Graves' Disease Support Group
Graves-Basedow disease is a medical disorder that may manifest several different conditions including hyperthyroidism (over activity of thyroid hormone production), infiltrative exophthalmos (protruberance of one or both eyes and associated problems) and infiltrative dermopathy (a skin condition usually of the lower extremities). This disorder is the most common cause of...
Hi everyone,
I need some advice with my most recent labs. A quick recap:
I was diagnosed with GD in August 2011, Dr. overmedicated me with MMI and I became hypO. My MMI dosage was finally lowered in January 2012, and my new Dr. has been gradually lowering the dosage. I've been at 2.5mg a day for a little over 6 weeks now, and my symptoms have been improving (yay!!!), but I still suspect that I'm slightly hypO.
My worst symptom right now is the extreme fatigue, which has been particularly bad in the past week. I get 8 to 12 hours of sleep a night and I still have difficultly getting out of bed. After work, I can barely keep my eyes open. I haven't been running around or doing anything more than usual, so I can only attribute the cause to GD.
Current symptoms:
extreme fatigue
hair loss (not as bad as it was a month ago, but significantly more than normal hair loss)
occasional jittery/fluttering heart
anxiety
loose/soft stools in the mornings only
My questions:
My FT4 and T3 have barely changed from the last labs. From your experience, would you say I should stay at the 2.5 mg a day? Or should my dosage be lowered to 1.25 mg a day?
Last month I had my first-ever TSI test. My result was 214 -- obviously it proves that I definitely have GD, but how bad is that on the spectrum, compared to others on here?
Here are my labs:
7/15/2011
Free T4 3.63 (Range 0.81-1.54)
TSH less than 0.01 (Range 0.35-4.0)
*** Prior to starting methimazole.
8/5/2011
Free T4 3.39 (Range 0.81-1.54)
TSH less than 0.01 (Range 0.35-4.0)
T3 379 (Range 58-158)
TPOAB less than 3.0 (Range: less than 5.6)
ESR Westergren 8 (Range 0-20)
*** Prior to starting methimazole.
10/3/2011
Free T4 1.1 (Range 0.81-1.54)
TSH less than 0.01 (Range 0.35-4.0)
*** 10mg/day of methimazole. Most hyper symptoms gone or decreased.
10/27/2011
Free T4 0.9 (Range 0.81-1.54)
TSH 0.01 (Range 0.35-4.0)
*** 10mg/day of methimazole. HypO symptoms began and increased.
1/9/2012
Free T4 0.74 (Range 0.81-1.54)
TSH 9.24 (Range 0.35-4.0)
*** 10mg/day of methimazole. Severe hypO symptoms.
2/20/2012
Free T4 1.03 (Range 0.81-1.54)
TSH 5.24 (Range 0.35-4.0)
*** 5mg/day of methimazole. Severe hypO symptoms are mostly gone, but definitely still feel hypO.
3/15/2012
Free T4 1.18 (Range 0.81-1.54)
TSH 3.69 (Range 0.35-4.0)
T3 94 (Range 58-159)
TSI 214 (Range less than 140)
*** 2.5mg/day of methimazole. Still have hypO symptoms.
4/4/2012
Free T4 1.17 (Range 0.81-1.54)
TSH 2.91 (Range 0.35-4.0)
T3 95 (Range 58-159)
*** 2.5mg/day of methimazole. Still have hypO symptoms -- see symptoms at top of post.
I need some advice with my most recent labs. A quick recap:
I was diagnosed with GD in August 2011, Dr. overmedicated me with MMI and I became hypO. My MMI dosage was finally lowered in January 2012, and my new Dr. has been gradually lowering the dosage. I've been at 2.5mg a day for a little over 6 weeks now, and my symptoms have been improving (yay!!!), but I still suspect that I'm slightly hypO.
My worst symptom right now is the extreme fatigue, which has been particularly bad in the past week. I get 8 to 12 hours of sleep a night and I still have difficultly getting out of bed. After work, I can barely keep my eyes open. I haven't been running around or doing anything more than usual, so I can only attribute the cause to GD.
Current symptoms:
extreme fatigue
hair loss (not as bad as it was a month ago, but significantly more than normal hair loss)
occasional jittery/fluttering heart
anxiety
loose/soft stools in the mornings only
My questions:
My FT4 and T3 have barely changed from the last labs. From your experience, would you say I should stay at the 2.5 mg a day? Or should my dosage be lowered to 1.25 mg a day?
Last month I had my first-ever TSI test. My result was 214 -- obviously it proves that I definitely have GD, but how bad is that on the spectrum, compared to others on here?
Here are my labs:
7/15/2011
Free T4 3.63 (Range 0.81-1.54)
TSH less than 0.01 (Range 0.35-4.0)
*** Prior to starting methimazole.
8/5/2011
Free T4 3.39 (Range 0.81-1.54)
TSH less than 0.01 (Range 0.35-4.0)
T3 379 (Range 58-158)
TPOAB less than 3.0 (Range: less than 5.6)
ESR Westergren 8 (Range 0-20)
*** Prior to starting methimazole.
10/3/2011
Free T4 1.1 (Range 0.81-1.54)
TSH less than 0.01 (Range 0.35-4.0)
*** 10mg/day of methimazole. Most hyper symptoms gone or decreased.
10/27/2011
Free T4 0.9 (Range 0.81-1.54)
TSH 0.01 (Range 0.35-4.0)
*** 10mg/day of methimazole. HypO symptoms began and increased.
1/9/2012
Free T4 0.74 (Range 0.81-1.54)
TSH 9.24 (Range 0.35-4.0)
*** 10mg/day of methimazole. Severe hypO symptoms.
2/20/2012
Free T4 1.03 (Range 0.81-1.54)
TSH 5.24 (Range 0.35-4.0)
*** 5mg/day of methimazole. Severe hypO symptoms are mostly gone, but definitely still feel hypO.
3/15/2012
Free T4 1.18 (Range 0.81-1.54)
TSH 3.69 (Range 0.35-4.0)
T3 94 (Range 58-159)
TSI 214 (Range less than 140)
*** 2.5mg/day of methimazole. Still have hypO symptoms.
4/4/2012
Free T4 1.17 (Range 0.81-1.54)
TSH 2.91 (Range 0.35-4.0)
T3 95 (Range 58-159)
*** 2.5mg/day of methimazole. Still have hypO symptoms -- see symptoms at top of post.
TSI goes up when one is either hypER or hypO from overmedicating as it looks like in your case...
{{{hugs}}}
Thanks for the response :-)
I think I'm going to try the 1.25 mg dosage.
My Dr. got back to me regarding my latest results, and he seems to think that there are fine since I'm "in-range", but I told him I'd like to try with a lower dosage and lab again in a month, and at least he was okay with me trying it.
Though, he said that the lowest dosage is 2.5 mg and if I want to go any lower, I should alternate 2.5 mg every other day. Uhhh... I don't think so. I have no problem quartering 5 mg pills, so I'm going to go with the 1.25 mg a day. Alternating just seems like a bad idea, given the short half life of MMI. Is this correct?
Also, regarding my fatigue, he said that I may have anemia and asked if I would like to look into that. I didn't know until I looked online that oftentimes hypothyroidism and anemia go hand-in-hand. Thank you Dr. #1 for overmedicating me so that I may be anemic now! Do you know which tests I need for anemia? Should this correct itself on its own when my Free Ts go up?
I have low Iron because of having more than several autoimmune diseases, especially Rheumatoid Arthritis will do this for me. My iron has been checked every time for the past few years and I get my labs done four times a year...
{{{hugs}}}
Happy Easter to you too as well...! :-)
I'll be going in for some iron tests later this week.
In the meantime, I told my doc that I'd rather do 1.25 mg/day instead of 2.5 mg every other day. He was fine with it. It definitely doesn't seem like a good idea to have your hormones yo-yoing back and forth. Next thyroid labs will be in a month! Fingers crossed that I start feeling less hypo!
By the way, if I want to go lower after the 1.25 mg/day, what would be the next lower step? I don't think I can halve 1.25 mg, so after that, I would assume I would have no choice but to alternate 1.25 mg every other day? Why don't they make MMI in smaller dosages! It seems like a lot of people could use the smaller dosages.
I've decided to try the 1.25 mg a day for the next 4-6 weeks, then do labs and see where I am. I've already been doing the 1.25 for a few days, and already I feel a very slight improvement; less sluggish. Fingers crossed that my symptoms continue to get better!