General Medicine

» Elaine Moore - New Labs! am I getting better?

In response to New Labs! am I getting better? posted by nurseheatherone:

Hi Heather,
Yes, many of those symptoms are seen in hypothyroidism including anxiety.SOB and GERD symptoms and digestive complaints and depression and joint pain can all occur in hypoT.
I'd try 5 mg and if your next labs don't show FT4 close to the high end of the range I'd opt for 2.5 mg daily. Best, Elaine

» nurseheatherone - New Labs! am I getting better?

In response to New Labs! am I getting better? posted by daisyelaine:

Thanks elaine! I am not sure what I would do if I didn't have you her to answer these questions for me! I reaaly appreciate all that you do!it is a bit scary though that you see these things but my endo and GP do not. I have also been getting a bit dizzy too, so you are probably right, I may have changed too quickly. This is my first day on 5mg and my Dr. does not want to see me for another 2 months, is this the norm for F/U, even though my levels changed soo rapidly. I can get my labs drawn earlier than that, what time frame would you recommend? Also, when should I check TSI again? do they ever add thyroid hormones to prevent these rapid changes and people from goign hypo with Graves?
Thanks again,
Heather

-- posted by nurseheatherone

» mariammc - graves'

Hi Elaine,

How have you been? I've been waiting to post until i had some lab results (have not been here for a while).

I've been taking the methimazole, 5mg, once a day, and just received some results in the mail from my doctor.

The TSH is 0.00, and the Free T4 is 1.47.
I have an appointment again in October to see the endo.

Are these good results? This is all that was on the lab report.

Thank you,

Maria

-- posted by mariammc

» dana65 - Another Graves questions

Hi Elaine . . Is remission of Graves Disease that is achieved through medication more permanent or longer-lasting than remission achieved through a natural approach? - Dana

-- posted by dana65

» dana65 - Another Graves question

Hi Elaine . . Is remission of Graves Disease that is achieved through medication more permanent or longer-lasting than remission achieved through a natural approach . . . or is there any research data that can answer that? -- Dana

-- posted by dana65

» Elaine Moore - New Labs! am I getting better?

In response to New Labs! am I getting better? posted by nurseheatherone:

Hi Heather,
Checking your labs in 5-6 weeks would be a good idea, and this would show if you need another dose reduction. If you feel fine, though, you could wait closer to your next appointment.
Yes, thyroid hormone is added along to the ATD in a protocol known as block and replace therapy. There are studies showing that B&R offers benefits and other studies showing it has no added effect. personally, I think it's a good protocol because it keeps levels from falling too low. Over time, the ATD is reduced and people are left on thyroid replacement hormone alone once they're near remission.
Keeping TSH low puts the gland to sleep and this helps reduce thyroid antibody production while ensuring that you have enough thyroid hormone for your body's needs.
Take care, Elaine

» Elaine Moore - graves'

In response to graves' posted by mariammc:

Hi,
These are good results. FT4 is right where it should be with the usual range being 0.8-1.8. TSH stays low for a long time and doesn't mean that you're still hyperthyroid although some doctors get confused by this. You probably want to continue on your 5 mg dose although if FT4 falls more when you have your next labs, you'd probably need to reduce to 2.5 mg. Best, Elaine

» Elaine Moore - Another Graves questions

In response to Another Graves questions posted by dana65:

Hi Dana,
Studies show that remission is most likely to be permanent in people who stay on a low dose of ATDs long-term, average 4 years. This would be similar with a natural approach in that you'd want to continue your efforts even after you think you're in remission.
Remission is also more likely to be permanent in people who don't smoke and in people who make dietary and lifestyle changes. As to whether remission is more likely using alt or ATDs I don't think there have been studies. However, studies show that about 1/3 of people with Graves' disease using no conventional treatment achieve remission spontaneously. This makes sense since Graves' disease is self-limited. Best, Elaine

» eyeseelinda - Remission

Saw the question on remission and thought I'd share my results. I took Methimazole for about 15 months after diagnosis and stopped on Feb 1 of this year when my labs all came back perfect. In my recent checkup my TSH was low again, down to .0316. T4/T3 normal. I am experiencing some slight symptoms of hyperthyroid, including the very fine hand tremors I experienced the first time around. Luckily nothing when it comes to rapid and irregular heartbeat this time around. My doctor wants me back on anti-thyroid drugs and I asked not to go back on Methimazole--I lost quite a bit of hair, got a skin rash, and felt extremely tired. So we're trying PTU. The good news though is that my eye proptosis remains completely corrected with no signs of recurrance, which makes me very happy. Elaine, any comment on the recurrance of hyperthyroid in my case would be appreciated, especially when it comes to the lab results: TSH .0316, T4 1.4, and R3 346. Thanks!!

-- posted by eyeseelinda

» eyeseelinda - Safe to take Melatonin for jet lag if you have Graves Disease?

Hi Elaine, quick question for you. I have trouble with jet lag when I travel and I've got a 14 hour flight coming up. A friend of mine suggested Melatonin, which I've heard about. Are you aware of any interactions or issues with this herb in patients with Graves Disease? Thanks Elaine.

-- posted by eyeseelinda