Advice on subclinical hyperthyroid

[citizenm]

I was wondering if I could get your thoughts, I have been diagnosed with subclinical hyperactive thyroid (graves). My symptoms have been mild, primarily a change in period and some tiredness that have been around since September. I have had 2 blood tests as follows:

October

TSH <0.1 (0.3 - 3.05)

FT4 27.2 (10.0 - 28.2)

FT3 7.8 (4.3 - 8.1)

antibodies: not taken

November

TSH <0.1

FT4 21.2

FT3 6.2

Anitbodies : 3.88 (0.81 - 3)

January

TSH <0.1

FT4 22.2

FT3 6.2

Anitbodies : not taken

Even though my TSH is suppressed and my FT4 and FT3 would be considered in the 'normal' range my endo keeps referring to this as borderline. It has been suggested that l take Propranolol in the hope that it will bring my FT4 and FT3 down and subsequently increase my TSH. I do not have heart palpitations at the moment, my heart rate according to my tracker has increased to 71 bpm on average which is in the high end for me but this fluctuates through the month. Ideally I would like to monitor this but my endo seemed to stress the importance of protecting the heart now. It was also mentioned that private health insurance would not cover anything that was deemed 'monitoring'. We have agreed to do another blood test next month, this time with antibodies to see where they are going.

I would be grateful if you could give your thoughts as to what you would do in this situation.

Thanks in advance for any responses!

[jimh111]

Your endo should be checking your antibodies, specifically TRAb antibodies I believe. I think it would be a good idea to take some propranolol if your thyroid hasn't settled down. This is because it will not only protect your heart but it also reduces T4 to T3 conversion and so allow your TSH to come up a little. Often if the TSH is suppressed for a long time it fails to recover when fT3 and fT4 normalise. This seems to cause problems with T4 to T3 conversion. If your thyroid doesn't recover and you have to have it removed sometime in the future you want your TSH production to be good, otherwise you get all sorts of problems with doctors who don't want to give you enough hormone because 'your TSH is low'. If you need propranolol perhaps go for the lowest effective dose that brings your TSH above .e.g 0.3.