What should I do?

[kvmj]

I had RAI on 08/31/2021 due to swallowing issues. My latest labs were drawn on 02/02/2022 and are as follows: TSH 9.31 (.465-4.68) T4 .54 (.78-2.19) T3 3.7 (2.8-5.3) I had been on 5 mg Methimazole since early December. I saw an NP and I think she's a fairly new graduate. She wanted me to cut the dose down to 2.5 mg., but I told her that I thought I shouldn't take any Methimazole at all. She cautioned me to be alert for symptoms of hyperthyroidism. I don't think that there's any chance that I'll be hyperthyroid ever again.

I think that I'm hypothyroid and should have maybe been put on levothyroxine. Should I contact the endocrinologist?

[SeasideSusie Remembering]

I am hypothyroid, never hyperthyroid, so no personal experience but following RAI, which basically kills your thyroid any medication should be levothyroxine, your test results show that you are very hypothyroid. I think you need to see someone with more experience.

[pennyannie]

Hello kvmj :

Yes, and yes : and why are you still taking the Anti Thyroid mediation ?

Your TSH is around 4 times too high and shouting out hypothyroid - your T4 is under range and your T3 - the most important and protected number of them all is at just around 44% through the range and wanting T4 to convert to more T3 but there isn't any reserves as your T4 is under range.

RAI slowly burns out the thyroid in situ and is said to be more difficult to treat.

For optimal conversion of T4 into T3 you need optimal levels of ferritin, folate, B12 and vitamin D ;

RAI is known to " trash " vitamins and minerals so maybe get these tested so we can see where these are and maybe need to recommend supplementation.

I had RAI thyroid ablation in 2005 and was put immediately on 100 mcg T4 :

[PurpleNails Administrator]

You should be carefully monitored after RAI as it expected that levels become hypothyroid. Were you made aware of this?

How frequently have you been tested?

You should have stopped methimazole and begun levothyroxine long before your TSH & thyroid levels reached this sort of level.

RAI is used to reduce entire thyroid and stops the thyroid being able to produce hyper levels. If the entire thyroid is swollen and that can cause swallowing issues it can help with reducing thyroid size, but if the swallowing issue isn’t caused by diffuse swelling it won’t solve the issue.

Has it improved the swallowing issue?

[kvmj in reply to PurpleNails]

I've been tested every 6 weeks. I was told that I would have a 50-50 chance of emerging with a functioning thyroid. I am no longer taking any Methimazole. This NP (nurse practitioner) works under a very good endocrinologist. I'll get in touch with him.

Yes, swallowing issues have gotten much better, but not eliminated.

Thanks for the advice. It's what I thought.

[SlowDragon Administrator]

See different endocrinologist urgently

This one is clueless