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...
These labs are just for the last few months. I was taking 2.5 mg MMI once daily in the evening before the first of these labs was drawn.
12/11/2012 -- stopped MMI that evening, endo said afterwards that it was good I did. I said I tried to relate my symptoms to my labs, and he agreed that I must be sensitive to those things.
TSH 3rd generation, 1.64 (0.30-5.60 UIU/ML)
Free T4 1.0 (0.60-1.12 NG/DL)
Free T3 2.27 (2.5-3.90 pg/mL) --Low
I asked for supplementation that I could take "as needed" but the endo refused. He gave me the copy of the labs at the end of the visit and I called him when I got home because he had not told me that my fT3 was low. He said he doses to the TSH because the T4 and T3 levels change too rapidly and the TSH shows what the averages have been like. He said I could have more labs on the 20th.
12/20/2012
TSH 3rd generation, 1.64 (0.27-4.20 UIU/ML)
Free T4 1.04 (0.60-1.12 NG/DL)
Free T3 2.96 (2.5-3.90 pg/mL) --33%
02/07/2013
Thyroid Stim Immunoglobulin 320 (0-139)
Thyroglobulin, Quant. 5.3 (0.5-55.0)
antithyr. less than 20 (0-40)
TSH 3rd generation, 0.98 (0.27-4.20 UIU/ML)
Free T3 2.46 (2.5-3.90 pg/mL) --Low
Free T4 -- no report. Apparently not ordered.
The endo told me that I would always have a high TSI.
I asked him if he was willing and able to keep me in the upper portion of the normal range with my thyroid hormones.
He agreed, telling me my TSH was below 1.0.
I asked for monthly labs.
He said the insurance company would probably object.
I said I understood I wouldn't be able to see him each month.
He said he would make an appointment for me to come back in June, which he did; and he gave me a standing lab order once a month.
He didn't mention my T3 and apparently didn't order the Free T4 test this time. He gave me a copy of my lab report.
I called him back. Again, I told him I wasn't happy with my Free T3 numbers.
He said that the medicine takes a couple of months to get out of the system, and of course the Free T3 was low--that was what the medicine was for.
He said I could take the next blood test on Monday, March 4th, and he would prescribe supplements if I was still low.
03/04/2013
TSH 3rd generation, 0.99 (0.27-4.20 UIU/ML)
Free T4 0.99 (0.60-1.12 NG/DL)
Free T3 2.56 (2.5-3.90 pg/mL)
The office called me and said the doctor was very happy with my labs and to see that my FT3 had "skyrocketed" up.
I gave up, and decided to find an endocrinologist who actually specializes in the thyroid instead of mainly diabetes.
I found some in Denver. I live near Salt Lake City.
04/02/2013
TSH 1.01 (0.27-4.20)
Free T4 0.99 (0.60-1.12)
Free T3 2.59 (2.50-3.90)
Might hear from doctor tomorrow or Monday.
12/11/2012 -- stopped MMI that evening, endo said afterwards that it was good I did. I said I tried to relate my symptoms to my labs, and he agreed that I must be sensitive to those things.
TSH 3rd generation, 1.64 (0.30-5.60 UIU/ML)
Free T4 1.0 (0.60-1.12 NG/DL)
Free T3 2.27 (2.5-3.90 pg/mL) --Low
I asked for supplementation that I could take "as needed" but the endo refused. He gave me the copy of the labs at the end of the visit and I called him when I got home because he had not told me that my fT3 was low. He said he doses to the TSH because the T4 and T3 levels change too rapidly and the TSH shows what the averages have been like. He said I could have more labs on the 20th.
12/20/2012
TSH 3rd generation, 1.64 (0.27-4.20 UIU/ML)
Free T4 1.04 (0.60-1.12 NG/DL)
Free T3 2.96 (2.5-3.90 pg/mL) --33%
02/07/2013
Thyroid Stim Immunoglobulin 320 (0-139)
Thyroglobulin, Quant. 5.3 (0.5-55.0)
antithyr. less than 20 (0-40)
TSH 3rd generation, 0.98 (0.27-4.20 UIU/ML)
Free T3 2.46 (2.5-3.90 pg/mL) --Low
Free T4 -- no report. Apparently not ordered.
The endo told me that I would always have a high TSI.
I asked him if he was willing and able to keep me in the upper portion of the normal range with my thyroid hormones.
He agreed, telling me my TSH was below 1.0.
I asked for monthly labs.
He said the insurance company would probably object.
I said I understood I wouldn't be able to see him each month.
He said he would make an appointment for me to come back in June, which he did; and he gave me a standing lab order once a month.
He didn't mention my T3 and apparently didn't order the Free T4 test this time. He gave me a copy of my lab report.
I called him back. Again, I told him I wasn't happy with my Free T3 numbers.
He said that the medicine takes a couple of months to get out of the system, and of course the Free T3 was low--that was what the medicine was for.
He said I could take the next blood test on Monday, March 4th, and he would prescribe supplements if I was still low.
03/04/2013
TSH 3rd generation, 0.99 (0.27-4.20 UIU/ML)
Free T4 0.99 (0.60-1.12 NG/DL)
Free T3 2.56 (2.5-3.90 pg/mL)
The office called me and said the doctor was very happy with my labs and to see that my FT3 had "skyrocketed" up.
I gave up, and decided to find an endocrinologist who actually specializes in the thyroid instead of mainly diabetes.
I found some in Denver. I live near Salt Lake City.
04/02/2013
TSH 1.01 (0.27-4.20)
Free T4 0.99 (0.60-1.12)
Free T3 2.59 (2.50-3.90)
Might hear from doctor tomorrow or Monday.
My doctor is out of town until Monday but his office will put an urgent message to him to contact me about my labs.
Maybe cd could comment since her TSI and TRAb were 'up there' and she went hypO and is now taking a replacement med rather than the ATD.
Good luck and {{{hugs}}}
Are you having any symptoms? How long were you on Methimozole? What were your labs like when you were diagnosed.? Just trying to understand all this. Odvious, I don't feel stupid, not understanding all this, because it doesn't look like our medical profession knows either. LOL
My endo here puts me off about prescribing supplements. That is why I want to go elsewhere.
My husband insists that I only go to doctors that are mainline, traditional--no ND types.
I researched into it, having decided to go to one who specialized specifically in the thyroid and also the pituitary. All endos here in Utah treat diabetes, so I don't think they care much about the thyroid. The one I chose in Denver is Virginia Sarapura.
Not only am I hypo post Graves, but I believe I was hypo pre-Graves. For over 26 years I have dealt with my symptoms and was tested, mostly just TSH, and found to be "in the normal range."
I got no copies of my labs during those years, and my primary doctor retired about 6 years ago, just before I was diagnosed with GD.
Since then, I have been looking for a new primary care doctor, and I think I found her, but I don't think she will treat hypothyroidism when I don't have a TSH of 3.0 or more.
I was first tested with a zero TSH in 2008 by my OB/gyn. She sent me to be treated by my family doctor. He tested the FT4 which was 1.91 (0.8-1.8) and confirmed my low TSH.
He sent me a copy of the lab report but said I didn't need meds at that time. He wanted me to make an appointment in 3 months for a recheck and highlighted that on the letter, but for some reason I got confused (I think I am autistic--Asperger Syndrome) and I thought it was crossed out instead of highlighted.
By the first of 2009 I was having severe double vision, and a specialist wrote to my eye doctor that my TSH was "very suppressed at 0.01" my TSI and TSH receptor antibodies "both markedly elevated" also saying "Once her thyroid is under control...will refer her to one of our strabismus surgeons...to realign her eyes..."
An appointment was made for me with the endo I have now, "endo #2", but it was about 3 months out and my doctor was worried I would go into "thyroid storm" because my pulse was so high. He found a different endo for me who would see me right away. Once I had the new endo, I just kept going to him for a while. I call him "endo #1".
I went to endo #1 from about May 2009 to April 2010. He started me out on 30 mg MMI and a beta blocker, with instructions to discontinue the beta blocker after one month and reduce my MMI to 20 MMI daily. He had me taking the pills in a divided dose morning and night. By the end of the first month, I could hardly function.
I don't remember much very clearly, but when I was on 2 pills in the morning and 2 in the evening, I would take them right one day then forget the morning of the next day. When I saw that it was forming a pattern of forgetfulness every other day, I simply skipped the morning doses, and did much better.
I forgot to get my labs done before my next appointment, though, and got a thorough scolding from Endo #1. He made me promise to "be compliant" on my meds. I played the game, and he started reducing my meds. By the end of March 2010 I had had enough and began weaning myself off the MMI.
I spent a pleasant summer hyperthyroid, but my other doctors would nag me about getting treatment for the GD, so I went to Endo #2 for a second opinion. He has treated me from Sept 2010 until now.
Estrogen competes with the same T4 receptacle that converts T4 into T3. If you have a shortage of T4 or a shortage/abundance of Estrogen...you will have a mini war going on with the estrogen for the T4 receptacle that converts to T3 resulting in a low FT3 level. Adding Selenium with Vit E will help but in the long run...if your FT4 does not come up that little bit more and your FT3 still says low...even with the Selenium...you may have to add a small amount of T4 hormone with T3 added...Big Hugs...Kathy
I just got a call from my endo's office saying that they are sending the information to the new endo in Denver--no other comment as to my labs. I just figure they would not be willing to supplement me anyway. I have more hope with Dr. Sarapura in Denver because she is primarily involved with thyroid patients and teaches at the University of Colorado Denver.
I have been taking vitamin E for a long time, and recently have added Brazil nuts since I know they are high in selenium. I like eating dried apricots with them. I used to eat that combination when I was in my twenties and thirties, every time I felt "strange" and it seemed to help me feel better.
I also had a bacterial vaginal infection and went to someone in my OB/gyn's office. I asked if she would test me for hormone levels and she said, "No. I already know your Estrogen and Progesterone levels are zero." She also asked me why I quit using the premarin that had been prescribed for me last August. I told her I thought it made me feel worse, but when I was on bioidentical Progesterone I felt better. (My doctor had taken me off the progesterone because of cancer scares.)
We talked a little about the thyroid. I told her I had been off the MMI since early December but felt hypo now. She asked who I see and I told her. She asked if I stopped the MMI on my own or if my endo took me off. I wish I had told her "both," but I really just said he stopped it, because he had approved it. I also showed her my thyroid lab report I had just picked up (April's) and she said "Good!"
I know there is a great difference in the traditional medical approach and naturepaths'. I saw once that someone commented on a certain site showing guidelines regarding thyroid treatment from the AACE, but concerned that it was written in "medicalese". I can read it, and was intending to write a summary to post on this forum. I know why they consider the TSH test to be so good and the FT4 and FT3 to be mostly ignored, still, they say that doctors should consider each patient individually, etc., which is why I think a real thyroid doctor might be better.