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...

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Labs! What does this mean?

scorpiogirl76
scorpiogirl76
Hello everyone! So, I haven't been feeling so well the past few days (been having that "off" feeling and had one episode of that middle of the night "surge" which in the past is usually a T3 surge) so I decided to lab (i've been using mymedlab.com (lab corp) when I feel off now so I don't have to wait on doc).... I stopped putting down the TSH a long time ago since I was never showing any movement... and in May, I didn't even bother with the TSH to be tested. However, this time around, I did test it and OMG... I'm on the map! What does this mean? Am I headed toward remission? Was I misdiagnosed and Graves was an error? Or am I just going so hypo that i've been added to hypo hell on the map? ANY ADVICE is appreciated as I am confused over here. :) Anyhow, here are my results since April to give you an idea of what my levels have been doing:

April 20ish labs (quest labs):

Free T3: 390 (range 230-420)
Free T4: 1.1 (range 0.8-1-1)

PTU 37.5 mg. Propranolol 10 mg twice daily.

Labs from May 20 (Lab Corp):
Free T4: 0.97 (range 0.82-1.77)
Free T3: 3.3 (2.0-4.4)

Lowered to 25 mg of PTU per day. Propranolol 5 mg every morning and 10 mg every night at bedtime. (after a week, switched PTU to 25 mg one day and 37.5 mg other day (alternating days)).

Labs from June 23 (Lab Corp):
Free T4: 5.6 (range 4.5-12.0)
Free T3: 2.9 (range 2.0-4.4)
TSH: 0.447 (range 0.450-4.500)
T3 Uptake: 34 (range 24-39 percent)
Free Thyroxine Index: 1.9 (range 1.2-4.9)

Haven't seen doc yet. (see doc on July 7). Lab again on July 5 thru Quest (doctors lab orders).
dairytech
dairytech
Your mid range for your FT4 is 8.5... yours is low. Your mid range for your FT3 is 3.2...yours is low. You are hypo. You will need a med reduction in order for your levels to come up to mid range. With your levels being low and showing some TSH it could be false. Since your on PTU...25mcg is a very small amount...this is what happened to me when I neared remission. Since its hard to take a smaller amount of PTU than you are already taking and divide it up into 3 equal amounts you may want to think about dropping alternating days and think about skipping a day and see how your labs are. I would wean off slowly....remember slow and steady wins the graves race. Why are you still taking Propranolol...isnt that a beta blocker? Big Hugs...Kathy
scorpiogirl76
scorpiogirl76
Hi Kathy: Thanks for the advice..... I'll try alternating with skipping my morning dose every other day for now. I was put on Propranolol in April when I had an episode (racing heartbeat, palpitations, possibly thyroid dumping?) and ended up in the hospital. They put me on 10 mg twice a day and I reduced it myself about a month ago to 5 mg in morning and 10 mg at night. I'll reduce again in a week (will reduce PTU first)... and I'll do Propranolol 5 mg twice daily til I lab again. What do you think?

I am PRAYING PRAYING PRAYING for remission :) and no relapses. How long have you been in remission now?

Thank again!
~Hugs.
bransnana
bransnana
Hi! the fact that your tsh has risen is probably cause you're over medicated. A show in tsh in the first year is usually that, you are just over medicated and your labs show it like Kathy said. If you're taking 37.5 one day and 25 the next, just try 25 everyday. That might make your labs come up a bit. It's always a good sign when you take a small amount of meds and see a tsh. Don't let them take you off meds too soon though, wean slowly or just stay on a maintenance dose for now.
scorpiogirl76
scorpiogirl76
Thanks Brans... I won't let them take me off just yet. (I'm not ready myself)... I'll ween slowly over months if I have to. I'll drop down to 25 mg daily of PTU starting today and then in a week (after the 4th), I'll drop my Propronaolol to 5 mg twice a day and wait til next labs. I thought I may be either heading hypo or heading hyper as I keep feeling this weird sensation of not being able to get a breath which then sets my anxiety off and then my heartrate rises so then I get confused and think i'm going hyper again when I'm probably almost in hypo hell :) I've also been really tired lately but blamed that on getting up so early every day.... Everyone on this site always gives the best advice. Thanks so much.
dairytech
dairytech
I reduced really slow as well. The smallest amount of PTU I took was 25mcg. That is such a small amount thats why I suggested alternating. If you were taking 25mcg of MM that would be equivalent to 250mcg of PTU....that would be a different story. I kept myself in hypo hell for almost a year by reducing to slow. I dont wish that on anyone. In hindsight...I could have bumped it up a bit. But...you have to do whats comfortable for you and what you feel is safe. The one thing you can rely on is your labs...if you get them every 4 weeks when your reducing you wont slide one way or the other to quickly. Ive been in remission now for 1 1/2 years. I think you have a really good chance at achieving it. If you have any doubts I would ask Elaine Moore about it. I got a lot of help from her as well as the wonderful folks here. Big Hugs...Kathy
bransnana
bransnana
I think what she's taking is equivilent to 3.75 methimazole and 2.5 of methimazole. i took as low as 1.25 of mm for about 9 months before I cut it to 6 times a week, five times, four times etc..I was really going slowly, probably not necessary after 3 years. I was just afraid to get completely off but I am fine and my tsh is still kind of high after a month, 2.57. I go every 3 months after this. My doc seems to think I'll be fine. She was very positive, very odd for an endo! LOL!
scorpiogirl76
scorpiogirl76
I'm curious to see how my new endo will react with my tsh showing up. Wondering if she'll suggest stopping the PTU? But I'll ask to stay on it a bit longer.... as I too am afraid to get off of it. As well as the propranolol. Every time I have gotten off the beta blocker, I end up in the hospital with fast heart rate out of control... no fun :( I emailed Elaine to see what she has to say so i'll keep you updated. Thanks ladies for the advice.
dairytech
dairytech
Hmmm...I thought MM was 10 times stronger than PTU.
mmztcass
mmztcass
MMI has a half life of 5-6 times. PTU's half life is 2.

{{{hugs}}} :-)
scorpiogirl76
scorpiogirl76
Okay, Elaine wrote me back and said that it is quite possibly that I am being overmedicated which is causing my tsh to show up. OR there is a possibility I am heading into remission (Praying for that miracle- it's only been since August since I had the storm). She said to maintain my dose til next labs or drop to half my dose and if at next labs, my tsh is still showing, wait 6 more weeks to lab again and if tsh is still above 0.3, then I may very well be in remission! Praying Praying Praying :)

Now.... I woke up today with horrible body aches... my neck and shoulders especially. Feels like I worked out or something which I haven't. Could this be due to hypo-ness? (is that a word?). Or maybe just a bug?

Thanks.

Hugs.
dairytech
dairytech
This is very good news scorpio! When I look back at my labs vs meds...I was showing hypo and producing some TSH after just 3 months. I asked Elaine Moore if it was possible to go into remission so quickly and she assured me you could. Have you had your antibody tests done lately? It would be interesting to see where there at.

What your feeling now is hypo symptoms. I get the worst muscle and joint aches when Im hypo. If I go to far down the hypo rabbit hole I get headaches, constipation, brain fog, carpal tunnel and just an over all feeling of un wellness. Hang in there...reduce slowly and wait for your labs to show you which direction to go in next. Im hoping you are nearing remission... Big Hugs...Kathy
dairytech
dairytech
Oh...what did Elaine say about the beta blocker?
mmztcass
mmztcass
Slight thyroid level from the changes due to meds or diet, can have an impact on my sensitive body. I recenty lowered my ATD doses by 0.625 mg to 4.375 mg per day. I was at 5 mg of MMI. Boy did I feel the changes...but for good though. I did have a bit more aches and pains. This AM I woke up and almost bounced out of the Lazyboy style chair...except for the Rheumatoid Arthritis I have, I couldn't. But it was such a wonderful feeling...!

Woo wee...! :-)