What is Graves Disease
Graves-Basedow disease is a medical disorder that may manifest several different conditions including hyperthyroidism (over activity of thyroid hormone production), infiltrative ex...
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my current situation ... opinions please
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Hello everybody. I'd like to give you an update on what is going on with me and see how far off I am. I'm sure I will get blasted by some for taking things into my own hands, but that's ok.
Oct. 2nd was the last time I saw my Endo. I am scheduled to go back this Friday, and I have requested to be switched from the Physician's Assistant to the actual Physician. I also have checked with my insurance company regarding coverage on Free T3 & Free T4 testing and all is well there so I plan to take printed documentation to the doctor, requesting more thorough testing. Anyway, this is what has been going on. On Oct. 2nd my lab results were: TSH 2.930 (0.450 - 4.500) Thyroxine (T4) 6.4 (4.5 - 12.0) T3 Uptake 26 (24 - 39) Free Thyyroxine Index 1.7 (1.2 - 4.9) Methimazole has been reduced from 15mg/day to 5 mg/day. I did not take ANY of my medication again until a week later - October 10th. I started back on 2.5mg of Methimazole per day adn no other medication. I assume it took about a week for the meds to get out of my system because it was the week after the 10th that I started really feeling the hyper symptoms. About a week or two later I started having bad muscle cramps and tightening in the back of my legs. I assumed it was the hyperactivity so I increased my Methimazole to 5mg on an every-other day basis. The muscle symptoms are practically gone. That was going well but then I started having terrible headaches. I thought it was menstral but they weren't gonig away so I started monitoring my blood pressure more closely and realized that could be the cause. My distolic readings were going up and up so I started back on the beta blocker and saw almost instant relief, within 24 hours anyway. While off of the beta blockers, my last BP and pulse reading was 138/98 with a pulse of 77. After being on the beta blocker for two days, I am now at 116/70 with a pulse of 54. That is with a dose of 25mg Atenolol. I think I will try backing down to half that and see how I do. I was nearly non-functioning but am feeling MUCH better now. Please do not fuss too loudly. I have tried to stay on top of my symptoms and levels, especially BP. What is your experienced opinion on my current progress? I know that I am on the hyper side with my levels. I can feel it but being on the hypo side left me with the feeling of not having a life. I will post my new levels after I get them next week, as well as how it went with the "doctor". Thanks for your input. Posted on 11/09/09, 10:11 am |
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Your Oct. 2nd labs indicates hypO, not hypER. Remember many hypER/hypO symptoms cross over with each other. When you get the Free T3 and the Free T4 done together with the TSH, we can comment more.
{{{hugs}}} 
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Did I say I was hyper at the time of those labs? If so, I'm sorry. No, I knew I was hypO at that time. That is why I went off all meds for that short period of time and have reintroduced them slowly after going more towards the hyper side of things. Sorry for the confusion.
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Hi....a lot of the symptoms you describe...are hypo symptoms for me. Your blood pressure readings are actually on the high end of normal. Since each person is different...this may be normal for you. Here's a chart.
http://www.vaughns-1-pagers.com/me... Your pulse rate was also within the normal ranges. Here's a chart that shows the rates vs age http://www.cchs.net/health/health-... Sometimes its very hard to tell where your at by symptom alone. I have often had cross over symptoms when adjusting meds. There were times I was sure i was hyper only to find out the opposite. When reducing or increasing meds its really important to go slow. When ever I made a reduction...I never had to do a increase...I waited for the results of 2 blood tests and kept track of my symptoms before making another. For me...it was the second blood test that showed where I was truly at. It was hard because I was hypo most of last year and I just wanted to feel better. By taking it slowly...I reached my goal...remission. If you do to many changes in to short of a time your body becomes...confused...and you cant trust your symptoms. Reducing your meds yourself is not hard but you must have the test results to back them up. After looking at your test results and symptoms....my guess is...your hypo rather than hyper. Since we dont have your latest labs....its just a guess. Please...before making anymore changes...just tough it out until you get your lab tests back. Slow and steady wins the race. There comes a point in every ones treatment where fine tuning is needed. That unfortunately is up to the patient. You may be at that point now. If you reduce to fast you may run into problems. Its best to only do one reduction or increase within lab testing. Big Hugs...Kathy
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Oh...okay...post #1 and #2 happened when I was writing mine...lol...dont ya just hate that when that happens! Big Hugs...Kathy
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GA.....I understand your reasons for adjusting your meds but, please realize it usually takes 4 wks. for your levels to show the results of a dose adjustment.
Before changing your dose to 2.5mg MMI, you really should have run labs before doing so. Now, when you get labs, you really have no idea whether the 5mg dose, the 2.5mg dose, back to the 5mg dose actually did...... Also, please realize we can have transient hyPER symptoms after a dose adjustment. Getting labs done every 4 wks. and making small adjustments in dose is the best way to move forward. Truly, going from 5 mg/day to 2.5mg/day is quite drastic when you get to lower doses.....it would have been better to try 3.75mg. Since the 5mg dose was 1/3 of the dose that made you hyPO, you just might have fared well with that dose.....labbing at 4 wks. after taking 5 mg for 4 weeks would have shown what it accomplished. Then, you can tweak your dose if you're still not at least at mid-range FT4. Sometimes, we have to ride out our symptoms. Also, please don't take your meds on an alternating day basis.....that will cause you to swing from hyPER to hyPO symptoms extremely. Once daily can do that......split dosing into a minimum of 2 doses per day allows for more even "coverage" and stable thyroid hormone levels. Stable levels expedite healing. Please, no more dose adjustments until you get your labs....post them here as well as the doctor's recommendation and we'll be able to comment more. All the best, Carol
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I was wondering if the dose decrese was to big from 15mg a day to 5 mg a day was to big. I thought you had do a gradual dose decrese to help with symptoms and such.
Angel
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When I had hit hypO-hell I was at something like 20 mg of MMI. I reduced it by 5 mg to 15 mg. Then four weeks later, another 5 mg reduction to 10 mg. But apparently it was fast enough so Endo elected to take me cold-turkey for one month. I called Doc (Endo's friend) and told him I preferred to go off no more than five days and then restart on 2.5 mg. So I did this, but took the 2.5 mg once per day instead of the usual three times a day in divided doses. I went a bit hypER so I immediately began taking 5 mg a month later individed doses. Then I was able to whittle down to 3.75 mg of MMI for just about two years.
HypO-hell to me is when I really, really crashed with my thyroid and it caused problems with my AI diseases. This has only happened to me one time, thank goodness...! However, I've been slightly hypO a number of times and catching this in time before I totally crashed. Whew...! {{{hugs}}} :-)
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Hello,
I would agree with dairytech as I have done what you are doing.... when my doc drastically decreased my dose, I would increase my dose after a few days of thinking I was going way too hyper again... so out of panic, I increased my dose... and then I would feel so much better.... the symptoms would subside... well, it turned out I was way hypo when I was thinking I was way hyper again... my doc allows to reduce my dose according to my symptoms but says to give it a week to adjust and says if after that time, i dont feel well, then to increase only back to my original dose not to increase it more than that. so far, that strategy has worked. I wish you the best in this miserable journey of Graves... ~hugs to ya.
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Thank you for all of your words of advice, concern and even rebuke. I appreciate where you are coming from. Perhaps I did a wrong thing by ajusting my meds on my own. Truth is, I haven't been completely satisfied with my doctor and felt if she could flip flop me back and forth on the dosage with at least 10mg at a time then my ajustment of 2.5mg would not make that much difference. I did try waiting out the symptoms for at least a week before I would make any change and it was gradual, not all at once. It was becoming difficult to walk or sit and the headaches were approaching the migraine stage. Maybe I was still wrong but I believe I know my body and I tried to be very cautious. Anyway, I go back in at the end of the week and we will see what has happened then.
Thanks again for your input.
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