Graves’ disease (daughter)

[nancypapa]

Hi guys and happy new year. My daughter just tested positive for Graves’ disease. What are the test blood you recommend besides, TSH t3 t4 and antibodies

[PurpleNails Administrator]

TSHFT4 (Free levels as that’s what’s available for body to use)

FT3

Thyroid antibodies

TPO & TG antibodies often get tested but are not unique to Graves

To confirm Graves diagnosis you must make sure either

TRab or

TSI antibodies are tested

Folate

Ferritin

B12

Vitamin D

Nutrients are often low when hyper

Has your daughter been started on an antithyroid medication?

[nancypapa in reply to PurpleNails]

Thank you, yes the endocrinologist put her on medication and told her will do antibodies test to make sure is Graves’ disease but I also want the doc check her nutrients. Thank you appreciate

[PurpleNails Administrator in reply to nancypapa]

How much medication? Was it Carbimazole? It should be judged by the severity of the FT4 & FT3 levels.

And is a repeat blood test scheduled to retest and see how levels have responded?. That should be 6 weeks later, earlier if symptoms change or worsen.

[Stourie]

Why has the doctor put your daughter on anti thyroid medication before finding out if it is graves? Could it be a hashis flare? Just checking. Hope all goes well. Jo xx

[PurpleNails Administrator in reply to Stourie]

Stourie doctors often start antithyroid before establishing the cause.

Doctors should check the cause of hyper but many don’t as they are taught low TSH is extremely dangerous and should be urgently treated. As patients we know TSH isn’t the crucial factor the levels of FT4 & FT3 is far more important to us and low TSH with in range or minimally elevated frees probably doesn’t need anti thyroid treatment.

Graves & hashis are not the only reason for high thyroid levels. Nodules can cause continuous hyper which would need treatment. You are right that hashis often starts with transient hyper. It depends on how high the free levels are and amount of antithyroid. Too much and antithyroid would hasten the drop so monitoring is important. Once the frees are continuously low - levothyroxine is given & viewed by medics as a easy treatment.

The cause should really be Investigated but as doctors treat by TSH regardless of underlying reason they don’t test for it. They also don’t understand antibodies, cant treat or manage antibodies they so skip that step and treat all low TSH as hyper and high TSH as hypo without considering the cause.