latest blood work

[Pjd94]

hello everyone,

I’ve just got through my recent blood work. My TSH has always been 0.01 I’ve been on 20mg Carbimazole and now since 10mg.

Is it normal for my TSH to shoot up this high?

[Pjd94]

sorry forgot to add. Diagnosed with graves’ since April 22.

[PurpleNails Administrator]

It might be a sign your carbimazole dose is a little too high & making your levels too low. Dr will be please to see TSH respond & if you feel well at current level then no action for now. - monitor as usual.  If you think you might be having hypothyroid symptoms as they are lower side of range, speak to doctor about adjust to 5mg or 10 / 5 mg alternating days. My TSH never moved into range has been 0.01 for almost entire time.   Lifted fractionally once when FT4 & FT3 were kept borderline low for several months. 

[pennyannie]

Hello again :

More to the point - how are you feeling ?

Apart from the TSH bouncing up, your T3 and T4 are in range, and have dropped a little since June ?

If symptoms of hypothyroidism are starting to be experienced it might be worth titrating down the anti thyroid drug ?

The TSH seen in isolation has little value especially when dealing with Graves and on AT drugs :

It could mean this first phase of Graves Disease is coming to an end and your thyroid receptor blocking antibodies are at very low levels but the NHS generally allocate a 15-18 month window on the AT drug so it's too soon to know and without the TRab test being rerun just a guess.

As previously detailed the most current research is suggesting the longer the patient is on the AT drug the better the long term outcome for the patient after all we are looking at an auto immune disease so time is needed for your body to calm down and your immune system response to readjust.

In normal circumstances a TSH of 3 would suggest the person is starting to suffer with symptoms of hypothyroidism and if the TSH continued to rise T4 - Levothyroxine would be prescribe to support thyroid function.

[Pjd94 in reply to pennyannie]

thank you for your reply. I’m feeling a little more tired than usual and hair is falling out a bit more, but other than that I feel grand. I’ve been lucky because even after 1 month on Carbimazole my levels (apart from TSH) have been within range. I’m a bit surprised that my TSH has jumped that much already as they said it may never go up! The letter from my endo says just go by T4 levels, I’ve messaged me GP to see what she says

[pennyannie in reply to Pjd94]

Ok then - bit concerned to read about your hair loss - this could be due to low iron levels :

I would also suggest you get your core strength vitamins and minerals run - we need ferritin, folate, B12 and vitamin D maintained at optimal levels and when metabolism isn't running quite right these can simply nosedive through the ranges irrespective of how well and clean you eat, compounding symptoms.

If taking anything containing biotin this needs to be stopped a week before blood tests as it can distort/interfere with the analysis of the blood tests at the laboratory.