What the heck it keeps eating my response???

I'll try one more time... Yes I had the TRAB test, result was

I give up!!

tina:

Please leave out the plus and minus signs as this board does not accept them.

{{{hugs}}}

Yes I had the TRAB test, result was:

less than 0.51 ( range, 0.00 thru1.75). I also had the TSI test, result 25- range, (0 thru 139). I have used ATD'S two times in the past with suppressed TSH with FT3 and FT4 in the normal range, the low end of the ranges. That's why I believe my endo wants to take this route again because it's worked twice!! The PTU both times raised my TSH and my FT3 and FT4 didn't fluctuate much at all, either way, pretty much just stayed within a couple of tenths of a point. I've asked my endo and two other doctors why this is as my case is unusual and none of them knew the answer. They were just glad it worked and told me not to worry why. I just posted this same question to Elaine Moore in hopes she may know the answer. Does anybody here have any idea why it's worked for me twice?? It's so frustrating not knowing!!!

Thanks again for all your support everyone, you all rock!!

Thank you MMZTCASS for helping me figure out why I couldn't post!! I took out all the plus and minus and greater than signs. How weird...

Hugs to you:: :)

Please excuse my bluntness but, I don't consider taking ATD's to raise TSH when FT4/FT3 levels are hypo to have "worked".

I think you are very fortunate that your FT4/FT3 levels weren't driven even more hypo.

Healthy people have TSI levels less than 2. So, even though you didn't have TSI levels that would cause hyperthyroidism, you definitely have Graves'.

TRab less than .051 just means that the lab can't measure smaller units.

Please know that TRab is comprised of stimulating antibodies (TSI), blocking antibodies (TBII) and neutral antibodies.

Blocking antibodies are VERY powerful. They can either negate the effects of TSI and make the patient euthyroid (healthy thyroid levels) but, they, too, suppress TSH.

And, the blocking antibodies can override the effects of TSI and make the patient hypo (with suppressed TSH). This is what happened to me.

Your FT4/FT3 levels are lower in the range than mine were when I started thyroid hormone replacement (and my TSH was suppressed).

Your doctors are obviously confused by your TSH.

You are hypo and would benefit from treatment with thyroid hormone replacement and NOT another round of ATD's.

I am going to call my doctor tomorrow and see if he will start me on the hormone replacement. One more question though? Will the horomone replacement cause my TSH to drop even more or rise? I get soooo nervous and anxious when my TSH drops below .20 so I'm worried about going on hormone replacement...

Thank you so much for all your input cd3764

More likely than not, thyroid hormone replacement will cause your TSH to decrease.

Why is this a concern for you? Your antibodies are doing the job of TSH.....

And, for whatever it's worth, I've been taking thyroid hormone replacement for over 3 years now. My FT4/FT3 levels are near the high ends of their ranges and I feel awesome. On a "good" day, my TSH is .01.

When my TSH is higher, my FT4/FT3 levels are lower.....and I have had over 30 symptoms when my FT4/FT3 levels were a little higher than yours.

I've also had elevated blood glucose and cholesterol as well as elevated liver enzymes at times like that.....just to have a decent TSH. No thanks :)

I care more about how I feel and how my body is functioning rather than what's written for one *pituitary* hormone level on a lab report.

I guess our cases are a little different then. As I said my FT3/FT4 never jump around all that much, I checked all my lab work, they are always on the low end regardless of where my TSH is. And the reason I am so concerned about my TSH is because that's all I have to go on as far as how I am feeling. As I take ATD's and my TSH starts to go up I start to feel better. Like I mentioned in some of my earlier posts, my case is a little unusual as I don't ever have the high FT3 and FT4. Who knows?? I don't know what else to say. :( I will call my doctor though and see what he thinks about starting on hormone replacement.

Thanks again!

tlinaluski...the thing is..TSH is a Pituitary hormone not a thyroid hormone. Your TSH has nothing to do with your thyroid. When we look at the TSH its to see what the Pituitary is doing...its purpose is to instruct the thyroid to make more or less T4...that's all. When we have Graves our antibodies interfere or give false readings of the TSH. In the perfect world...our docs should never run the TSH let alone dose meds by it. When I look at my TSH its only to see the bigger picture...I would be very happy if I never got one run ever again but our medical community still places it on the thyroid blood panel. I'm very lucky to have a GP that knows this and ignores it.

Even if you did have something strange going on and ATD's brought your TSH up and your FT's stayed pretty close to the same place as they are now...you would still be hypo! I would not be able to function if these were my labs.

You have been given some great advise...cd and mmz know there stuff. My guess is you've been hypo for so long you dont know what feeling good feels like...Big Hugs...Kathy

Actually I do know what feeling good feels like as I have been feeling pretty darn good for over two years now. This has all come back to haunt me again though. I appreciate everybody's input and advice and will take it all into consideration. I will also speak to my doctor about the possibility of starting thyroid replacement if the ATD's do not put me in a remission state again. According to Elaine Moore I have subclinical hyperthyroidism which according to her does not been treatment, but could turn into hyperthyroidism. So another opinion on the board...Ugh!!

Take Care everyone and I will keep you posted on how I am doing in the next few weeks!!

Tina:

I think you meant subclinical hypERthyroidism which could turn into hypOthyroidism.

Thanks for letting us know how it's going for you.

{{{hugs}}}

My input, for what it is worth, is that your labs look a lot like mine were a month ago.

The biggest differences: I do have high levels of antibodies, both TSI showing the GD, and anti-TPO showing Hashimoto's. Also different symptoms, being horribly sensitive to the cold and having over-whelming brain fog, loss of appetite, libido, etc.

My new PCP is now providing T3 supplementation: 5 mcg Liothyronine up to 2x daily as needed. I started out one week ago with 2.5 mcg in the morning and it was such a jolt to my system that I didn't take it at all the next day. I have taken it every other day since then, and I finally feel healthy, alert, and alive.

To me, symptoms are everything. My doctor explained that I am "not a textbook case" and we need to work with the symptoms. He pointed out that 93% of people are well-served by looking at the TSH in the ranges as given, but some of us need more supplementation when we are at the low end, and some feel better at the low end.

With GD, I felt much better when my TSH went from 0 to 2.53 then worse all of the rest of the time when my labs were drawn. But

So the question is, how did you feel when you were treated for GD? If you felt better then go for it. I would start out slow and increase gradually if needed, though.

I think it's important to consider the context in which TSH is suppressed.

Case 1: Someone has full on Graves, high T4/T3 and suppressed TSH, they take ATD's get the T4/3 down but the TSH is still suppressed. This is the point when many doctors look at the TSH only wanting to push it up and drive the patient hypo - BAD. I am in total agreement with all of you that in this scenario going by the TSH is a mistake.

Case 2: Someone has lowered (if not suppressed) TSH after a longer period of normalcy of TSH/T4/T3 and has hyper symptoms. To me this is different and what tinaluski is dealing with. My Graves' onset looked exactly like this - my T4/T3 were tested and found to be fine, only my TSH was low and slightly under the bottom of the range. But I had hyper symptoms.....doc ignored it. Three months later I had full on Graves. So in this case where the TSH is *newly* falling it might mean something.

So which is why I'd vote Tina wait maybe four weeks and retest to see what's happening.