I only have Tsh level, need help.

[sarajuarez2912]

My Tsh level was 4.19 I'm taking methmaziole M, W, F (2.5 mg once a day) when first diagnosed with Thyroid condition I had graves and hashimotos last year around August. Now it seems like I'm struggling with hypo symptoms as told by my Specialist. Can anyone tell me anything for now about my Tsh level thanks.

[shaws Administrator]

When we give results it is helpful to also put the ranges - ranges are in brackets after the results. Labs differ and so do the ranges, I will say that if you had a blood test for hypothyroidism that the 4.19 could be near the upper part of the range, which is usually around 5. However, in the UK they will not diagnose until it reaches 10 and people can be quite unwell by then.

To get the most accurate results all blood tests have to be at the very earliest possible, fasting (you can drink water) and if you were prescribed levothyroxine, you would allow 24 hours gap between last dose and test and take it afterwards. This prevents the results being skewed.

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/testin...

[Jazzw]

I would say you either need less methmaziole - or possible none. You’re right - it looks like you’re being overtreated now which is why you’re getting hypo symptoms.

Are you able to get in touch with your specialist?

[shaws Administrator]

I see that you haven't yet had a response from those members who've Graves/had Graves and when they read your post they should respond. If you edit your post by pressing the down arrow across from Follow Post press edit and insert Graves, it will draw attention to your post.

[sarajuarez2912]

Yes thanks for the responses here. I've put on weight, but I don't look fat, the Specialist had ask me on my last visit which was a month ago if I was working out, I told her no, cause I'm not, I weight 164, and had never been that big in my life, not even when I was pregnant. I guess being at these weight has put a little strain on me. I had my pulse go up at my Doctors, not the Specialist, and not only my pulse but showed I had blood Pressure. The Doctor waited awhile to check my pulse and heartbeat again and said everything was fine, cause if I would had had blood pressure she would had prescribe me medicine. I don't know if I had an anxiety moment or happened to go through a blood pressure moment... I'm trying to lose weight by eating less... but it doesn't seem to work... I wonder what happened to graves? I was first diagnosed with graves and hashimotos, and last she told me was that she was dealing with hypo symptoms I have... confusing for me... lately I've been very anxious feelings, and they are terrible feelings. Thanks so much for reading.

[Silver_Fairy]

A year ago you posted that you felt wonderful, since then your TSH has risen and now shows you are overmedicated on the antithyroid dose.

How long have you been taking methimaziole?

If you have been diagnosed with Graves the Endo should be testing FT3.

[sarajuarez2912 in reply to Silver_Fairy]

I was diagnosed with graves and hashimotos from the beginning, and have been on this medication since the beginning, even tho I'm only taking it mon, wed, fri once a day, and it's 2.5 mg once a day. I wonder how long she's going to have me like this since she says I'm doing fine. She had put me down as disable for a year as being hypo symptom..... I hope good news comes out of this in the end.

[Valarian in reply to sarajuarez2912]

Hi Sarajurez, where are you ?

In the UK, we are prescribed Carbimazole rather than Methimazole, and I’m not sure how the doses compare, but given that you are only taking it every other day, this appears to be a pretty low dose.

When you were originally diagnosed, did they definitely confirm Graves’ through antibody tests ? Just wondering, because people with Hashi’s also have hyper phases, and in the UK we’ve seen people being told they have Graves on the basis that they had a low TSH on their initial visit to the doctor. Having both sounds like a real bummer, but you aren’t alone, and if you mention both Graves’ and Hashi’s in the title of your post, you are likely to get more responses.

Graves’ can’t be cured, the aim is to achieve remission with thyroid levels within the reference ranges. In the UK, a typical approach is to prescribe antithyroids (usually Carbimazole) at a relatively high dose until thyroid levels are within range, then gradually reduce the dose over the course of a year to eighteen months. During this time, we have regular blood tests and endo appointments.

How much was your original dose of Methimazole, and when was it last reduced ? Also, do you know the ranges for your recent tests (possibly in brackets following the result), as these vary from lab to lab, especially as it looks as though you are outside the UK

Given you were diagnosed with Hashi’s and Graves’ simultaneously, it might be worth asking for antibody tests to be redone. Also, you’d expect them to be monitoring FT3 and FT4 trends from one test to the next versus your antithyroid dose.

[sarajuarez2912]

Valarian thanks for your response. I'm starting to wonder what my Specialist is thinking since she last spoke to me , she said my Tsh level was perfect, and to continue same dosage, as I stated above on the M,W,F (2.5mg) I no longer know what to think since I'm also getting a little bit of heart palpitations, I hope she will check my other blood levels as you stated above, since they haven't been checked. Thanks and any other comments would be greatly appreciated, since it could help me in case of other symptoms that may arise. Again thanks for your information and your time, it's life saving and richly needed.

[helvella Administrator in reply to sarajuarez2912]

sarajuarez2912,

We are all wondering what your Specialist is thinking.

Some likely wondering IF she is thinking, at all.

Superficially, your story looks bizarre. TSH is not an ideal test, but being near (or above) top of range is not the right place for it.

Methimazole (and carbimazole) have short half-lives. Meaning that well before you are due your next dose, the level in your system will be low or very low. The short half-life is why it is so often recommended that seriously hyperthyroid patients should split dose (taking in two lots each day).