 you most likely also have some blocking TSH receptor antibodies, which is pretty common in Graves' disease. These antibodies block both TSH and TSI from reacting with the TSH receptor, thereby preventing hyperthyroidism. Like TSI, which are stimulating TSH receptor antibodies, the blocking antibodies also falsely decrease TSH levels.
Thyroid antibodies are proteins so they linger in the blood circulation for 2-3 months before being broken down into amino acids and excreted. So you're not going to see these levels fall slowly. A good rule is to test them every 6-12 months to see if they're falling.
Even without meds, there are things you can do to help your thyroid antibody levels fall. Read the article I wrote on using selenium to reduce TPO antibodies. This works the same for TSH receptor antibodies. And it's important to avoid known or suspected seasonal and food allergens. Thyroid antibody levels rise when your immune system is stimulated by allergens, infections, vaccines, chemical toxins, cigarette smoke, aspartame in Nutra Sweet.
I first wrote my book on Graves' disease in 2000 and then I started my website at elaine-moore.com/gravesdisease/ and one of my thyroid friends suggested I apply to write at suite 101. I've been writing here since probably 2001. I also act as a guest editor at Mary Shomon's about.com thyroid web site's hyperthyroidism board where I answer questions on the Ask Elaine Moore subtopic. There are some great topics here that are still in need of writers if you're interested. Best, Elaine

» Elaine Moore - Dizziness after 6 months in remission from Graves Disease

In response to Dizziness after 6 months in remission from Graves Disease posted by eyeseelinda:

Hi Linda,
You must have ESP. I wrote an article on beta blockers yesterday that you should be able to access today. One of the side effects of beta blockers is that they can cause bradycardia (which is an unusually slow heartbeat). I had that happen too and it was noted when I had a pre-op EKG last year. I was apparently taking a higher dose than I needed for hypertension. You want to measure your heart rate (pulse) after you've been at rest for 10 minutes. If your heart rate is lower than 60, you probably don't need the beta blocker any more. In hyperthryoidism, beta blockers are usually used short-term, until symptoms come into control. Thanks for sharing your eye pictures, and congratulations on your improvement. Best, Elaine

» Elaine Moore - Clinical Thyroidology article

In response to Clinical Thyroidology article posted by dana65:

Hi Dana,
I don't remember the issue but it has to be between 2-4 years ago. There used to be a similar case study at thyroidmanger.org the online thyroid text book. You may be able to find that one easier. Best, Elaine

» dana65 - Approach to Mild GD with Osteoporosis

In response to Approach to Mild GD with Osteoporosis posted by daisyelaine:

Hi Elaine . . Thanks for your response, including the mention of writing possibilities. I was the education writer for a daily newspaper for many years and do miss it at times, so I might consider that down the road. Two questions: I've begun a low-iodine diet, but this morning I was on a website (http://www.emedicine.com/med/topic929) that
said Iodine Drugs "Have long been used to treat thyrotoxicosis and are still important adjunctive therapy for hyperthyroidism in modern medicine." I'm trying to DECREASE iodine intake to help, but they sometimes ADD iodine? I'm confused!! - Dana

-- posted by dana65

» dana65 - Approach to Mild GD with Osteoporosis

In response to Approach to Mild GD with Osteoporosis posted by daisyelaine:

-- posted by dana65

» dana65 - Approach to Mild GD with Osteoporosis

In response to Approach to Mild GD with Osteoporosis posted by daisyelaine:

Hi Elaine . . I forgot to add my second question, which is: how long would it take for a low iodine diet with added selenium and L-carnitine to be reflected in lab levels, if it were going to help at all? I ask because my endo wants to see me in 4 weeks. I'll be out of town then, so her nurse is scheduling me in at 3 weeks rather than waiting for 6 weeks. I fear that's too soon to have my diet show any results. Thanks in advance for your input. - Dana

-- posted by dana65

» Elaine Moore - Approach to Mild GD with Osteoporosis

In response to Approach to Mild GD with Osteoporosis posted by dana65:

Hi,
The iodine used to treat hyperthyroidism is a very high dose that would be impossible to get from diet. This is Lugol's solution or strong solution of potassium iodide (SSKI). SSKI is the first medical treatment ever used to treat hyperthyroidism. In amounts of around 6 grams, SSKI inhibits the production of thyroid hormone as well as its release from the gland. However, the effect lasts only about 2-3 weeks before it stops because the body works to prevent hypothyroidism. So the dose must be carefully titrated. Naturopaths still use it and in the ER it's the first treatment used for thyroid storm since it works so quickly. It also is used before surgery for about 10 days to prevent hyperthryoidism and to fix the gland since it also reduces vascularity within the thyroid gland.

As for dietary iodine, the minimum daily requirement is 75-150 mcg daily. The average American diet provides 300-700 mcg daily because of all the iodine subsidized products. People eating lots of processed foods and junk food can easily exceed 1,000 mcg daily. In people predisposed to developing autoimmune thyroid disorders, amounts greater than 150 mcg daily can trigger autoimmune thyroid disorders, both hypothryoidism and hyperthyroidism. Best,Elaine