hyperthyroid t4 in blood and swollen eyelids

Hello I wondered if anyone can help, I am new here and have hit a dead end with the NHS regarding any advice or support at the moment. I have been feeling run down and my eye lids started swelling 3 weeks ago I done a blood test at the doctors they confirmed a hyperthyroid t4 diagnosis and have referred me to the hospital, my hospital appointment just came through and it is a video chat in one months time. I contacted my GP yesterday regarding my concern with my swollen eyelids and how much worse it may get in the month for the video chat appointment and the doctor just told me to call an opticians as hospital do not have the equipment to test my eyes, I have been to my local hospital with my daughter when they tested her eyes so unsure why a doctor would say this, is a video chat appointment one month from blood test normal (Referral to: Dumfries & Galloway Infirmary)

[SlowDragon Administrator]

welcome to the forum

Can you add actual blood test results

What else was tested

Presumably you are not on levothyroxine?

What time of day was test done

Were TSH, FT4 and FT3 tested

Also TPO and TG thyroid antibodies tested for autoimmune HYPOTHYROID also called Hashimoto’s. Hashimoto’s frequently starts with transient hyperthyroid results and symptoms before becoming increasingly hypothyroid

Testing TSI or Trab antibodies for autoimmune HYPERTHYROID, also known as Graves’ disease

Very important to test vitamin D, folate, ferritin and B12 as well with all thyroid issues

do you have any other symptoms

[Hidden in reply to SlowDragon]

Hello, thank you to yourself and all others for the useful information it has really helped. I seen an optician, and they said it certainly looks like Thyroid eye disease/graves but said that once thyroid treated it should settle. The reason I went to the doctors in the first place was in October last year I had a urine infection that turned into a kidney infection during this time I started getting a lot of negative mind related symptoms, intense rage, crying for no reason, like panic attacks on steroids, sweating, itching and fatigue, struggle to sleep, these episodes would last days at a time and then straight back to normal, I have had an episode each month, it feels like I get the cold or flu like symptoms and then turn into a part time psychopath for a few days. I called the doctor in November they offered me SSRI’s to take only on the days I am not ok I chose not accept the doctor suggested sometimes the pill/OC can cause some of these issues I have been having and suggested I come off the pill which I did and had my blood tested approx 7 weeks after stopping OC. Doctor called saying blood test was showing early stage menopause and T4 hyperthyroidism he put me on Propanalol 40mg twice daily they are helping with the on edge tremor I was getting (I found twice was not enough and am taking another at night). I received a copy of the correspondence between doctor and department of endocrinology it says TSH less than 0.03 with high Free T4 level at 39 pmol/L. Hospital referral is in 10 days they have also asked the surgery to do anti-TPO and TRAb before appointment, so I have arranged that on the 28th Feb. I am 44 years old and usually weigh 8 stone but just noticed I have lost 4 pounds and I am always eating!

[pennyannie]

Hello Jennifer and welcome to the forum :

Do you have access online to your medical records held at your surgery ?

If so can you please share with forum members the blood test results and ranges your doctor is referring to ?

True hyperthyroidism is considered life threatening if not medicated -

so if dealing with a fast pulse, anxious, nervous, insomnia and a shakey middle finger - to name but a few symptoms of hyperthyroidism - go directly to hospital.

Do you have a diagnosis of anything - hypothyroid with an AI thyroid disease ?

What issues does your daughter have regarding her ' eyes' - is it genetic ?

TED - Thyroid Eye Disease could be an issue - maybe an optician better placed in your area ?

The Thyroid Eye Disease charitable trust - teduk.org can signpost you to your nearest specialist clinic :

TBH - all we hear about are the NHS long O/P waiting lists and nothing seems to be as ' normal ' :

P.S. Please just ensure that if using any eye drops of ointments to ease any eye issues that they are all Preservative Free - even those prescribed by the NHS.

[PurpleNails Administrator]

GP surgeries very often won’t have the equipment but most hospital should.

I did find the opticians very helpful & thorough & if you need further specialist care they can write a letter to refer you.

Things you can do to help eyes. (All are safe to do if your eyes turn out NOT to be affected by TED thyroid eye disease)

Taking a selenium supplement is said the help protect eye.  200mcg for up to 6 months.  Then reduce to 100mcg.  Can be brought over the counter.  Bear in mind selenium rich food can take you over the maximum requirement.

*Preservative* free eye drops & wipes.  Rotating different brands seem to help.  Liquid versions for daytime & gel versions at nighttime.  

 I recently been using ocufresh carbomer lubricating eye gel - this is a light gel melts quickly.

For when eyes are dry I use warm compresses (eg wheat bags, microwaveable gel masks).  Very gentle massage toward lash line, can use fingertips or carefully with roller ball tool or gua sha facial stones.  Warmth & message “unclogs” the blocked Meibomian Gland (tiny glands along lash line) and allows lipid oil layer to flow.  This protects eye and helps retains the water.  

If swollen, inflamed & more painful, I switch to cold compresses.  

If you like to moisturise near your eye area use water based clear gels not oil / cream.  I did this as developed milia white spots round eye.  I found the puffiness & swelling reduced when I switched. 

Serious complications with vision or changes to eye appearance are very rare.  Don’t Google and panic over worst case scenarios, they are always the most severe examples.

It can help to keep a photo record of eyes eg take a photo every 2 or 3 weeks.

Many report TED triggered or worsened when thyroid levels are low / high or fluctuating. So the sooner your levels are under control the better for your eyes.

[Hidden in reply to PurpleNails]

Hello, thank you for all the advice it is greatly appreciated! I purchased the eye drops your recommended and they do help at night when I really feel most affected they are really good 😊, I also bought the selenium (also purchased l-carnitine, Vit D and B12) did start taking them but just stopped as did not want anything to affect blood test, thank you again I never expected a response from anyone let alone so much useful information!

[Forestgarden]

As PurpleNails says, a trip to the opticians is probably worth doing. If anything major is going on they will write to your gp - might even help to speed up your referral, you never know.