Here's a question for you????

[mandr33]

Do you think someone who has had Graves disease then had RAI to kill off thyroid should be treated the same as someone who is hypo eg TSH, FT4, T3 levels????

[marram]

Actually, no. Because the TSH is even more irrelevant than in hypothyroidism. They do not NEED to test the TSH, because there is no thyroid for the Thyroid Stimulating Hormone to stimulate!

For someone with Graves' there is really only one thyroid hormone which needs to be measured, and that's the free T3.

Why do I say this?

Graves' antibodies suppress the TSH so it is not relevant:

hotthyroidology.com/editori...

Also, if a person is on Levothyroxine, then the only T4 in the body will be the pills he/she takes, and the only T3 in the body will be what is converted from the T4. So you can see why T3 needs to be tested, but not TSH or T4.

Again, if the person is taking T4/T3 or T3 only, still the one to test is the T3.

Finally, due to the nature of Graves', they really should test for Graves' antibodies from time to time because flare-ups can occur and can attack the eyes.

Unfortunately for we Graves' folks, they test only the TSH and leave us to get on with it most of the time.

Of course, testing the TSH is also irrelevant for TT-for-other-reasons plus hashis and hypo-for-other-reasons folks too, because anyone who is taking any form of thyroid replacement will be disrupting the HPT-Pituitary-Thyroid feedback system. In their case. though, it's important to test the T4 to see if their thyroid is producing any of its own.

Marie XX

[bantam12]

The pituitary detects the amount of T4 in the body so if too low tsh goes up,if to high tsh goes down, as we all know, so I don't quite understand how measuring tsh is useless as it still indicates the T4 levels. At one time I had my dose reduced slightly and my tsh shot up to 17.5 so my pituitary sensed the lack of T4 and the tsh result indicated I needed to up my dose. If I had only T3 tested and my dose went on that result I would be way overmedicated as my T3 is always bottom end of the range any higher and I am hyper.

[mandr33]

Hi Marie, thanks for your reply. I had RAI in 2009 and have been fighting with my gp ever since. She kept telling me to lower my levothyroxine as I was over medicating. I have done to prove a point to her and started to have anxiety attacks, tiredness etc. I had my bloods done on monday and my T3 was 3.7 in the past its been around 4.2-4.5 and I have felt ok. I had a long conversation on the phone with her and told her I am going to upp my meds and explained basically what you said above. She thanked me and said I like it when my patients tell me new stufd, so she acutally listened hopefully I will start to feel better again soon. Many thanks for your reply.

Melanie

[Dora-33]

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