Thyroid Results HELP with TSH level/Graves

[Coast40]

I was diagnosed with Graves in June and for July have been on initially 40mg on Carbimonzale for 4 weeks then dropped down to 10mg in August after seeing consultant for the first time (initally my June's T4 was 51.4 (range 12-22) and TSH was 0.01 (0.27-4.2 range) and then my August blood test were T4 - 14 and TSH - 0.02.

I have had another blood test last week Sept - have had a ever so slight hoarse voice/sore throat and feeling a bit tired but nothing unusual and now my levels are T4 - 12.9 and TSH - 5.46.

Just trying to interpret results before I see consultant again this week - does this mean I am borderline Hypo now?! Would they reduce my meds to 5mg? Can someone explain the TSH/T4 !

Thank you in advance, this forum is such a helpful place x

[greygoose]

How were you diagnosed with Grave's? Were any antibodies tested? If so, what were they and what was the result?

You are not borderline hypo - not in the real world, anyway - you are hypo. But, your endo probably won't think so. You really do need some antibodies tested : TRAB or TSI for Grave's; TPO and Tg for Hashi's.

[Coast40 in reply to greygoose]

Thanks greygoose i was antibody tested I was diagnosed with Graves (0-2) and I was 4. Thanks that's really helpful - I will speak to him this week Can you explain though was the TSH level means too

[greygoose in reply to Coast40]

The TSH - Thyroid Stimulating Hormone - is secreted by the pituitary to stimulate the thyroid to make more hormone. The more hypo you are, the higher the TSH. Your TSH is high because your FT4 is low - and probably your FT3, too. However, your TSH doesn't change as quickly as the FT4 level, so that's why it was still suppressed when your FT4 was 14 - which is quite low. But, now it's caught up, and both your TSH and FT4 are saying that you're hypo.

[Coast40 in reply to greygoose]

Thanks Greygoose that SO helpful. Nice to know you can go online and get instant information yet all the docs do is send you a text saying get a docs appointment, even though you have a hospital app 2 days later lol! Much appreciated

[greygoose in reply to Coast40]

To listen to them, you'd think they don't need to go on-line, it's all there, in their heads - well, it is all in their heads but it's called 'delusion'!

[Valarian in reply to Coast40]

TSH often remains suppressed for quite a while with Graves’, but yours seems to have some back up pretty quickly. Since you appear to have been positive for Graves’, that sounds as though the Carbimazole regime has been successful, and you are on the way to achieving remission. However, the likelihood is they will want you to remain on Carbimazole for twelve months altogether, so they may gradually reduce your dose to 2.5mg every day, or even every other day.

TSH is produced in the pituitary gland when FT3/FT4 stores run low -it tells the thyroid to produce more hormone. In Graves’ disease, the antibodies take over this function, and carry on telling the thyroid to produce even when levels are well above normal range. The TSH signal is therefore not required.

It’s also possible that continued TSH suppression may be directly related to ongoing TRAb activity - ie the thyroid antibodies may suppress TSH directly, as well as indirectly causing it to be suppressed by creating an excess of thyroid hormones.

ncbi.nlm.nih.gov/pubmed/171...

[Valarian]

So you are still on 10mg/day of Carbimazole? That will in any case be suppressing your natural thyroid production, so you may be over-medicated rather than truly hypo. The most likely first step is that they will reduce your Carbimazole, possibly as you suggest to 5mg.

Did they test TPO as well as TRAb?

[Coast40 in reply to Valarian]

Hi Valarian, Thanks for the feedback that's really helpful. I need to get my results tomorrow printed off again. I am still on 10mg/a day of Carb, so hopefully they will reduce my meds - I am quite surprised my TSH level has picked up from 0.01 to 5.46 so quickly! I will message you tomorrow x

[jamalka in reply to Coast40]

Hey Coast, Your recent lab tests what were they and what was the result! Kindly, and what about the recent Carb-dose!