# My results



## Gio111ca (Oct 10, 2009)

Hi all,

Sorry for the delay, I just got these yesterday, so here we go:
TSH * 0.030 * L mU/L 0.340-5.600
FREE T4 8.28 pmol/L 8.00-18.00
FREE T3 *6.0* H pmol/L 2.3-5.2

Here were my December 1st results:
TSH * 0.10 * L mU/L 0.40-5600
FREE T4 16.82 pmol/L 8.00-18.00
FREE T3 *8.3 * H pmol/L 2.3-5.2

There seems to be some improvement, I am on Tapazole 1 + 1/2 pill per day.
My TSH is close to NIL, not sure why.

However, I just noticed this result (not too sure what it is):
ALKALINE PHODPHATASE *166* H IU/L 13-113

Any comments?

Thank you.


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## chopper (Mar 4, 2007)

You're not sure why your TSH is next to nil? Your T3 is off the charts - that's why.

You are still pretty hyper - that's for sure.


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## Gio111ca (Oct 10, 2009)

Hi nasdaqphil,

Didn't think my T3 was so off the charts at 6 ...

How can I increase my TSH? Or can't I?

Thx again.


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## chopper (Mar 4, 2007)

ok, I see. I read the old labs as the newest. I see Free T3 came down a bit but its still on the hyper side and above the range - that will keep the TSH low like that. Your Free T4 bottomed out I see.

What changed in between the old labs and the new labs? Did the doc change your dose or did you just get started on meds?

It seems like the Tapazole really brought down your Free T4 but you are converting T4 into T3 like crazy - UNLESS it's just to early to tell since starting meds and perhaps you have not stabilized yet since adjusting doses.

Do you have any symptoms?

The only way to increase your TSH is to lower your Free T3 and that would require meds.

Has your doctor taken a look at these numbers yet and if so, what did he say?


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## hillaryedrn (Dec 14, 2009)

Hi there! I wasn't sure exactly what that lab value meant, so I did some research. Here's what I came up with:

"A test for alkaline phosphatase (ALP) is done to:

Check for liver disease or damage to the liver. Symptoms of liver disease can include jaundice, belly pain, nausea, and vomiting. An ALP test may also be used to check the liver when medicines that can damage the liver are taken.

Check bone problems (sometimes found on X-rays), such as rickets, osteomalacia, bone tumors, Paget's disease, *or too much of the hormone that controls bone growth ( parathyroid hormone)*. The ALP level can be used to check how well treatment for Paget's disease is working."

Maybe they are looking at your parathyroids??

Hillary


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## Gio111ca (Oct 10, 2009)

I have been on Tapazole 1 + 1/2 pills per day since October 2009.

I believe the change in results form December to my latest comes from the fact that I quit smoking after the December results. I have an appointment with my endo in about 3 weeks and will see what he has to say.

Thank you for the info on the ALP test, that's what I saw on the net but never had any liver problems or anything like that (unless it might be caused by the Tapazole). The doc just asked for that test at the same time as sodium, potassium and other tests. My good cholesterol HDL (I believe) seems a bit low, and I wonder till what point my hyper condition is affecting these results.


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## Lovlkn (Dec 20, 2009)

Gio111ca said:


> Hi all,
> 
> Sorry for the delay, I just got these yesterday, so here we go:
> TSH * 0.030 * L mU/L 0.340-5.600
> ...


Did you have a Comp Metabolic panel run? There are more tests associated with liver function to determine why this level is high, also did you have the same tests run before you began the Tapazole and what were those results?

How long have you been on Tapazole? Are you splitting doses? Since you are taking 1/5 pills 3 doses evenly spaced is a good way to keep the drug level in your system.

Your labs are going down nicely - you need to re-lab in 4 weeks unless you begin having symptoms of hypo - then you should lab sooner. Right now your body is adjusting so you need to be patient.

You will most likely need a dose reduction soon as your FT-4 is already at low range - now it's a wait and see game to see here the FT-3 will settle along with the FT-4, goal should be at least mid range for both.

As far as TSH, you can ignore it as long as you have Graves antibodies as they keep TSH low. Make sure your doctor doesn't begin dosing you on TSH alone and keep them aware of any symptoms you experience as some will dose based on symptoms.

Cograts on the quitting smoking - I officially quit on Dec 18th. I have been a closet smoker forever and finally realized it's not a good thing for me to be doing.


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## Andros (Aug 26, 2009)

Gio111ca said:


> Hi all,
> 
> Sorry for the delay, I just got these yesterday, so here we go:
> TSH * 0.030 * L mU/L 0.340-5.600
> ...


Hi!! Are you feeling better? You still are very hyper but improvement is slow. Alkaline Phosphate could be from the antithyroid med. They are notoriously hard on the liver.

Have you talked to your doctor about this?


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## Gio111ca (Oct 10, 2009)

Hi,

Andros, hope all is well. I will talk to my endo about my Alkaline Phosphate as soon as I see him (in about 3 weeks).

Lovlkn's, I have been on Tapazole only since October 2009, I take 1 pill in the morning and 1/2 pill before dinner, that's it, so it's been roughly 5 months now. Hope it stabilizes eventually, thanks for your input.


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## Lovlkn (Dec 20, 2009)

Gio111ca said:


> Hi,
> 
> Andros, hope all is well. I will talk to my endo about my Alkaline Phosphate as soon as I see him (in about 3 weeks).
> 
> Lovlkn's, I have been on Tapazole only since October 2009, I take 1 pill in the morning and 1/2 pill before dinner, that's it, so it's been roughly 5 months now. Hope it stabilizes eventually, thanks for your input.


How often do you have labs drawn? Are you going to have another set drawn before your next endo appt? If it were me I would, I had labs abut every 4 weeks while on Tapazole and most months I had to adjust dose by 1/2 pill or so either way.

I wonder if some propranol might be something to consider to lower your FT-3?


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## Gio111ca (Oct 10, 2009)

I usually do a blood test every 1 1/2 month, but it will be the second time only that I see my endo because it takes 6 months to get an appointment, it is impossible to see him more than that, so my results go to my family doctor who can see me every 3 months if I am lucky, but it is pretty useless because that is not his specialty, so it is really hard to get a good followup, but that is how the system is done here, you see a doctor when there is availability, not when you need to.

I have had no medication adjustment since I began taking the Tapazole.


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## Lovlkn (Dec 20, 2009)

> that is how the system is done here, you see a doctor when there is availability, not when you need to.


Where do you live?

You never answered if they did liver function tests on you before beginning the Tapazole.


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## Andros (Aug 26, 2009)

Gio111ca said:


> Hi,
> 
> Andros, hope all is well. I will talk to my endo about my Alkaline Phosphate as soon as I see him (in about 3 weeks).
> 
> Lovlkn's, I have been on Tapazole only since October 2009, I take 1 pill in the morning and 1/2 pill before dinner, that's it, so it's been roughly 5 months now. Hope it stabilizes eventually, thanks for your input.


Hope you are not taking any other med that is hard on the liver and alcohol would also be contraindicated at this time.

Everything thing is good; hope the same is true for you. 
Take it day by day; that is all we can do!


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## Gio111ca (Oct 10, 2009)

I live in Montreal, Canada, and no, I had no liver test before taking Tapazole as I never had any medical problems till I was diagnosed with Graves in October 2009, although the symptoms began quite sometime before that.

Andros, no, no alcohol at this time. Also trying to cut down on coffee.


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## Andros (Aug 26, 2009)

Gio111ca said:


> I live in Montreal, Canada, and no, I had no liver test before taking Tapazole as I never had any medical problems till I was diagnosed with Graves in October 2009, although the symptoms began quite sometime before that.
> 
> Andros, no, no alcohol at this time. Also trying to cut down on coffee.


You are such a wise soul. Good for you!! Gee; I am worried for your medical care. Most of us saw doc every 4 weeks at least while on anti-thyroid med.


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## Gio111ca (Oct 10, 2009)

Andros, you guys must be in the States?

Unfortunately, the health care system in Canada is made in such a way that you can see your doctor when he has availability, not when you need to, but that is a different subject.

If i could, I would see my endo every 4 weeks, but that it truly impossible, like i said, it's even hard to see him every 6 months (was there in October and managed to squeeze in an appointment in March). This is why I am grateful for such informative sites such as this one.


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## Andros (Aug 26, 2009)

Gio111ca said:


> Andros, you guys must be in the States?
> 
> Unfortunately, the health care system in Canada is made in such a way that you can see your doctor when he has availability, not when you need to, but that is a different subject.
> 
> If i could, I would see my endo every 4 weeks, but that it truly impossible, like i said, it's even hard to see him every 6 months (was there in October and managed to squeeze in an appointment in March). This is why I am grateful for such informative sites such as this one.


And I am grateful that you have health care. All "systems" can be criticized but when it is all said and done, what you have in Canada is something to be grateful for.

You will be fine. I have friends who live in Canada and when you do see the doctor, the care is exemplary most of the time. Unlike the U.S..


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## Lovlkn (Dec 20, 2009)

If that is the case at least try to get your labs every 6 weeks- alternating between doctors unless you can have them run privately.

Your next labs will tell you where your meds need to be and you may begin to feel some hypo symptoms if your FT-3 begins to fall into range or lower range.


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## Gio111ca (Oct 10, 2009)

Ok thx Lovlkn, will keep you guys posted.


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## Gio111ca (Oct 10, 2009)

Hi all,

While waiting to go and see my new ophto, I noticed I am getting a blind spot in my vision in my right eye. The blind spot is inwards when I look at my nose, I see like a black cloud. I have been seeing a round light from time to time in that eye, but all opthos who checked it said noting towards that.

Any input would be appreciated, thank you.


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## Andros (Aug 26, 2009)

Gio111ca said:


> Hi all,
> 
> While waiting to go and see my new ophto, I noticed I am getting a blind spot in my vision in my right eye. The blind spot is inwards when I look at my nose, I see like a black cloud. I have been seeing a round light from time to time in that eye, but all opthos who checked it said noting towards that.
> 
> Any input would be appreciated, thank you.


Sounds like you are starting to get eye involvement. Oh, dear. When do you see the ophthalmologist?

I typically had halos, wavy lines, flashing lights and blind spots. So, I am thinking it is from thyroid but at this point, the eyes must be treated independently of the eyes.


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## Gio111ca (Oct 10, 2009)

Hi Andros, I will see another ophthalmologist next month only. I am wondering if the situation can stabilize once my Thyroid levels get better.


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## Andros (Aug 26, 2009)

Gio111ca said:


> Hi Andros, I will see another ophthalmologist next month only. I am wondering if the situation can stabilize once my Thyroid levels get better.


While having your thyroid levels in a good place helps, once the antibodies start attacking the eyes, they must be treated independently.

http://www.springerlink.com/content/kj78430r38812h42/


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## Gio111ca (Oct 10, 2009)

I was reading on the net and came upon ¨Scotoma¨. Not sure if that's what it may be. Regardless, what is the treatment, do you know?

Thanks again for your help Andros.


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## Andros (Aug 26, 2009)

Gio111ca said:


> I was reading on the net and came upon ¨Scotoma¨. Not sure if that's what it may be. Regardless, what is the treatment, do you know?
> 
> Thanks again for your help Andros.


Well, yes that is a word for it. It would appear that there are quite a few pathological reasons for scotoma so best confer w/the ophthalmologist on this. The cause would determine the treatment options.

The doctor may wish to do an MRI of the obits to see if there is a lot of interoccular swelling which could be compromising the optic nerve which would be typical of Graves' exophthalmos.

I will worry for you so keep us in the loop.


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## Gio111ca (Oct 10, 2009)

I have previously done the Xray in the tube (sorry not sure about the technical term).

My endo asked for another blood test and he should take me down from 1 pill and half per day to just 1.

I mentioned to him how I was seeing blurry from my left eye and was experiencing a black blind spot in my right eye, and he prescribed me some pills till I go and see the ophto (only if really needed he said). He said these pills will relieve the pressure on the eyes from the inside (I don't really feel any pressure).

So I have not gone to get the prescription because he said to use them only if required. I am trying to read the name of the product but cannot read his handwriting, seems like ¨Prednisoic¨? A Google search shows Prednisone; the search also shows this prescription is the most damaging to the eye ! Maybe the endo should have mentioned that little point ...

Anybody familiar with those pills? He too thinks my previous ophto jumped to quick to want to operate me, as there are other alternatives prior to doing surgery.

Thank you.


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## Andros (Aug 26, 2009)

Gio111ca said:


> I have previously done the Xray in the tube (sorry not sure about the technical term).
> 
> My endo asked for another blood test and he should take me down from 1 pill and half per day to just 1.
> 
> ...


Hi! So good to hear from you!! I had to take Prednisone for a very very long time "for" my eyes and I did get drug induced Cushing's Disease from the Prednisone but it did help my eyes.

However, we each are so different and what may not be damaging for one,could be for another. Don't do anything you are not comfortable with and please do re-discuss this with your doctors.

How are you feeling right now? And when is your appt. with the Ophthalmologist? Soon?


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## Gio111ca (Oct 10, 2009)

Hi Andros, good to hear from you.

I am feeling ok, seems like my levels are within a respectable range .

But it also seems that my eyes are not getting much better, but then again, not much worst either. However, after reading the side effects of Prednisone, I will absolutely stay away from it unless I really need it, which I find I don't at this time. I can live for a while with a blurred vision and a blind spot, because I feel it is affecting my vision at .01%, so it is still 99.99 % good (if my math is ok).

Honestly, the only thing that is bothering me are the bags under my eyes, nothing else is really bothering me, but I don't think there is much I can do about that ( I tried cold water and stuff but nothing worked.)

I actually had a look recently at some surgery on Youtube to get rid of this fat ( I guess that is what it is? ) under the eyes, but not a pretty sight to see. I will try to avoid any pills or any treatments unless really necessary. I have an appt with my opth on April 13th, so will see what he has to say.

Sorry to hear what you went through Andros, quite an experience, I can relate.


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## Andros (Aug 26, 2009)

Gio111ca said:


> Hi Andros, good to hear from you.
> 
> I am feeling ok, seems like my levels are within a respectable range .
> 
> ...


Thank you for your caring comment. I will be anxious to hear what the Ophthalmologist has to say when you go on 4/13. That seems like such a long way away.

If you have periorbital edema and I think that you do, not much seems to help. Sleep with head elevated and continue the ice packs. It's a total mess; it surely is.


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## Gio111ca (Oct 10, 2009)

Thx Andros, will keep you posted. I really hope it is different from the last one who just concluded he was ready to operate.


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## Andros (Aug 26, 2009)

Gio111ca said:


> Thx Andros, will keep you posted. I really hope it is different from the last one who just concluded he was ready to operate.


I hope so too for reasons previously discussed. I am very worried for you right now.


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