General Medicine

» nurseheatherone - TRab/TBII/TSI

In response to TRab/TBII/TSI posted by daisyelaine:

I agree with you Elaine, I took the prozac for 2 days and then stopped it because I realized I did nto want to be stuck on it. I saw the new endo today and he said that did not recommend RAI if I was going to TTC this year and said that he was going to recheck my labs and TSI and have me a prescription for 50 mg PTU for 1x a day if my labs come back hyper again. He was soo much better than my first endo! He also said that we should try to keep my thyroid intact for as long as possible. My only symtoms right now are nervousness and anxiety, it has been almost 3 week off the Tapazole and I had a axiety attack that came out of no where last night. The only meds I am on is 6.5 mg of atenolol. I am expecting my period any day now so that is probably why my anxiety is getting worse, but no physical symtoms yet this month:)I do have xanax and buspar on hand have you heard which one works better for anxiety? just incase this persists. Sometimes I wonder if it is the thyroid or just my head with this awful anxiety, I took half of a 0.25 mg xanax one night and it put me in a full blown attack so I have not taken it since, part of me wonders now if I was just nervous about taking it, I remember you saying that it can cause nervousness in early treatment too. ANyway, I am hopeful about this new endo, he seems like he may be easier to work with! hopefully this is a good start to the new year!
Thanks again, Heather

-- posted by nurseheatherone

» nurseheatherone - New Labs!

In response to TRab/TBII/TSI posted by nurseheatherone:
HI Elaine,
Well after almost 3 weeks off of Tapazole my new endo called me with my new labs today. He said that my TSH was .6 and my FT4 and FT3 are all within mid-normal range. I am hoping this is good news! I do feel better than I have in a very long time. I even got my period 2 days ago and have very mid headache and backache that motrin is taking care of. The anxiety has decreased and I think the stress of all of it along with PMS was aggravating it. I am awaiting my TSI results and will see if they have decreased from the 143% they were in July. My endo did say that he was not sure if my labs were on their way back down and I am going hyper again or if I am heading for remission, I guess only time will tell. Is it possible that I was also having side effects of Tapazole as well as going hypo, every Dr. that I talk to denies that I was hypo but why do I feel so much better now? I hope it lasts!

Oh, I spoke with my naturopathic Dr. and he wanted me to start taking 2 2000IU Vit D3 daily, is this too much to take, how much calcium do I need to take with it? Also should I be early of getting lidocaine with a little epinephrine( I think it is the special one for head procedures) in my scalp for a biopsy of a pilar cyst? My dermatologist would not do this without a consent from my endo?
Thanks, Heather

-- posted by nurseheatherone

» aviano - Androgen Levels

In response to Androgen Levels posted by daisyelaine:

Elaine:
Forgive me for "reviving" this thread [or beating it to death, LOL!]; but I'm trying to understand. In hyperthyroidism an increase in SHBG's should DEcrease free androgen levels, correct? What I'm noticing is an increase in free androgen levels when TSI raises.
Can you say more about this? And is this a partial culprit in the exacerbation of "bipolar" symptoms?
Thank you so much,
Avi

-- posted by aviano

» nurseheatherone - New Labs!

In response to New Labs! posted by nurseheatherone:

Hi Ealine, just an update from the last post, my endo called me today and told me that the antibodies are 37 meaning the disease is still active. He said that this was a different way of measuring the TSI (they are still awaiting those results)anyway he said that since my last TSI was 143% it meant it was about the same. He said that we would just cross our fingers and hope that my labs stay normal. Do you have any idea what this other test was? does this mean that I am less likely to go tino remission? He wants to see me again in 6 weeks to retest my labs. If the disease is still active though I am assuming I will probably go hyper again?
Thanks again, Heather

-- posted by nurseheatherone

» nurseheatherone - New Labs!

In response to New Labs! posted by nurseheatherone:

I recieved my labs from my internist today TSH-.95,FT4-1.53,T3 114, TSI 179%! higher than before( could that be because I went a little hypo?) my cortisol was high at 26.8( normal 22.4) and after halfing the beta blocker in 2 weesk my cholesterol dropped over 40 points and my triglycerides went down by 30 points? also I am no longer hypo, but unfortunately my TSI is higher, and since two days later my TSH was .6 I may be on my way back to being hyper. I remember you saying that TSI are what cause some hyper symptoms, so maybe since mine got higher at whatever point, maybe that is why the anxiety kicked in gradually. Sorry about all of the posts, just trying to make sense of all of this
Thanks again, Heather

-- posted by nurseheatherone

» Elaine Moore - TRab/TBII/TSI

In response to TRab/TBII/TSI posted by nurseheatherone:

Hi Heather,
Your new endo sounds perfect. I like his logical approach. Have you tried magnesium, calcium, B complex, or evening primrose oil for the anxiety. They can all help. Both Buspar and xanax can cause symptoms of nervousness. I'd try the supplements or use a tincture of lemon balm. Lemon balm is very effective at reducing symptoms of anxiety. I have an article on it here that you might find helpful. Best, Elaine

» Elaine Moore - New Labs!

In response to New Labs! posted by nurseheatherone:

Hi,
Recent studies show that most, if not all, people with autoimmune diseases are deficient in vitamin D. Your doctor's recommendation is fine. I'd probably take 1500 mg calcium with around 700 mg magnesium daily.
Your labs sound good and suggest that you may be in remission since you're secreting TSH normally. Most normal young people have levels been 0.3 and 1.0.
I think your ATD dose was inappropriately high and caused hypothyroidism and this led to many of your symptoms. Glad to hear you're feeling better too. Best, Elaine

» Elaine Moore - Androgen Levels

In response to Androgen Levels posted by aviano:

Hi,
The increase in TSI should lead to an increase in thyroid hormone levels. Increased thyroid hormone levels can cause increases in androgens, for instance the excess estrogen causing breast enlargement in some men with hyperthyroidism. I'm not sure anyone has figured out the exact mechanisms in thyroid dysfunction and bipolar polar, although as I've mentioned the two disorders go hand in hand.
Most people I know with bipolar disorder are hypothyroid but tend to experience fluctuating thyroid hormone levels and often need adjustments to their doses. When their thyroid hormone levels rise too high they tend to get more manic. You bring up a good point in that it could be a rising TSI causing the rise in thyroid hormone levels and exacerbation of symptoms. Best, Elaine

» nurseheatherone - New Labs!

In response to New Labs! posted by daisyelaine:

Hi Elaine, that would be wonderful if I were in remission! what about the TSI antibodies being 179%, doesn't that indicate that the disease is still active? I was thinking about pregnancy in the near future if my labs stay stable, but I rememeber you saying that it would be good for TSI to be around 50% or lower before concieving? I will definetely look into lemon balm and the other supplements, I have been off of all supplements for a while now to make sure they were not causing any symptoms, but I will start them again. Thanks again for helping me put all ofthis together!
Heather

-- posted by nurseheatherone

» Elaine Moore - New Labs!

In response to New Labs! posted by nurseheatherone:

Hi Heather,
You want TSI to be around 50% before considering yourself in remission. Some people, who also have blocking TSH receptor antibodies, will remain euthyroid with higher TSI levels because of the blocking antibodies preventing TSI from reacting with thyroid cells. So you could remain euthyroid with your 179% TSI. Because you are euthyroid, you'd be a good candidate for block and replace using a low dose of PTU along with a low dose of thyroid replacement hormone to prevent hypothyroidism. You might want to ask your endo about this.
You might also want to consider what factors are preventing TSI from falling, such as excess dietary iodine, allergens, stress, etc. Even though it sounds too simple to work, stress reduction techniques such as meditation and yoga, really do help the immune system heal.

As far as TSI levels and conception, it's best to have TSI levels below 300% activity. TSI levels normally fall during the second half of pregnancy as the immune system slows down. Early on, TSI can contribute to fetal hyperthyroidism but this occurs in less than 1 % of pregnancies, and is most likely to happen with higher TSI levels (over 300%). Take care, Elaine