Hi guys .... I’ve just been told to stop taking all meds. So no more Levothyroxine and Carbinazolol.
I’ve also been told I have an 80 0/0 chance I’ll relapse so carry on and order your prescription and keep it safe so that if you do relapse back to your condition you can start it again. That’ll save you having to wait for an appointment to order it again.
I’ll keep you updated on my condition as I try and kick start my thyroid.
Is there anything I can do to help me on my task. Like gluten free foods or exercise?
Although it was exercise that put me flat on my back in the first place.
Thanks
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It would be in your best interests to ensure that your ferritin, folate, B12 and vitamin D are all solid and strong, and read as ' optimal ' in the ranges.
Check out the Elaine Moore Graves Disease Foundation website, if you haven't already, and just keep a journal and try to learn how best to manage yourself -
You may have to adjust and reconsider your life style and diet choices -
I wouldn't suggest you ' kick start ' your thyroid into action - cut yourself some slack, and let your body recover in it's own time.
Graves can be stress and anxiety driven so just try putting one foot in front of the other, and see how you go - and I don't think your endo's parting words were necessary as this statement must have left you feeling anxious and already anticipating a repeat performance.
Well I think it was a very irresponsible comment for a doctor to make and shows no real understanding of your health issues.
But realistically, why am I surprised ?
You do need to know, in writing, what you have been treated for, along with the relevant positive antibody tests confirming the diagnosis.
I'm guessing as you were prescribed Carbimazole you tested positive for the TSI/TRab antibodies unique to Graves Disease, but guess work isn't acceptable, is it.
It might help you to collect and collate all your blood test results so that you can try and gain some understanding of your levels of T3 and T4 in relation to the drugs prescribed at various times.
I'm not aware there is any NHS structured ' treatment ' for your thyroid antibodies.
The NHS do not know how to control or reduce this element of the disease , so tend to ignore the antibodies after the first blood test of diagnosis.
There is currently research into the production of a vaccine for Graves but it's not available yet, and so currently there is no ' cure ' to this auto immune disease.
Your own immune system has attacked your thyroid and it is because the thyroid is such a major gland your symptoms can be diverse with some considered life threatening.
The NHS treats the symptoms, not the cause, by blocking all thyroid production thereby giving you some respite whilst your T3 and T4 start reducing back down into normal range.
The hope is your immune system will have ' calmed down ' as, it would seem, you have ridden out this phase of the disease, but it is a disease and you now need to read up and understand all the things that Graves is and what you can do yourself to help mitigate a further ' hyper ' phase.
The information I'm getting is to say the least confusing and overwhelming all at once.
On my first trip (on my back) to the Emergency hospital, I was told I'm in a thyroid Storm and the endo had not seen results so high, I think they retested them 4-5 times before I was given a bed. Lol I don't remember much except I had a tube in my arm and given the Carbazole and Levothyroxine at night and again in the morning, although told it could take up to 10 days for it to be fully working. From that first date I've been on 40mg of Carbimazole and 150 of Levothyroxine. Until Monday gone, my endo stopped all meds, to see if my thyroid can kick start again on its own.
I don't think our immune system attacks our bodies, there must be something else going on within our bodies that causes " Thyroid malfunction in general either hypo/hyper. These days most so called "Endocrinology experts" etc, came up with term "Auto- Immune conditions etc, that sounds quite scientific Indeed,also scare to a patient no doubt!. In fact this is my strictly personal opinion that they don't actually know what causes all these problems with Thyroid itself. In a matter of fact to me Thyroid it's secondary gland to something more that's going on in our guts ( infections etc and emotional aspects to thyroid is strictly excluded from Endocrinology doctors point of view. to it. Just to summarize my opinion overall I don't believe that thyroid itself is main issue here, there must be something else going on. Healthy digastive system is crucial for all aspects of human health and wellness,not excluding dealing with emotions and stress especially long term one.
It's my understanding that Graves is an auto immune disease to which there is generally some genetic predisposition, maybe a generation, or two, away from you, of thyroid health issues.
The thyroid is the victim in all this and not the cause :
The cause is your own immune system mistakenly attacking the thyroid gland and disrupting the normal rhythm of your body :
The thyroid is a major gland and when it comes under attack by your own immune system, the symptoms experienced can be said to be life threatening, and indeed reading of peoples symptoms on here, it can be a scary time for the individual.
I was diagnosed at age 56/7 and just had dry gritty eyes, exhaustion and was suffering from insomnia , and from reading on here believe I was undiagnosed hypothyroid for a good few years beforehand.
Everybody's journey with Graves appears to be unique to them, which therefore makes it a poorly understood and badly treated AI disease.
A vaccine is currently being trialled, so presumably there are some antibodies on which to test.
I have learnt of my own situation back to front after becoming very unwell some 8 years after RAI treatment in 2005.
I can't see any personal history on your profile page, so should just like to add the Elaine Moore Graves Disease Foundation website is an excellent adjunct to this amazing website should you want further information on all things Graves Disease.
I was diagnosed with Hyperthyroidism over a year and a half ago. Currently on Carbimazole 20 mg. I have had weird experience with this medication every time I start it and when I finish it gives me withdrawal symptoms with high fever 38 degrees and vomiting I was in Spain at that time on holiday,went to their AE they ran tests doctor said that I was very close to get punomenea,which I've never had in my whole life. I agree these pills control symptoms etc nothing more. I will stick to my previous post no one will perswade me on thi call my stubborn idiot I don't care. All these current solutions to Grave's are just easy fix especially RAI,why on earth would I swallow radioactive pill for?. That will make me permanently Hypothyroid, if I'm Hyper there is maybe 1% chance it can be fixed,but if I took RAI that chance is gone. Sure it's easier for Endocrinologist to treat me know as I won't be bothering him/her anymore ,my go would be giving me Synthetic hormon since my Thyroid was burnt out by RAI. To me it's mental if you think about it logically. More about me: I developed Hyperthyroidism over really painful relationship it cannot be talked here it's a lot stress involved. Funny enough three months prior to my diagnosis I had other tests done by GP including Thyroid everything was within norm. When we broke up I could only go to work/home/sleep/ eating one meal a day for six weeks like that, then I started loosing weight over three stones in six weeks. My GP got scared and sent me to hospital within one day. All possible tests done/ CT scan of my lungs etc. Diagnosis Overactive Thyroid ,sent to Endo. I asked him could this be emotional he denied.
I meant emotional cause of deep stress and emotional pain. Modern doctors don't see connection between psyche & soma. It's my personal experience. Everyone is different good thing to have however is an open mind.
I was attacked by a work colleague whom I employed as my assistant manager and guess what - 4 months later I was diagnosed with Graves Disease -
Why don't you start your own post and tell us all your ' take ' of Graves as it is a poorly understood and badly treated autoimmune disease, and by sharing we can also learn from each other of how to get through things that doctors simply have no understanding or answers on.
It's all related in my opinion. We don't know how to deal with emotions, we suppress it within,our system needs to find a way to release it especially when it is prolonged and unresolved. I think we are born with different constitution of nervous system,weireing etc, body organ strengths and weaknesses. I take Carbimazole 20 mg/day. My but D is low too. I take vitD supplements. Once I went to Chinese doctor to find an alternative for Hyperthyroidism, it work what he was doing,or was it a placebo?, Who knows?. Treatment would have involve two years of once a week acupuncture and specially made tea , he was mixing all that in front of me. Price wise £80/week too expensive like for me for two years,if I had funds I would have definitely continued.
Sebastian.. there are lots of reasons why people HAVE TOhave their thyroid out. There not mad at all.
I fully understand where your coming from. Yours was a break up from a relationship. Mine the new Oxford morphine rules came out and doctors pushed it. My morphine intake halved meaning half the day I was in serious pain it ended up I just couldn’t work. (A joiner)
So stress. I’ll feeling towards yourself. Deep down it can set off a chain reaction but sadly when it happens there’s no simple answer to going back to a normal life. It can get close but somethings broke inside you.
Have you managed to obtain your anti-body results as suggested in your post of 3 months ago. Also you replied to yourself on that thread and not the people making suggestions - so they did not see them. Use the REPLY button below !
I 'm sorry but I cannot see your results so cannot comment on vits and minerals but testing was suggested some 3 months ago. B12 - Folate - Ferritin - VitD usually have to be requested as they are not routine.
Please please find out about which anti-bodies were tested as suggested to you 3 months ago.
Stopping meds just like that sounds drastic to me. From reading here - I am not a Doc !
Most of the results you see posted here are from private companies. Never assume anything when it comes to your health - sadly thyroid knowledge is poor among the medical profession - we have to be our own advocates ...with the help of the thousands here !
You can phone the surgery and request results - you do not have to give a reason - they are legally yours. Say you will collect in a few days. I am concerned your e-mail will be 'missed' ....
I've just been told that I can not have my blood test results ? I was also told to change this by seeing a doctor although getting an appointment with the corona virus outbreak Doctors are only booking a month ahead, so you'll have to ring at the end of the month to try and get an appointment ?
Click onto your picture next to your username above and you will find your earlier posts.
You will read that your results do NOT contain the all important anti-bodies that will confirm your diagnosis and for which many of us are waiting ....
Are you still on 40mg. Carbimazole plus 150mcg. levo ? If so it would be advisable to cut back the dose very slowly. You should also have your antibodies retested as if they are still high you will probably relapse. I was in this position a year ago and was titrated down to the lowest effective dose which I am happy to stay on longterm as I feel well.
I have never heard this. Do you not mean you were on Block and replace where the carbimazole blocks your thyroid producing the hormone and the levo replaces what you are not making? What dose are you on at the moment ?
I really think it is unwise to stop such a high dose without titrating down. Can you not discuss this with your doctor and get them to agree to monitor you .
Thanks, but the endo says this is normal ? He added they will continue to monitor me over the next year or so, depending how things go, with the 2 monthly bloods testing.
No, they are not. Antibodies are not tested as a matter of routine, although they really should be - especially if the doctors suspects Grave's. But, they rarely are. You will need to raise the question with your doctor. You need:
TRAB or TSI antibodies for Grave's
TPO and Tg antibodies for Hashi's
Both need to be tested for. But, if you don't say anything, they probably never will be. I cannot stress enough how important this is. We had someone post on here recently that had her thyroid removed because they said she had Grave's. Turned out she didn't, she had Hashi's. You really, really need to be proactive over this and not just let it ride, assuming that doctors know what they're doing. For the most part, they really don't.
Nutrients are not automatically tested, either. That is something you have to request, and sometimes insist on. Doctors do not learn about nutrients in med school and have no idea how important they can be. And, as you have a doctor that is telling you to stop everything cold turkey, it is obvious yours is more ignorant than the average. You need to look out for yourself. x
Thanks for this information, on the night I was rushed into the Emergency hospital, I was tested many many times as the endo had not seen bloods that high before so tested again and again as he/they thought something was wrong on the testing side. It wasn't I was having a thyroid Storm as he said. I was also told with the antibodies found I had Graves so I have been tested for it to be told it by the endo.
I'm sorry to say this but just because the doctors say they have tested for Grave's, doesn't actually mean they have. The problem is that some of them don't know the difference between Grave's and Hashi's. And, they test for Hashi's, and call it Grave's. We've seen this many times on here. Which is why you need to know the name of the antibodies they tested for. Just saying they were Grave's antibodies doesn't prove the were. This is why we always need to get copies of your blood test results, not just to see the results, but to see what was actually tested.
It may be NORMAL but not necessarily the right course of action. The first endo I had was going to stop medication. He said I would pobably relapse and would need either thyroidectomy or RA ablation. He didn't see the need to measure my antibodies. I sought a second opinion with another endo who said it was necessary to first measure my TRab and when he found it still raised he kept me on a low dose of Block and replace which hopefully will give me a better chance of remission eventually. Just be aware you have choices and there is no rush to make them. Stopping so abruptly could make you very unwell again. Is this really the way you want to go ?
Thanks for the advice….. Thinking about it that would be the right way to go, as I don't want a relapse to reoccur.
I've just been to my doctors as I asked for a printout of all my Blood tests I've had done as I want to follow my own diagnosis of my thyroid and Graves, as I've kept a diary of foods I've eaten, when and how cooked etc...
However I was told NO ? I couldn't have them as your GP has not allowed access. You will have to see your GP and ask him to allow you access, he may not give it though. he next appointment I can have is in May, bloody May ? and things with the corona virus outbreak may change that too so we cant book appointments that far ahead.
I then asked well how can I get an appointment then ? Keep phoning at the end of the month I was told...
Your receptionists are breaking the law. You are entitled to access to your medical records and results by law.
Go back to the surgery and say that under the Data Protection Act 2018 and GDPR (General Data Protection Regulation) you are entitled to access to your medical records and all test results.
The receptionists may insist that they need the permission of the doctors before releasing data to you, but that's normal. Just say you'll be back in the next couple of days to pick up the copies of the data you've requested.
Take proof of identity with you when asking for info from your medical records.
Don't get into an argument, remain polite, and if they continue to be obstructive come back and tell us what excuses they are using.
Humanbean is quite correct. You mustn't allow yourself to be browbeaten when requesting copies of test results and any other entries on your medical record. GP practices and hospitals dislike such requests, but that's just tough.
You are entitled to copies - free of charge since a recent change to data protection law - of any part of your record. I believe the only items which may still be charged for are copies of x-rays and scans.
The circumstances in which a doctor can prevent access to your information are extremely limited.
I don't understand this country and its "funny", "silly", rules. You go to Spain/Poland and other countries,look up phone book of any Specialist in any medical field like Endocrinology,ring up book an appointment privately. 90% if these professionals work in the public hospitals and see private patients too. It's affordable. Same thing with labs same story you go you pay you get your results same day or next day. Wtf you can't see your blood work results. What I know about GP's in the UK if you don't have major weight loss in short time, Don't bother otherwise Antibiotics or Pain killer that's their treatment for most complaints, or don't worry it's just stress etc,and don't you dare bringing up two issues upon your visit,as it's one at a time, gonna have to book another appointment for your other issue,and include waiting time on the phone if you get an appointment for this week. Please don't take my options personally it's just my experience with GP's in this country. Real story incident, I work as carpenter,one guy got he's four fingers cut of by circular saw, supervisor takes him over to AE they bandage it and said come back in two days. Horrendous.
I didn't do block and replace I took just PTU but I wasn't monitored properly by my Endocrinologist and became ill, you can read my story on my profile page. It took several months for my thyroid to recover because my levels were very low and the TSH always lags behind so you will need to do a blood test. You will know if you are becoming hyper again by your symptoms but you might go into remission like I have. If you don't go into remission you can always restart your block and replace. I know people who are on carbimazole for years and someone I know over 10 years and just needs to have regular blood tests. As someone said join Elaine Moore's site in the US which is very good and full of information and she helped me a lot... here is the link.
WOW just read your story, what a horrible experience it must have been for you...
I was very lucky compared to you then, Friday Morning I went in to see my GP with my partner not feeling well at all and looking worse again, I'm told. My GP asked questions and rang through to the nurse and arranged blood test, I was asked to go through to the nurse and my bloods taken. After talking again to my doctor he said He would see me again in a few days to see how I'm doing and should have the test results back by then.
HOWEVER, that afternoon the hospital rang my Doctor and told him my blood results, "Through the Roof" and asked him to arrange for me to go to our Emergency Hospital. My GP rang me and told me not to drive up there as he would arrange a Ambulance to pick me up.
I was a bit shocked now, as after my visit to the doctors I felt a lot better ?
I was taken to Cramlington Emergency Hospital and booked in with further blood test being done. I was kept in over night with a tube hanging out my arm I was told the next Morning by my now endo that I had Graves and a hyper thyroid, and given Carbazole and Levothyroxine, and told they may take up to 10 days to work ? As I told him I was going on holiday in 5 days time ! I was let out of hospital after the endo brought 6 student around me and after looking at my charts and asking questions to the endo, I was told by the endo he had never seen blood levels that high before ? They were very, very, high he added.
So everything was diagnosed all in one go ….. As I say Very Luck or Unlucky Lol
I would not recommend stopping cold turkey you should do it gradually. I did stop taking PTU because my Endocrinologist had let my levels get too low and my TSH was 9. I felt very ill so I went to Dr Skinner who is no longer with us and he advised I took Levothyroxine which I did for a short time which helped my thyroid. Somebody on this site thinks I don't have Graves' but all I will say is a very experienced Consultant did a ultrasound on my goitre and told me it was definitely not Hashimoto's because she had seen 100s and mine looked nothing like someone who had the disease.
Just to add to what Marz has said, we do see misdiagnosis disturbingly often on the forum, so post the numbers (with the lab reference ranges) as soon as you get them.
I don't want to add to your worry, but I notice you're in the north-east of England, where knowledgable endos are vanishingly rare -in fact, they may actually be extinct. Read up all you can about your condition, and keep checking in here for advice and support.
The bloods I put up were in fact from my last appointment 3 months ago my recent bloods are ....
Free T3. 4.1 /3.1-6.8
Free T4. 22.1. /10.0-22.0
Thyroid function. 0.99. /0.30-4.50
He told me the idea behind bloc and replace is they try to make the over active thyroid go over active so when you come off the meds the over active thyroid behaves itself ? For more info on it I should ask my Endo doctor at the hospital more about it.
Levo has to be taken to force my thyroid over active and make my thyroid do it’s work itself to bring it under control by itself
I'm sorry to tell you this but if your report of what the doctor said is accurate then your doctor is a dangerous raving lunatic.
If you have an overactive thyroid then your thyroid is over-producing thyroid hormones. The commonest treatment for this in the UK is an anti-thyroid drug called carbimazole. This stops your thyroid from producing so much thyroid hormone and, if the dose is correct, lowers your thyroid hormone levels to be about the same level as a person with a healthy thyroid.
Some endocrinologists treat overactive thyroid differently. They give the patient enough carbimazole or other anti-thyroid drug to reduce your thyroid hormone output to practically nothing - in effect making you very hypothyroid (i.e. underactive). That is the Block part of Block and Replace. By blocking your own thyroid hormone completely they hope to prevent you from suffering as a result of fluctuations in your own thyroid's output of hormones.
Then they treat you as if you are hypothyroid and give you Levothyroxine as they would any hypothyroid patient. This is the Replace part of Block and Replace. If the doses of carbimazole and levothyroxine are correct for you then you will end up with thyroid hormone levels similar to those of a healthy person.
In the link I gave to one of your earlier posts you also mentioned these results :
TSH. <0.01. MIU/L. 0.30 - 4.50
Free T3. 48.7. Pmol/L. 3.1 - 6.8
Free T4. >100. Pool/L. 10.0 - 22.0
I am not sure if they were results from when you were still untreated, or whether you were being treated. If they are results from when you were being treated then the doctor treating you should be shot because they appear to have screwed up big time - and very dangerously so!
Thank you for a very informative reply to my postings.
The last results when I was still ill, were taken 3 months after I first went to the hospital, My first results were apparently worse, or much higher than those?
The first results you have posted are more recent ones. (I plan to post All results when I'm allowed to get them …...
Thanks again for explaining the Block and replace process, its put so simple just for me.
My Meds have not changed since I started with this illness, I would have thought they would have changed at some point as on all appointments I told the endo and GP that I'm still not feeling as I was before this happened. Granted I do feel better than when it first happened, but told them I still have days at a time when I feel really ill and return to bed all day because I can't move or feel sick and tired. Sometimes sleeping for 2 days and one night at a time.
What are your thoughts on stopping all my meds at once as advised on Monday last... ?
I mentioned Fruitandnutcase having been treated with Block and Replace. I think she stopped cold turkey, but my memory is definitely not to be trusted, so hopefully she will respond.
I started B&R in November 2012, the treatment lasted exactly a year (as I was told when I started) - the endo said they used the fast treatment - a year didn’t sound all that fast to me though.
When I stopped I was taking 40mcg carbimazole and 75/100mcg levothyroxine- then I stopped totally and yes,one day I was taking all that - the next day I took nothing at all and I haven’t taken anything since.
I can’t remember how likely it was to come back but they kept saying I would have RAI should I relapse! Not if I could help it I thought.
In the end I went to see my own GP, I mentioned all the offers I’d had of RAI and that I didn’t want that, if I relapsed I wanted to have more block and replace and asked if the hospital could insist on me having RAI - no, or if they could refuse to treat me - no. So I went off home and relaxed.
I had read about thyroid patients eating GF food so I went totally gluten free to see what happened and although I was a bit sceptical about I I did regular home fingerpick blood tests and watched my antibodies steadily fall. Once they started to fall nothing on earth would have made me eat gluten again.
I also totally cleaned up my diet - out went the junk, I haven’t had my favourite McDonalds since 2013! How I loved a McDonalds followed by a McSlurry . That was one reason for all my long distance walking. MsDo don’t do much GF in the U.K. so I gave it up I also ditched biscuits, cakes and chocolate although I could eat GF cakes and biscuits but they are still junk food and I ditched Diet Coke and fizzy drinks.
In came lots more green leafy and other vegetables, I eat fruit but not stuff that is very sugary, I eat chicken, an odd steak, maybe lamb or pork and we have fish twice a week, breakfast tends to be a two egg omelette, mushroom blueberry or spinach and pink grapefruit. I drink water or decaf tea or coffee.
I used to do a lot of long distance walking, I had to stop that completely at one point but I refused to give up my nice friendly gym and my Pilates so I kept going but reduced everything I did, I’d say the most exercised part of my body was my tongue at that point. My Pilates teacher is a qualified physio so she adapted things and kept me going.
Now I can do long walks, I gave up the gym and tend just to walk and I’m back at Pilates after breaking my arm in January, boy does it feel good.
I supplement with Vitamin D and K2 - to help the bones, B12, vitamin C, often a probiotic and sometimes CoQ10. I have regular soaks in a bath with magnesium flakes or use a BetterYou magnesium spray and I also rub in their body butter I’m lucky that my ferritin and folate are ok or I’d supplement them too and I do regular home fingerpick blood tests just to see what’s happening. No point in supplementing if you don’t need to.
I felt that it took a while for my body to get back to it’s ‘new normal’ - I’d been undiagnosed for an awful long time. By the time I was, I’m sure my doctors thought I was a total hypochondriac - I was even told a couple of months before diagnosis that I ‘was needing my holiday’. All I was actually needing was for someone to test my thyroid and discover I was off the scale hyper with zillions of antibodies and send me to an endocrinologist!
So go forth, try not worry about that 80% and do the things you enjoy. I wouldn’t go wild with exercise though, certainly not to begin with but you should get back to how you used to be pre Graves. I hated how when it was at its worst it robbed me of whoI used to be. Good luck 🌞
Wow, access to online medical files - you have discovered the Holy Grail of your doctor’s surgery! Lucky you, I appear to only be able to order prescriptions and make appointments at the moment with my surgery.
Maybe if you forget things you could keep a notebook handy and jot down what you are looking at before you move onto something else. I became the Queen of Lists when I had Graves - although I’ve always been a list person. I make lists for the satisfaction of crossing things off.
My local hospital has a fabulous website where I get all my test results, letters, appointments etc. The only thing I don’t see is the x-rays I had done.
I went to my GPs yesterday with a list of things that I considered needing testing in my blood.
The nurse asked who has ordered this blood test. I replied me ! She replied with .... you can’t just order a blood test willy nilly, it has ty o be the endo or GP in your case. I then stood up and started putting my coat back on and asked could she arrange an appointment with my GP to waist a 10 min slot saying you refused to give me a blood test, as he had said at the start of my problems should I need further blood tests just pop in ?
Whoo she said. I’m not refusing anything here. I said you are.
After phoning someone she said OK. It seems it’s ok to go ahead.
I said right. I need vitamins with B12. Antibodies. TSI, TRab, TPO,, Tg. Folate, Feritin too
She said WOW I’ll have to look half of those up as I’ve been here 18 years and never tested some of those ? We spent googling on Google to find them. However she didn’t know and couldn’t find TSI and Tg ? So said I’d have to come back after speaking with a doctor but sent off the 5 bottles of blood.
Here’s hoping the hospital will see TRab and test for TSI and test TPO and test Tg ?4 hours later a txt from the hospital arrived saying the GP requested blood test has arrived.
I’ll get another when tests results are available to view usually in 3-4 days...
What a day and night. I also got a txt from my surgery say could I come to the surgery for my request ? Anyhow it was late so decided not to go I’ll go on Monday. Lol
Well, when you find the questions to ask amongst all 970 pages of paper, you'll need to start a new post as most people will not see your post way down here.
This is some sort of rolling screen and very rarely do people ' look back ' at old posts -
I did because I remembered writing to you, but some people helping us on here, answer so many posts they just have to go on new post date orders.
They will however look back and see your history to refresh their mind of your case so don't worry, you'll get picked up, but as I say, always start a new post with any new vital information for immediate response.
Good luck : Start at the beginning : Look for positive antibody blood tests : original T3 and T4 blood test results and medication : and see how the levels of all the above have responded to the medication, and then, supply your most recent T3 and T4 blood test, plus the current antibody levels :
And start a new post when you surface !!!
P.S, A brief resume with the new post is probably a good idea, so to try and help the Admin and community have an idea of where you currently are in your thyroid treatment and journey.
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