I have been feeling absolutely awful- weak and fatigued beyond believe, ended up in A&E last night with super high pulse. Was convinced it would be due to my graves but was told my bloods were normal and it was likely viral
TSH 1.5 (Range 0.23-5.6)
Free T4 19 (Range 9-28)
Free T3 6.1 (Range 3.1-6.8 )
Is it possible these number are normal but not optimal and could still be affecting me? I feel like no one is listening.
Thanks so much 🙏🏾
HI LeeS171186, welcome too the forum. 
Do you realise you posted this twice? Which can become very confusing. Might be a good idea to delete the second post.
So, it's difficult to answer your question because we know nothing about you, no info on your profile. For example, what are you taking for your condition? And how was your Graves' diagnosed?
You results are strange but without more info we can't know why. But of course, it's always possible that the results are not right for you. Thyroid disease is a very personal thing. But doctors only know to do bloods and if the results are within the ranges, they say they are normal. But that's not necessarily true.They may not be normal for you.
Hi greygoose, thank you so much for your reply 🙏🏾
I was diagnosed with hyperthyroid/Graves (positive trabs) in April last year after becoming quite unwell with symptoms including palpitations, tachycardia, fevers, tremors, poor swallow, weight loss and hair loss.
I was initially started on carbimazole 40mg once daily and propranolol 40mg three times daily. I very quickly became hypothyroid and medications were stopped in September.
I am currently unmedicated but have been feeling increasingly symptomatic since beginning of January and two thyroid function tests later, my GP have said they are satisfied that results are normal. I requested more thorough blood work to rule out any decencies, however I have also questioned optimisation of my thyroid numbers.
Understand the complexity of the condition and am looking to seek more knowledge from those who have the experience with it.
Thank you again 😌
FT4: 19 pmol/l (Range 9 - 28) 52.63%
FT3: 6.1 pmol/l (Range 3.1 - 6.8) 81.08%
Well, your FT4 is 'normal' (euthyroid). But your FT3 isn't. It's rather high compared to your FT4, but your TSH doesn't reflect that. And to my untrained eyes, that looks more like Hashi's results than what I've seen of Graves'. Did you have any other antibodies tested than TRAB?
What time of day was the blood draw for this test?
Thank you so much, I will discuss with GP on Friday and follow up with endocrinologist next week. All the more knowledge I can fan helps me to ask the right questions.
These bloods were taken at 0930am. No further antibodies were checked at time of diagnosis, or since.
Grateful for you taking time to respond 😌
You're welcome.
Graves Disease (hyperthyroidism) needs to be confirmed via positive TRab or TSI:
TRab
TSH receptor antibodies
TSI
Thyroid-Stimulating Immunoglobulin
TPO & TG antibodies may be Graves or Hashimotos.
TPOab
Thyroid Peroxidase antibodies
TGab
Thyroglobulin antibodies
….TRAB confirms positive Graves (can you recall your levels for this?), but it is possible to be positive for both Graves and Hashimotos. Have you ever had any other antibodies tested? I was initially diagnosed as Graves by my Endo, but later antibodies confirmed Hashimotos. I also ended up in A and E with fast pulse/ tremor/ palpitations etc so understand this can be very scary. I
Have you tested key thyroid vitamins- ferritin, folate, B12 and vit D? Having these optimal supports thyroid health.
Hi Buddy195, thank you so much for your supportive response 😌 Sorry for your experience and hope that your symptoms are being managed well
Unfortunately I wasn’t told antibody level for graves and felt it was such a whirlwind I never asked appropriate if any questions at the time to be honest. No other antibodies were checked
I’ve asked to have those levels checked and have an appointment on Friday, very much hoping for an explanation as to why I’m feeling so whacked.
Did you ever experience whooshing sound in your ear? Like your heartbeat thumping in your head? 🙈
Yes, I experienced similar symptoms in the past. I felt extremely ’hyper’ yet my thyroid bloods did not indicate hyperthyroidism. Were you offered a beta blocker at all for fast pulse, or has this now subsided?
I was initially prescribed carbimazole 40mg once daily and propranolol 40mg 3 times a day. I then became quickly hypothyroid and medication was stopped in September. I’ve since read of ‘block and replace’? method and question whether that should have been approached with me. More questions to ask when I see someone next week 🙏🏾
pennyannie and PurpleNails are very knowledgeable about treatment for hyperthyroidism, so will tag them in.
Have you experienced any problems with your eyes at all (dryness/ grittiness etc)?
Ah thank you so much!!
Oh my goodness yes!! Itchy, gritty, red, puffy/swollen. Endo suggested early TED symptoms and to use preservative free drops for comfort?
Thank you for listening to this!! I feel heard!!! 💖
I recommend you take a Selenium supplement, 200ug daily, as this has showed to help in mild/ moderate TED when taken in the first 6 months. Many take a maintenance dose of 100ug daily when the active phase of the condition has passed.
Preservative free lubricating eye drops are important, such as HycoSan or Hyloforte. For light sensitivity wear sunglasses (even indoors if needed).
If you have any eye pain, my TED ophthalmologist said to take ibuprofen (with food to protect your stomach). Also worth doing is using 2 pillows at night, to elevate your head.
Above all, please don’t overdo it on Google images, as they show ‘worst case’ scenarios.
I received great advice and support from TEDct, so it may be worth geting t their information pack. They run a telephone advice line, hold regular webinars and have a Facebook group. TEDct helped me find a TED specialist ophthalmologist in my area.
I also recommend you take ongoing photos of your eyes/ alignment and store in ‘hidden’ on your phone, as you don’t want to be looking at them all the time. Having this bank of photos over time is useful when I have both endocrinology and ophthalmology appointments.
Keep posting and asking questions - we are here to help and support 🦋
Hello Lee and welcome to the forum :
If this were Graves Disease your TSH would have been hi-jacked by your immune system and be stuck down - low suppressed at around 0.01/5 and the NHS initial treatment with an Anti Thyroid drug such as Carbimazole is for 15-18 months.
There are 2 Auto Immune diseases that can cause hyperthyroid type symptoms Graves and Hashimoto's and they can both start off in a similar way and why we need to have the results of the antibody blood test and the medical evidence of proof of diagnosis prior to medicating.
Hashimoto's causes transient hyper type phases as this AI disease systematically attacks and disables your thyroid with you ultimately experiencing reduced thyroid hormone production and needing to be placed on thyroid hormone replacement for hypothyroidism.
Do you have there your initial blood tests from back when first placed on Carbimazole please- showing your TSH, Free T3 and Free T4 - are there any antibody results and ranges there - looking like TPO or TgAB ?
Sorry your immune system has also attacked your eyes - and yes, as I read you already know any treatment to ease the discomfort need to Preservative Free.
So my thinking is you are dealing with Hashimoto's and you might find the research and suggestions of Dr Izabella Wentz of interest - and she writes as - thyroidpharmacist.com
Your need ferritin, B12, folate and vitamin D levels tested too
What were last results
What vitamin supplements are you taking
Was your carbimazole dose adjusted at all? 40mg is a high starting dose & it’s usually reduced / lowered to keep you from going hypothyroid.
It’s usually to remain on at least a 5mg daily for around 18 months. Propranolol should also be reduced slowly too.
Block & replace is selected if adjusting carbimazole isn’t effective. Either unbalance FT4 & FT3. One being low the other high or fluctuations are so unpredictable treatment doesn’t stabilise. Doctors dislike block & replace because it requires higher antithyroid doses. Although it does stabalise effectively & allows for less frequent monitoring.
Were doctors monitoring frequently? Eg 6 weekly? Because inadequate management of treatment can leave people very unwell & drs say is it the condition and suggest early definitive treatments.
Obtain previous results & check the right antibodies were tested confirming positive Graves.
There are private options for thyroid funtion & key nutrients. Arranged via post & DIY fingerprick sample. Might be good idea to arrange for full picture.
There are other causes of very fast pulse (tachycardia) other than high thyroid hormones. One of the more common ones on this forum is low iron and/or ferritin (iron stores). Also anaemia, which can be caused by low iron/ferritin, and by low vitamin B12/folate.
You might find this link of interest : en.wikipedia.org/wiki/Tachy...
I have had problems with iron/ferritin for many years, and low levels have resulted on occasion in a heart rate between 150 and 170 beats per minute.
I would suggest, if possible, that you ask your doctor to do an iron panel, and make sure you get the results of the tests and the reference ranges for each test. Then you could post them in a new thread on here and ask for feedback.
bloods normal, still bad symptoms 
I got my bloods back...
Recent Bloods
Free T3 level - zero is normal?
