# Graves, PTA, Hyperthyroid



## learian3 (Dec 17, 2012)

Hi, Elaine, and thank you in advance for any thoughts you have on the following. . . I was diagnosed with Graves in 1995 and had strong allergic reactions to both PKU and Tapazole with symptoms worsening and labs indicating that I was becoming more and more hyperthyroid. RAI was given and within a week a goiter presented. I was so sick that my endocrinologist in consult with a surgeon recommended a thyroidectomy. After the surgery, I learned that it was a partial with only a "tiny bit" of thyroid gland left. Six weeks post surgery I had a TSH of 110; and after six to nine months, all labs came back normal except for a suppressed TSH. 132 mcg / day of Synthroid seemed to keep me fairly asymptomatic. Free T4 and T3 were in range with a suppressed TSH being the new "norm."

In 2012 I started have symptoms of hyperthyroidism again--running very hot, breaking sweats, and feeling a little breathless. My internist recommended lowering the dosage of 132 mcg slowly. It's been about one year, and my current dose of Synthroid is 88 mcg. My Free T4 was high but did fall back into a normal range. I still have symptoms and have been referred to an endocrinologist who states that he has treated cases like this before.

What is happening here? Has my thyroid grown back? Do I still have Graves? Is the recommended course of treatment to continue to lower my daily dose in the hopes that symptoms will remit. Frankly, the issue for me is not so much a suppressed TSH but rather that I am symptomatic. In this case, I realize that the two are related; however, I am more concerned with the clinical picture than just the numbers. Obviously, there was an almost 20 year period when a suppressed TSH left me symptom free, and now that's not the case.


----------



## Octavia (Aug 1, 2011)

Hello, and welcome!

My guess is that the tiny bit of thyroid tissue they left has multiplied. Thyroid removal is almost never a perfectly "clean" surgery, and even the best surgeons leave some tissue behind because it's in such a sensitive area.

Curious to see what others have to say...


----------



## Lovlkn (Dec 20, 2009)

> After the surgery, I learned that it was a partial with only a "tiny bit" of thyroid gland left


If they told you it was a partial I bet they left more than a tiny bit. What they left very well could have begun to grow back, you may also have thyroid tissue in your body - other than your throat.

Maybe ask for a sonogram of the area?


----------



## Andros (Aug 26, 2009)

learian3 said:


> Hi, Elaine, and thank you in advance for any thoughts you have on the following. . . I was diagnosed with Graves in 1995 and had strong allergic reactions to both PKU and Tapazole with symptoms worsening and labs indicating that I was becoming more and more hyperthyroid. RAI was given and within a week a goiter presented. I was so sick that my endocrinologist in consult with a surgeon recommended a thyroidectomy. After the surgery, I learned that it was a partial with only a "tiny bit" of thyroid gland left. Six weeks post surgery I had a TSH of 110; and after six to nine months, all labs came back normal except for a suppressed TSH. 132 mcg / day of Synthroid seemed to keep me fairly asymptomatic. Free T4 and T3 were in range with a suppressed TSH being the new "norm."
> 
> In 2012 I started have symptoms of hyperthyroidism again--running very hot, breaking sweats, and feeling a little breathless. My internist recommended lowering the dosage of 132 mcg slowly. It's been about one year, and my current dose of Synthroid is 88 mcg. My Free T4 was high but did fall back into a normal range. I still have symptoms and have been referred to an endocrinologist who states that he has treated cases like this before.
> 
> What is happening here? Has my thyroid grown back? Do I still have Graves? Is the recommended course of treatment to continue to lower my daily dose in the hopes that symptoms will remit. Frankly, the issue for me is not so much a suppressed TSH but rather that I am symptomatic. In this case, I realize that the two are related; however, I am more concerned with the clinical picture than just the numbers. Obviously, there was an almost 20 year period when a suppressed TSH left me symptom free, and now that's not the case.


Tch; yes it is true. If a bit of tissue is left behind and sometimes that simply cannot be helped due to possible damage to surrounding tissues and organs, it will replicate.

And yes; once Graves', always Graves'!

Has your doctor ordered RAIU? This would be a good idea if it has not been done. See if there is an uptake. If there is, RAI probably would be the final coup here if you chose to do that.

Also, see if your doc will run the FREE T3.


----------

