37yo male. I was diagnosed with Graves in august from antibody test, t3, t4 and TSH. I was on methimizole 30mg daily since then. I started experiencing hypo symptoms about 2-3 weeks ago. Very cold intolerant, loss of appetite, constipation, sore and fatigue. My last bloodwork November 3rd, which is done every 3 weeks confirmed free T4 was now Low. T3 free is now in normal range on that same bloodwork too. We cut my dose back 4 days ago from 30mg to 10mg daily. I woke up last night in a full sweat. This morning I had a full on anxiety attack and my blood pressure is back up to 130/90 from a consistent 110/80 daily readings. Is it possible to modulate that quickly from feeling hypo back to hyper?
At time of diagnosis
TSH was less then .01 normal range 0.33 - 4.70 uIU/mL
t3 free was greater then 13pg/ml
free t4 was 5.61 ng/dl
Trab was 25.6 IU/L normal range 0.00 - 1.75 IU/L
this most recent bloodwork November 3rd showed
t3 free was 3.5 pg/ml normal range 2.3-4.2
free T4 was .7 ng/dl normal range .89-1.76
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Woodsman4
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In short in a nutshell - yes - especially if your Graves is still raging - maybe the AT drug dose was reduced too much - slow and steady is always the best way to go with thyroid hormones and blood tests are just a snapshot in time.
So you have an over range TRab - Thyroid Receptor antibody blood test which is indicative of Graves Disease - an Auto Immune disease which generally only gets diagnosed when your thyroid or eyes start being attacked by your immune system -
Quite why your immune system has turned and started attacking your body, is of course the 64 million $ question ?
When Graves is raging it can feel like a roller coaster of symptoms - though without the fun - as you an experience extreme highs and lows of symptoms as the thyroid malfunctions with successive immune system attacks.
There are 2 main Graves antibodies -
the TRab - a Thyrod Receptor blocking and the TSI - aThyroid Stimlating antibody -
between them they fight for control of your thyroid - bit like a football being kicked from one end of the pitch to the other - and these 2 extremes of symptoms can burn / cancel each other out - leaving you feeling relatively normal for the time being.
If Graves is raging and you can't find a dose of the AT drug to leave you able to function there is the treatment option of Block and Replace -
whereby the AT drug is increased to fully block your new daily thyroid hormone production BUT a prescription is given for T4 - Levothyroxine - so adding in a measured dose of thyroid hormone so your T3 and T4 do not fall too far through the ranges causing the equally disabling symptoms of hypothyroidism.
Graves is a poorly understood and badly treated AI disease as no 2 people have the same initial symptoms/ life style - and everybody's journey with Graves unique to them but common triggers seem to be stress and anxiety and there is currently no cure for Graves.
All the Anti Thyroid does is semi-block your new daily thyroid hormone production while we wait for your immune system response to calm down and your T3 and T4 to fall back down into range, with your symptoms hopefully relieved and your thyroid reverting back to normal.
The NHS generally allocate around a treatment window of 15-18 months with the AT drug and you should be regularly monitored and your AT drug titrated down as your T3 and T4 levels fall back down into the ranges - bit like an plane being put in a holding position - while we wait for your immune system response to calm down.
When metabolism is running too fast as in hyperthyroid or too slow as in hypothyroid - the body struggles to extract key nutrients through food, no matter how well and clean you eat -
and non optimal levels of ferritin, folate, B12 and vitamin D can - in themselves - compromise your ill health further than necessary - so suggest you get these run and we can advise on the results as some NHS ranges are too wide even to be sensible.
Your most recent reading shows your T3 in range with a T4 slightly lower than the bottom of the range - this may even itself out - as blood tests tend to run behind symptoms by a couple of weeks - hopefully you will start to feel a bit more comfortable - are you eyes involved ?
We do now have some research papers you might like to keep for future appointments :-
That is excellent information. It's been rather difficult finding a lot of information on graves in general let alone males with graves. We seem to be far less common. My dose was bumped back up yesterday and just in the 12-24 hours I feel world better.
As I'm trying to eliminate stress and anxiety from life in hopes of undoing any triggers and calming the graves or burning it out. Having the correct information and good understanding helps so much in easing my stress and worry. Waiting with knowledge and a plan is so much easier than waiting in the unknown thinking it will never end and you are dying.
I am actually stateside at the moment being treated here by a naturopathic doctor
As for that 64 million dollar question. While not simple, it seems the common denominator comes down to genetic predisposition or rather epigenetic. Then you give a perfect storm of stress on your body and there you have it. Under that stress and your body's dumping of hormones your thyroid will appear to be the problem to your body and your immune system will be tricked into attacking it to solve that problem. Not to mention throw in a lifetime of endocrine disrupters and it's probably not helping. Eliminate stress and anxiety seems to be the best idea. Easier said then done
There is likely a genetic predisposition with Graves with someone maybe a generation away from you with a thyroid health issue - and whatever has happened, has happened, and your immune system triggered - Graves can occur after a shock to the system, like the unexpected death of a loved one, after a car accident - or simply out of the blue.
I was verbally abused and physically threatened by a man I employed as my assistant manager and then spent a few months trying to get some action through the company greivance proceedure - I ended up resigning and collapsed in the last few days of my notice period.
I had developed a new symptom - insomnia - I now realise I was already hypothyroid - and couldn't shake it off so went to the doctor and diagnosed with Graves :
Chocolate tea pot comes to mind regarding the company and the unit I managed was, unbeknown to me, due to closed down anyway - and nobody cared.
Ok - so if staying in the States, Elaine Moore is Stateside so you might find it useful logging into her forum if you're looking for more local support -
I hope the alternative practioner works out for you - as I read they do have a ' better understanding ' of auto immne health issues.
You might like to look up Dr Eric Osanskey ?
I only started my research on Graves 10 years post RAI thyroid ablation which was back in 2005 - and too late for me - and then more ill than I had ever been in all my life and when finding no answers through the NHS - I purchased Elaine's first book as I thought - maybe that Graves had come back again - only to learn it never went away.
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