New blood work advice please

[Pjd94]

Hello everyone,

Hope you are all keeping well.

So I was diagnosed with Graves in April of this year after symptoms of high heart rate/palpitations, nervousness and heat intolerance. I was placed onto 20mg Carbimazole and Propanolol.

My blood work is in the photos, first bloods were on diagnoses 14/04. Since then I’ve stayed on 20mg. After my 2nd bloods my doctor wanted me to up to 25mg but I felt soooo much better and I am down from 30mg Propanolol 3 x a day to 10mg 2/3 x a day. I asked on the next bloods for T3 also. Pretty much all symptoms have disappearedx so my doctor agreed to stay on 20mg and do bloods earlier (3rd set). I understand my TSH will take a while to be detected again and that should not influence my dosage ,

I’m also taking vitamin D and C, cod liver oil, magnesium, selenium and iron.

My question is what is likely my next dosing for my new blood work. Will I stay on the same or reduce? Waiting contact from my doctor.

Thank you,

Paige

[PurpleNails Administrator]

I should think by the next test you will know if the 20mg is level is right dose to keep you at same level or if it start to push you too far into hypothyroid.

If it’s been coming down and stays about mid range then 20mg might be right dose for you. For now, later on the might all change.

Once you get to a more stable stage, testing too frequently has no benefit as you need around 6 week to see full outcome of dose adjustment.

Propranolol has a affect on levels too & lowers FT3 so that is another variable to bear in mind.

[pennyannie]

Hello again :

It's good to read that you are feeling better.

Titrating the dose of AT medication is a logical step and which you can help with.

It can take considerable time and skill trying to replicate your own unique levels of thyroid hormones and by making a note of your symptoms as you go through this first phase of the disease, you can offer suggestions as to where you feel more better, and having some control over you treatment plan is important, as this should be a two way conversation.

There are a list of symptoms on the Thyroid uk website, thyroiduk.org so a guide to remind you, which is what, and it does get complicated as some symptoms can be both hyper and hypo symptoms.

When one's metabolism isn't running as ' normal ' there is a tendency for core strength vitamins and minerals to fall through the ranges as you will have trouble extracting your essential nutrients from your food, no matter how well, and clean you eat.

It will be in your best interests to ask for your ferritin, folate, B12 and vitamin D to be run as these need to be maintained at optimal levels and not just ' somewhere ' in an NHS range.

Your TSH may never recover because of the Graves antibody interaction and yes, you are correct in that the TSH should not influence your dosage - you must be dosed and monitored on your Free T3 and Free T4 blood test results.