Am I having a Relapse of Graves Disease?

[SickLeo17]

I suspect that I’m in the early stages of a Recurrence of Graves Disease.

I’m jittery and anxious, agitated with obsessive thought patterns, irritable and having trouble falling asleep at night especially with the really sore feet. My skin is dry and I’m constipated which is confusing as that’s a hypo symptom. Blurry vision with teary eyes. My appetite is reduced, like last time, oh and bad dreams

[Heloise]

Hi Leo, I think it can go back and forth, some doctors call it all hypothyroid. There are some here that had Graves and some experience which might be more helpful. they are under Related Posts. healthunlocked.com/thyroidu...

[Valarian in reply to Heloise]

Graves’ is definitely a hypERthyroid condition, which goes through periods of remission, and can be encouraged into remission with antithyroid drugs such as Carbimazole. Thyroid levels on first diagnosis may be double the reference range.

When people with Graves’ are in remission, their thyroid levels within range - they don’t normally swing between hyper and hypo, although while on antithyroids, their levels may drop below range temporarily due to over medication. This doesn’t make them hypothyroid.

There are a few people who really do have Hashi’s and Graves’ , in which case, the medics will treat whichever is the current problem. It also seems that around 15-20% of people with Graves’ may later develop Hashi’s.

ncbi.nlm.nih.gov/pmc/articl...

quora.com/Is-it-possible-to...

healthcentral.com/article/g...

[SlowDragon Administrator]

Insomnia and sore feet can be low vitamin D or low FT3

Anxiety can be hypo as well, not necessarily hyper. Dry skin and constipation are usually hypo

For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies.

Plus very important to test vitamin D, folate, ferritin and B12

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

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

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should ideally be done as early as possible in morning and fasting. If on Levothyroxine, don't take in the 24 hours prior to test, (and if on T3 don't take in 12 hours prior to test), delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

Did you try strictly gluten free diet yet? It might help reduce swings

[SickLeo17 in reply to SlowDragon]

Hi. Yes I am vit D and calcium deficient. My ferritin levels are 10.

However, my vit D has been deficient for well over 6 months now and the sore feet symptom has only been back recently

[SlowDragon Administrator in reply to SickLeo17]

So how low was vitamin D and how much are you taking

Calcium will naturally rise as vitamin D improves

Ferritin is extremely low. Have you had full iron panel done to test for Anaemia. Assuming iron is also low you will need ferrous fumerate supplements or iron infusion to bring up to half way in range

What about B12 and folate levels

[SickLeo17 in reply to SlowDragon]

Vit D has been sitting around 35 (50 - 150)

Calcium 2.21 (2.25 - 2.65)

Iron 9 (10 - 33)

B12 and folate are normal

Ferritin 10 (20 - 290)

Yes full panels have been done often with little improvement ferritin was 8 and now 10.

I’m booked in for iron infusion on Monday.

Dr said I need to supplement with vit d for a few years

[Valarian]

The symptoms are a bit of a mix, but if it is the beginnings of a Graves’ relapse, or any other thyroid problem, the only way to be sure is to have your blood tested. As you’ve got Graves’ (currently in remission - it can’t be cured) you should be having at least annual blood tests, so I would just tell your surgery you’re worried about your symptoms, and ask for your next TFT to be brought forward. You could ask for a vitamin panel at the same time.