Does this look like Graves. Worried.

[Mrskimmy]

Hi all - hoping you might be able to help as I’m feeling pretty worried.

I’ve been feeling unwell (shaky, anxious and heart beating out of my chest). GP has done bloods and referred me to an endocrinologist. He didn’t give me any indication of why, but am I right to presume it could be Graves?

These are my blood results:

Serum TSH <0.03mU/L (0.35-5.5)

Serum free T4 38.2 pmol/L (10.0-19.8)

Serum thyroid peroxidase ab >1300iu/ml (0.0-60)

TSI 6.58 iu/L (<0.56)

I’ve also got a serum ferritin of 7.5ug/L (10-291) and generally low haemoglobin and haematocrit. I’m taking iron tablets now.

I know you guys can’t diagnose me on here, but any pointers on what to ask at my endo appointment would be really appreciated.

I’m feeling pretty anxious.

Thanks

K

[SlowDragon Administrator]

So has your GP prescribed beta blockers to help slow great rate and reduce anxiety or anything else, like carbimazole?

Your definitely need FT3 tested

You also need vitamin D, folate and B12 tested

Lots of Graves' disease patients say this site by Elaine Moore is helpful

elaine-moore.com

[Mrskimmy in reply to SlowDragon]

Thanks for the website tip, and for coming back to me.

Just looked at my bloods again, and they didn't look at T3, but they did measure Folate, B12 and Vitamin D. Vit D looks slightly low, but the rest were in range.

Its good to know that theres options for treatment from my GP before my referral. I wasn't offered anything, except given the prescription for Iron.

Depending on the wait time to see the endo, I may go back to see if I can get something to help the anxiety and shakes, it feels pretty crippling some days.

Thanks again!

[SlowDragon Administrator in reply to Mrskimmy]

Can you add the actual results and ranges on the vitamins

Being within range is not the same as optimal

Vitamin D needs to be at least around 80nmol and around 100nmol may be better

How low was vitamin D result?

[Mrskimmy in reply to SlowDragon]

Sure!

Total 25- OH Vitamin D was 40.9nmol/L

the ranges look a bit different for this. My lab report just says below 30 is deficient, 30-50 may be inadequate and over 50 is desirable. (???????)

B12 was 452.0 ug/L (211.0-911.0)

And folate was 7.35ug\L (>5.38)

I hadn’t realised that the vitamins were so important for thryroid - I’ve got so much to learn!

[SlowDragon Administrator in reply to Mrskimmy]

B12 and folate on the low side. Recommended both be high within range on Levothyroxine

Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial.

chriskresser.com/folate-vs-...

B vitamins best taken in the morning after breakfast

Recommended brands on here are Igennus Super B complex. (Often only need one tablet per day, not two. Certainly only starting with one tablet). Or alternative brand - Jarrow B-right

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Suggest you retest TSH, FT3 and FT4 once you have given vitamins time to improve

Almost certainly needs to be done privately unless you can get endocrinologist to test

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw). This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

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

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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

Getting vitamins optimal is first step. This can improve conversion of FT4 to FT3

Selenium supplements can help improve conversion of FT4 to FT3 as well

[SlowDragon Administrator in reply to Mrskimmy]

Vitamin D deficiency is common with both Hashimoto's and Graves

vitamindcouncil.org/vitamin...

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

[pennyannie]

Hello Mrskimmy

I would think the TSI antibody test being over range is indicative of Graves Disease.

Your metabolism is probably running fast, and it is most important that you keep your strength up during the phase, and as previously mentioned vitamins and minerals need to be kept optimal to give your body all the support it needs.

I believe my doctor gave me my diagnosis and a prescription for Carbimazole, whilst I waited for an endocrinology appointment.

My immediate symptoms of insomnia, exhaustion and dry gritty eyes reduced and I returned to work.

Graves is an autoimmune disease and as such its for life, it's in your blood, your DNA.

There is probably some genetic predisposition, maybe a generation away.

I read Graves is stress and anxiety driven and can come on because of a shock to the system, like a sudden death or car accident.

Something has triggered your immune system to attack your thyroid.

Left untreated Graves is said to be life threatening because it tends to attack the thyroid which is such a major gland, responsible for your whole body synchronisation.

There are several treatment options and am sure your doctor will offer reassurance.

I read of people on different medications over different time scales, some finding long term resolution on low dose anti thyroid medications, and some finding remission and being able to stop the medication totally.

The medical profession do not know how to reduce the anti bodies that cause Graves.

This will be very much up to you - some time might be spent reading up about all things Graves to equip you better to help yourself.

You might like to read the following :-

Graves Disease - A Practical Guide by Elaine Moore - this lady has the disease and wrote this book, since there was little help available to her when she was diagnosed in the late 1990's in America. She has since dedicated herself to medical research and also runs a Graves Foundation and website offering very comprehensive help to all Graves patients.