General Medicine

» Elaine Moore - advice on grave's

In response to advice on grave's posted by petersonc:

Hi,
Stress itself doesn't cause thyroid levels to rise. But it's the most common trigger for causing or worsening symptoms in autoimmune thyroid disorders because of its effects on the immune system.
It's possible that you responded well to meds last year but weren't truly in remission when you stopped meds. Ideally, you would have weaned off meds slowly and been tested when you were on a very low dose like 1.25 mg for 6 weeks or so. If your thyroid function tests were normal then, you were probably in remission. If meds were stopped just because levels were
ok and you'd been on meds a year, you probably weren't truly in remission.

Regardless, stress can cause relapses, and when this happens continuing on meds usually works fine. The best approach is to stay on the lowest dose of methimazole needed to keep your FT4 level within range. Over time, the dose can gradually be reduced. As I mentioned, when thyroid function tests including TSH remain within the normal range with a very low dose of methimazole remission is likely. Some people take longer to start secreting TSH though and in this case, when remission is suspected and TSH is low, a TSI antibody test can be used to confirm remission. Best, Elaine

» nurseheatherone - Internal Racing Feeling

In response to Internal Racing Feeling posted by daisyelaine:

Thanks for the info, I will try them out. I already avoid most dairy, have completely cut out aspartame, and am trying to avoid allergens and just figure out if I have any. I am goign to start excercising again today and will try out yoga. I got my new labs back and after almost 2 months of being off of Tapazole my TSH is .444, FT4-1.26 and T3 is 111. I feel good except for the anxiety at these numbers and my Dr. is happy. The only numbers that were elevated was my cholesterol at 220 and HDL at 37:( I am hoping the excercise and stopping atenolol will help. I am just hoping that I am not heading down to hyperthyroid again, I doubt it looking at T4 and T3 though. DO you think my TSH could be falsly low because of the TSI?
Thanks again, Heather

-- posted by nurseheatherone

» Elaine Moore - Internal Racing Feeling

In response to Internal Racing Feeling posted by nurseheatherone:

Hi Heather,
The recommended normal range for TSH is 0.3-3.0, and most normal adults have TSH levels between 0.3 and 1.0 mu/L. Your level could be falsely decreased by TSI and it's known to be falsely increased in GD because of this. Your levels look great.

Cholesterol levels are typically elevated in hypothyroidism. Your elevated cholesterol could still be a reflection of your being hypothryoid from meds a while back, or it could be that your thyroid hormone levels now are a bit on the low side for your body's needs. HDL is your healthy form of cholesterol, and ideally your level would be higher. Exercise can help raise it. I don't see any signs that you're moving back into hyperthyroidism. Best, Elaine

» petersonc - advice on grave's

In response to advice on grave's posted by daisyelaine:

Hi Elaine,
Thanks for the info.. I am on 5mg methimazole now and before was on 10mg. When he said I was in remission, he had me completely quit taking the meds and then two weeks later I had labs done. He said I was in remission. When he runs labs would it be unusual to ask for levels of vitamins like B,D, and calcium?? I was wondering if these need to be monitored or is it just okay to start muli-vitamins and extra calcium???
Does stress impact the immune system which in turn causes the graves to be active??
Also, I am not sure if i have come across the levels for subclinical graves.. I was wondering about this because me endo was suprised that i had graves because my levels were not off by alot and my thyroid uptake scan was almost normal. And an ultra scan shows my thyroid to be almost normal size just slightly larger but not much..
anyway thanks for the info and sorry for rambling
carla

-- posted by petersonc

» Elaine Moore - advice on grave's

In response to advice on grave's posted by petersonc:

Hi Carla,

If you were on 10 mg when you stopped meds, your labs would have looked ok after 2 weeks. TSH lags about 6 weeks behind thyroid hormone levels. If your 10 mg dose was too high your FT4 and FT3 levels may have been low while you were on meds and would have moved intot he normal range after two weeks.

Subclinical hyperthyroidism refers to normal FT4 and FT3 with a low TSH. This would be associated with a normal uptake.

You could and should have a metabolic profile along with a magnesium level. The metabolic profile includes sodium, potassium, chloride, calcium, glucose and tests for kidney and liver function.

It's fine to take multivitamins without blood levels. Most doctors don't test for levels of vitamin C or vitamin B, but lately more doctors are testing patients for vitamin D. Best, Elaine

» juicymango - L-Carnitine & diet for Graves

Hi Elaine
I was on carbimazole for my Graves for 15 months and recently tapered off, however, my T4 levels have risen again, from 17.5 to 26.5 in the last 4 weeks (normal range 12-24).
I have 2 questions: I'm going to try L-acetly-Carnitine but do you know if it will reduce the T4 in my blood as well as reducing the symptoms (so I don't have to argue with my endos, who treat according to lab results and not symptoms)?
Secondly, I have been trying to heal my thyroid and immune system through a diet with lots of goitrogens, juice and raw food as all my research seemed to indicate raw food and bowel cleansing to heal auto-immune conditions, however, John Johnson's website recommends avoiding green leafy veg (because of their cadmium content), goitrogens and fruit. Do you have any knowledge/ experience that could help me sort through all this?
Thanks
Helena

-- posted by juicymango

» juicymango - Systemic enzymes and Graves' disease

Hi Elaine
Sorry, I know you haven't even had a chance to answer my last questions yet, but I have been taking Vitalzyme, a systemic enzyme supplement, for the last 2 weeks to improve my overall health, immune system and energy (it now seems I have pernicious anaemia as well as Graves') and it has belatedly occurred to me to worry that the enzymes are also increasing the efficiency of the excessive thyroid hormones. Do you know anything about this subject?
Thank you
Helena

-- posted by juicymango

» Elaine Moore - L-Carnitine & diet for Graves

In response to L-Carnitine & diet for Graves posted by juicymango:

Hi,
Goitrogens are great for reducing thyroid hormone levels, and carnitine will slightly lower your levels too. Most studies I've seen don't support the cadmium/vegetable connection. One of the major sources of cadmium is cigarette smoke, and that you would want to avoid. Mercury is more of a problem than cadmium, and you should limit the amount of tuna you eat. Raw foods help a great deal and I know quite a few people who've achieved remission following a raw foods diet.

Remember that total T4 measures both free hormone and the protein it's bound to. In this form, thyroid is inactive. And your level will rise from either thyroid hormone or binding proteins. Estrogens cause a rise in binding proteins so T4 will rise even though you have level available hormone when you're on estrogens. For this reason I wouldn't worry about your level much. It would be much better if you were tested with FT4 and FT3 levels, which measure your free, available thyroid hormone. Best, Elaine

» Elaine Moore - Systemic enzymes and Graves' disease

In response to Systemic enzymes and Graves' disease posted by juicymango:

Hi,
The enzymes will help you absorb nutrients better. If you're ingesting too much dietary iodine the enzymes could help you produce more thyroid hormone. But I don't think that's the case unless you're drinking green juices or inadvertently ingesting foods or drinks high in iodine. If you're avoiding fast and processed foods, iodine shouldn't be a problem.
I'd check labels and make sure nothing you're taking has iodine or kelp. Premenstrually, your thyroid hormone levels can rise so watch that you have your levels tested around the same time each month. Even natural estrogens influence total thyroid hormone levels. Best, Elaine

» juicymango - Green juices and carnitine for Graves' disease

In response to Systemic enzymes and Graves' disease posted by daisyelaine:

Thanks Elaine
It's great to be reassured that enzymes and raw foods are a good way to approach healing. However, I do drink green juices. I avoid dairy, processed foods, seaweeds and algaes and coconut because of their thyroid-stimulating properties but do land vegetables also contain a lot of iodine? I recently completed a week of juice feasting which included 1 head of celery and 1-2lbs of leafy green veg/ broccoli per day. Could this be a problem?
Also, sorry, I think I may have got confused, I think it is Free T4 that is tested and this that has risen to just out of the normal range. It was tested at the end of my week of juices and although it was raised slightly above their healthy range I didn't have any hyper symptoms. However, I would prefer to lower it a little and certainly to stop it rising further. Do you think that L-acetyl-Carnitine would help with the test results?
Helena

-- posted by juicymango