Fluctuating Thyroid levels long after RAI

[SET5555]

I had RAI for hyperthyroid about three years ago. I’ve been steady on 100 mcg Levo with nothing changing for the last year. My tsh steady at 1.0

Now, all the sudden it seems to be fluctuating. Tsh going to 0.5 (usually it’s supposed to go more hypo over time). To my knowledge my thyroid is dead or on its way out. The nodule shrinking.

I didn’t have Graces or Hashi’s so I’m just curious why this is happening. I did have hysterectomy leaving the ovaries a couple years ago and might be going through early perimemopause. Would that cause thyroid to fluctuate, even getting higher?

[shaws Administrator]

The most important question is 'How Do You Feel' on your dose. There could have been some changes of the excipients in the tablets.

[greygoose]

Is TSH all your doctor tests? That is totally inadequate to know what's going on.

Do you always have your blood taken at the same time of day? TSH fluctuates throughout the day.

[SET5555]

Due to hormone fluctuations I “feel” all over the map. Up and down with different symptoms depending on the week.

It might be due to other hormones though.

I just wondered if menopause can make your levels go up if you don’t have an active thyroid.

Grey goose, they do t3, t4 bloodwork, but not during just regular visits to the primary. Have to wait for my once a year with the endo for that.

[pennyannie]

Hello SET5555

RAI is a quick fix but a slow burn and read of some people still having some own thyroid production 8-10 years after the treatment.

The RAI slowly burns out your own thyroid in situ and also read the correct dose of RAI can be difficult to gauge.

Ultimately you become hypothyroid and need thyroid hormone replacement, and this dose may need to be adjusted as your own thyroid slowly dies rendering you disabled.

A fully functioning working thyroid would be supporting you on a daily basis with approximately 100 T4 - Levothyroxine and 10 T3 - Liothyronine, and I just think that if there has been a medical intervention of either thyroid surgery or RAI ablation both these vital hormones need to be on the patients prescription for if, and probably when, required.

Levothyroxine is a pro hormone and your body needs to convert this T4 into T3 which is the active hormone the body runs on and is said to be about 4 times more powerful than T4. and I read that most people use around 50 T3 daily in order to fully function.

It is important to know how well you are converting the T4 into T3 and so these do need to measured and a ratio established. But as you will realise that even with a fully functioning ' 'well oiled' machine you have ' lost ' that little bit of natural thyroid T3 production you once had, and that represents 20% of your overall wellbeing, and over time this might start to pull you down.

Your own ability to convert the T4 into T3 can be compromised if your vitamins and minerals are not optimal and would suggest you get tests actioned on your ferritin, folate, B12 and vitamin D. and these need to be at optimal levels and not 'just simply ' in the NHS range.

RAI is known to ' trash ' vitamins and minerals :

If you can't wait a year to find out some answers you can pay privately to have your bloods drawn, as do many of us on here. There are details of companies on the Thyroid uk website and currently Medichecks have a discounted ThyroidUltraVit blood test which covers all the test we need to see if you wish for some further help in this matter. You can even arrange for a home visit should that suit you better, and once with the results start a new post with the results and ranges and people better able than myself will help you understand what it all means.

P.S.

I'm with Graves Disease and had RAI back in 2005 and am now self medicating as I wasn't able to acquire a trial of T3 on the NHS.