Although I have an endo appointment later this week, I would like help understanding my results. I always find appointments very brief and there is not enough time to take in information and ask questions. I have huge respect for the wisdom and experience on this forum and wonder whether you can provide some insight for my latest set of results as well as answer some additional questions.
My results and treatment to date:
25.5.22 GP test 1.30pm No fasting – No diagnosis at this point
TSH <0.01 (0.27-4.2)
FT4 25.7 (11.2-20.2)
31.5.22 Private test 6pm No fasting – Results led to diagnosis of Graves with 10mg Propranolol prescribed twice a day, 20mg Carbimazole prescribed once a day.
TSH <0.01 (0.27-4.2)
FT4 24.2 (12-22)
FT3 10.5 (3.1-6.8)
7.7.22 Private Test 11am No fasting. Results led to Propranolol stopped and carbimazole reduced to 10mg once a day.
TSH 0.01 (0.27-4.2)
FT4 15.7 (12-22)
FT3 4.15 (3.1-6.8)
19.8.22 Private Test 8.15 After fasting. What do these results mean? Will carbimazole be stopped? Will FT4 and FT3 come into range if carbimazole stopped?
TSH 2.22 (0.27-4.2)
FT4 7.5 (12-22)
FT3 2.74 (3.1-6.8)
Are the following likely to be due to my current thyroid levels…?
1. Weekly migraines – I have always suffered from severe migraines but not as frequently as the last 6 weeks. I take sumatriptan which can stop the migraine if I take it early enough. Currently I have headaches almost permanently.
2. Disrupted sleep. I can get off to sleep but wake up in early hours and cannot get back to sleep.
3. Itchy legs
4. Random twitches/spasms all over – this was a problem when I was hyper but is still a problem.
5. Inability to focus/concentrate when trying to work.
Many thanks for all your help.
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Meringue4
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In your first post you say you have been diagnosed with Graves’ disease (autoimmune hyperthyroid)
But has endocrinologist actually tested TSI or Trab antibodies for Graves’ disease
Carbimazole certainly needs reducing
These results possibly suggest Hashimoto’s….autoimmune HYPOthyroid disease
Hashimoto’s frequently starts with transient hyperthyroid results and symptoms before becoming increasingly hypothyroid
Endocrinologist should always confirm Graves’ disease by testing TSI or Trab antibodies
You are now EXTREMELY hypothyroid or taking too much Carbimazole
25.5.22 GP test 1.30pm No fasting – No diagnosis at this point
TSH <0.01 (0.27-4.2)
FT4 25.7 (11.2-20.2)
This first test doesn’t suggest Graves’ disease…..looks more like early stage Hashimoto’s
31.5.22 Private test 6pm No fasting – Results led to diagnosis of Graves with 10mg Propranolol prescribed twice a day, 20mg Carbimazole prescribed once a day.
TSH <0.01 (0.27-4.2)
FT4 24.2 (12-22)
FT3 10.5 (3.1-6.8)
This second test also doesn’t suggest Graves’ disease…..looks more like early stage Hashimoto’s
Make urgent appointment with endocrinologist or GP
Get dose Carbimazole reduced (possibly stopped)
Insist on full thyroid antibodies tested
TSI or Trab antibodies for Graves’ disease
TPO and TG antibodies for Hashimoto’s
Request/insist on testing vitamin D, folate, ferritin and B12 levels too
Vitamin levels are frequently low with Hashimoto’s or Graves
We see a small but steady stream of Hashimoto’s patients misdiagnosed with Graves’ disease if all thyroid antibodies aren’t tested
Thank you for this information and your suggestions.
I am seeing the endo later this week and I will ask about Hashimoto's.
I will definitely get B12, ferritin, folate and vitamin D tested and post the results on here. Vitamin D was actually tested by the GP in May. The result was as follows:
131 (50-200). She did not test the other vitamins.
I have not had a coeliac blood test done before. From your experience, do GPs generaly agree to test these things or they tests that generally need to be done privately? Thank you for the private testing links.
I am very keen to have all vitamins and minerals as optimum as they can be as I also have an osteoporosis diagnosis and ideally would like to manage it as naturally as possible.
With a history of osteoporosis in the family and my own recent diagnosis, I try to watch my calcium intake carefully and supplement when I know I am not taking enough through diet alone. My calcium tablets have added vitamin D and k.Since my osteoporosis diagnosis I have also tried to follow advice to get at least 20 minutes sun exposure every day. In addition I try to eat and drink foods naturally high in vitamin d or fortified.
I am not on any osteoporosis medication at present while I try to stabilise my thyroid situation so I am very keen to optimise nutrients through diet. Your information is very useful especially the links for magnesium and I think I will start to take supplements for this. I am naturally a very anxious person, find it difficult to relax and suffer from insomnia. A night time supplement would help my thyroid znd bone health as well as helping my mental state. If you are allowed, could you recommend a specific brand. I note from the videos the dose should be 400- 500 elementsl magnesium per day. I am not worried by the side effects on toileting ( thst would be a bonus for me!)
As already detailed your results are now looking very low and as your Graves is still in it's first phase you might be more comfortable being fully supressed on the AT drug and have a measured dose of T4 - Levothyroxine prescribe to =try and keep your T3 and T4 from not falling too far through the ranges.
As for the symptoms being experienced they all ca be symptoms of Graves, and or a thyroid AI disease because the thyroid is the body's main engine and conductor of everything so anything and everything can be affected.
When metabolism isn't running as it should either too fast or too slow the body has trouble extracting key nutrients from your food, irrespective of how well, and clean you eat.
Your core strength vitamins and minerals, especially those of ferritin, folate, B12 and vitamin D are likely to nose dive so it will be a good idea to get some results and ranges of these and we can advise as to where these need to be maintained, for optimal support through this first difficult phase of Graves Disease.
I think I mentioned Elaine Moore to you last time - elaine-moore.com and there are sections within Elaine's website detailing reasons why you may have been diagnosed Graves, and another suggesting more holistic and alternative treatment options to consider and suggestions on how to manage stress and anxiety and do things that you want to do and find ways of learning how to relax and ' turn off ' .
The most current research is suggesting the longer the patient stays on the AT drug the better the options are for the patient - pubmed.ncbi.nlm.nih.gov/338... :
I believe mainstream medical are still working to guidelines suggesting a 15-18 month window with AT drugs and then look to definitive treatment and thyroid surgery / RAI ablation if your Graves hasn't resolved, as the way forward.
We are looking at an auto immune disease for which there is no cure, which is said to be life threatening if not mediated.
The thinking is it's is better to be hypothyroid than hyperthyroid - well - I'm not sure who finds it easier, and indeed it's all a question of degree - and if you are well on the AT drug there is no reason why you can't stay on it long term.
Of course it is a much more expensive treatment option than having RAI thyroid ablation, as I did, and now self medicating to be as well as I can be managing lingering Graves thyroid eye disease caused by the RAI and hypothyroidism.
I am definitely going to get my vitamins checked as both you and Slowdragon suggest.
I am particularly interested in Elaine Moore's holistic and alternative treatment options and suggestions on how to manage stress and anxiety but cannot find these. Can you tell me where on the website to look? I am sure I'm being very silly in not being able to find this information.
Another very silly question... I have just come back from holidaying on the coast where everyday I ate seafood. I believe that this may have a high iodine content. Could this have had any impact on my very strange latest blood results? I am thinking high iodine would result in high FT4 and FT3 not lower.
Once again... many thanks to both you and Slow Dragon for your wisdom and suggestions.
On the main page of Elaine's website there is a subset of headings :
Home : Articles : Blog : Forum : Books : Resources : and About :
Left hand side of this main page details various snippets of articles you may like to dip into :
Right hand side of this main page details Elaine's published books on Graves Disease.
Within Articles you should find the opening question - What is Graves ? -
On the left and right had columns on this opening article - you should see
Category Graves Disease on the left and Articles by Category on the right hand side :
You will see mentioned various snippets of interest, including headings such as causes, treatment, triggers, the TSH, goitres, life style, alternative medicine, lemon balm, complimentary medicine plus a whole raft of information on everything and anything Graves related.
As for the seafood I'm glad you were able to have a holiday and apart from being jealous I do not know the answer but it wouldn't have stopped me enjoying the seafood and would guess in the overall scheme of things the knock on effect minimal and it's too late now anyway.
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