Graves?

[Dee1962]

Hi

My appointment with the endo was brought forward from end of May to last Thursday (they'd had a cancellation). I had a 4th year student doctor see me first, then the dr, who is a professor, no less! Anyway, using the results of a blood test I had 4 weeks ago, he asked her what she could see that was odd about it. He said that it was because the TSH (?) was low, and T3 and T4 were raised. I don't have a copy of the results, but am I right in thinking that this could indicate Graves Disease? I have a swollen thyroid, no nodules. They had me sip and swallow water - alot! I had a blood test on Thursday too and dr said he'd contact me with result, but not til next week.

[Dee1962]

Do they do them at the same time?

[Fruitandnutcase]

It’s antibodies that indicate whether or not you have Graves. As my doctor said I had a very overactive thyroid with antibodies, even then I didn’t think of Graves. It was onlyafter cominon here I began to w9nder then it was me who asked the endo if I could have Graves! Im not sure the G word would have come up if I hadn’t mentioned it!

[Dee1962]

Just one more question - is it possible to be euthyroid with Graves disease?

[ShootingStars in reply to Dee1962]

Yes, it's possible but would be temporary, as Angel_of_the_North explains. It is also possible to have both Hashi's and Graves antibodies. Rare, but it does happen. This is why in the beginning it's best to test for both, establish if you have either or both diseases, and then as time goes on, monitor elevated antibodies as well as occasionally monitor antibodies for the opposite disease.

[Angel_of_the_North]

Not necessarily Graves. Could be Hashis (autoimmune HYPO thyroidism) just after a flare when the dying thyroid release a lot of hormone into the blood stream - but you become more hypo afterwards. Different antibodies are involved and the treatment is different. TSI or TRab for Graves and TPO and/or TG for Hashis.

[ShootingStars]

No kidding! Based on these doctors making her sip and swallow a bunch of water (huh, what??), I would have to guess that they didn't know that they needed to test thyroid antibodies.

[ShootingStars]

Hi Dee1962. What sorts of symptoms do you have? Regarding diagnostic results, some patients don't realize that it is the right of all patients to get copies of all your labs and other diagnostics. You don't have to wait in the dark until next week to get those results if you don't want to. You can ring up that endo's office, tell them you need your copes, and they have to release your results to you. Considering how many times we've seen on this site that doctors incorrectly tell patients their levels are all normal and that they don't have a thyroid problems despite symptoms and bloods showing they do, or that they don't need more medication when their bloods and symptoms indicate that they do, it could very well be that they don't quite know how to read and interpret your thyroid blood tests.

The thyroid antibodies that need to be tested are: TPOab, TGab, and TSI.

If you have a swollen thyroid, this is not normal. What did these doctors say about this? Did you have a thyroid ultrasound to determine that you don't have any nodules? Sometimes lymph nodes around the thyroid can also be enlarged, which show up on an ultrasound and are measured. What were the measurements of your thyroid and any other abnormalities? Depending upon your ultrasound results and your labs, there are several treatments for an enlarged thyroid. If your labs indicate thyroid disease, taking thyroid medication often reduces the size of your thyroid.

[Dee1962 in reply to ShootingStars]

I have quite a swollen thyroid; extreme sweats, particulary at night; getting up to go to the loo in the night (something I've never done until the last few weeks); exhaustion; anxiety; forgetfulness. Probably other things I can't think of right now.

[Dee1962 in reply to ShootingStars]

Oh, and no, I didn't have an ultrasound, both just felt my neck. It seemed more like an exercise for the student doctor, rather than diagnosing me. The student did most of the obs, not the consultant.

[ShootingStars in reply to Dee1962]

Oh, just OH! Biggest fail, ever! Those docs just keep failing left and right, don’t they? Idiots! They can’t diagnose anything for the life of them! Do they think they have X-ray vision and magic thyroid analyzing hands? To tell you you don’t have nodules, based on a feel?!?

They are going to kill someone if they haven’t yet! What is wrong with some dumb people? I can assure you that just feeling your neck is not at all how it is determined that you don’t have nodules! There is no possible way that just feeling a neck can determine if you do or don’t have nodules. Nodules are within the thyroid, are often very tiny and cannot usually be felt. Sure, if a person ignores their enlarged thyroid long enough and doesn’t take meds, yes, their nodules can become HUGE, and then they can most definitely be felt. Those two should be fired for medical negligence!

Dee1962, you absolutely MUST get a thyroid ultrasound ASAP. You have thyroid disease, a goiter, odd blood results (but based on those characters “diagnosing you” I wouldn’t be surprised if their analysis of your bloods is all wrong.) You need an ultrasound to rule out thyroid cancer. It is not super common, but it does happpen and is very treatable.!Every person who has a swollen neck needs to rule out they don’t have cancer! I know that I did, as did everyone else I know with a swollen neck.

You also must get your antibodies tested. They might very well be the cause of your damaged and enlarged thyroid.

Please do not follow any of the advice of those “doctors” because they are on a big losing streak! I hope you can quickly find a new and competent doctor for all of your health needs.

[Dee1962 in reply to ShootingStars]

I should also add, I was sent home with leaflets about RAI and thyroidectomy, to 'read'.

[ShootingStars in reply to Dee1962]

HUH? What the fruitloop? Throwing RAI and TT literature at me after being told I don't have nodules and no referral to get an ultrasound must have been confusing and frightening! Did they explain why, or just throw them in your face as you were leaving? First they misdiagnose that you don't have nodules based on water drinking and pocking and prodding (with their winning history, doubt they know how to palpate), no referral for accurate thyroid diagnostics: ultrasound. Then they're throwing RAI and TT literature at you? Since that one winner is a prof and he's teaching other docs in the UK, now we know why docs in the UK are so incompetent: they were taught by the likes of that guy!

For the record, they cannot determine that you need RAI or a TT based on blood work or prodding your neck. Only an ultrasound and the correct lab tests can determine that. Most people with goiters experience a reduction in the size of their goiter once on the right medication, but not always.

Those two are so incompetent. They should not be allowed to see anymore patients, let alone that prof teaching young docs. This is medical negligence and incompetence. Can you file a complaint against their license, so it goes on the record and other patients who thoroughly vet their docs (checking license is one way), are warned about him?

Who large is your neck swollen? Barely, you can tell a little, it's big, or it's huge?

[ShootingStars]

That is horribly criminal! Shame on them! When you guys get your tests through the NHS, do you have to pay anything? If so, how much? What's the cost when you have to go and run the tests some place yourself?

[ShootingStars]

I see. Almost free (not that it is, as I'm not sure how your taxes work) is good, but worthless if they don't order the right tests. Running tests privately sounds expensive, but is probably close to or less than what we pay here for healthcare, co-pay, etc. No matter how it's done, it all adds up and costs a lot in the end, doesn't it? Is that $70 to $100 for each test?

We have to pay an office visit, some sort of a fee for each lab test, then the prescription. Some offices also send you an extra bill for the remainder of the office visit after your insurance pays. It's complicated!

I just met with a new Naturopath last week. She had a few tests she wanted to run. Then I asked if she was up for ordering some tests that I wanted. She said yes. She kindly ordered about 12 or more tests for me! Between the ones she ordered and all the ones I ordered, (both lists had some more unusual and probably expensive tests) I am afraid to know what the cost to me will be!

[ShootingStars]

I’m not sure if we do or not. We all pay income, state, local, and other taxes. Some states also have sales tax on certain types of items.

Health tourists who skip without paying? How can people do such an unethical thing and probably have no continence?

Barely any preventative care? You’re kidding. Your health system sounds really messed up, I’m sorry to say.