What is the difference between pre-TT Graves' and post-TT Graves?

[lau99]

Hi all, thank you again for all the helpful comments on my last post. I'm really glad to be a part of this community - I only wish I'd known about it a little over 5 years ago, but perhaps that's a post for another day.

I wanted to ask if anyone had any insight on what happens to the body when one's thyroid is removed - or indeed,

- Why does 'overmedication' not always look/feel the same as being hyperthyroid pre-surgery?

- Does something happen to the body's ability to use thyroid hormones once the thyroid itself is gone?

- If perhaps it could be that the body becomes 'used to' having too much thyroid hormone when in active Graves', does this mean that it's reasonable to expect that a person who lost their thyroid due to Graves' might need more than the 'normal' amount of replacement for the body to function correctly?

- Also, does the existence of Graves' disease/antibodies have any effect on hormone replacement post-TT?

[jimh111]

After a thyroidectomy Graves' antibodies can no longer stimulate the thyroid to secrete too much hormone. However, the antibodies can hang around for a year or so and stimulate deiodinase, the conversion of T4 to T3.Often TSH can remain low for quite a long time after Graves' recovering after many months if at all. So, TSH is not always reliable after Graves' or hyperthyroidism.

[pennyannie]

Hey there :

As I understand things :

Pre definitive treatment for Graves - If running with high T3/T4 thyroid levels for some time the body may have ' shifted gear ' and adjusted to accommodate same -

post surgery you may find you need to maintain higher levels of thyroid hormones as your body ' gears ' are now at a slightly higher level than considered ' normal ' :

As for the Graves antibodies these circulate in your blood and can wax and wane throughout your life after all we are looking at an Auto Immune disease for which there is no cure - with stress and anxiety being common triggers - but without a thyroid - there is now no target to attack.

There is no way of cleaning these antibodies from your blood and they tend to ' cling on ' -

get ' stuck on ' - on the fine follicle hairs of the TSH receptor sites throughout your body -

which pushes down on the TSH receptor - which in turn - lowers a TSH reading and if you still had a thyroid would power up / increase your own natural thyroid hormone production.

Without a thyroid - the Hypothalamus - Pituitary - Thyroid - HPT axis - on which the TSH relies on as working well - is now open ended as your thyroid is not there to close the circuit -and your natural ' power to respond ' to a low / suppressed TSH reading - gone -

as your thyroid is not there to respond in the normal way - and now in a bucket .

Similarly with RAI thyroid ablation - this toxic substance burns through the thyroid is situ -ultimately totally disabling the thyroid to respond to a TSH reading -

the HPT feedback loop now down regulated with this circuit loop non functioning as the thyroid now burnt out and unreceptive - though still in situ :

Which ever way round you go - without a thyroid - we have lost our automatic recharge of thyroid hormones - the TSH means little - if anything-

and we must manually recharge ourselves of thyroid hormones daily and try and find a balance of thyroid hormones that works best for us -

with the thyroid gone - the antibodies have little if any effect on anything :

All these rules and guidelines seem to presume people have a thyroid -

I have not found a paper on how to treat Graves patients - post definitive treatment - through surgery or RAI thyroid ablation.

Hope that makes some sense :

[pennyannie]

Thinking on -

in a nutshell - the difference being -

Pre - trusting mainstream medical -

Post - Disillusioned - and at some point in time finding yourself on a forum talking to strangers.