# New labs and symptoms



## skimordiegirl (Mar 10, 2011)

Hi, everyone! I just got my lab ranges back from the Dr. Forgot to ask for them last week. Close to 3 weeks ago I started getting a rapid heart rate (in the high 90's) mine is usually around 65 resting. I went to the primary and he did my thyroid labs which were:

Through Quest labs

TSH 0.04 (0.40-4.50)
T4 Free 1.4 (I think the ranges are 1.4 - 12.0)
t3 Free 3.5 (again I think the ranges are 3.5 - 7.7)

So.. I have been on a ride since then. I was on 1.25mg methimazole alternating to 2.5 mg every other day. I am supposed to be taking now 2.5 mg decided by one endo who never listens to my complaints, and told by another endo to take 2.5 mg's twice a day. I got a rash on the 2.5mg tiwce a day so she wanted me to switch to PTU, which I didn't because I know that the rash always goes away for me within a few weeks. (Raised welt type rash, itchy, but only lasts for a few hours at the most)

My heart rate still hasn't gone down. She did not want to put me on a beta blocker because my heart rate is still concidered normal (under 100 when resting)

I went to the cardiologist who wants to put me on a 24 hour monitor because my heart rate with go from 74 to high 80's very quickly. He is thinking about a different type of blocker which works on sodium channels. It will not effect the heart rate but help with Palps, which I only have every once in a while (once a day)

Is it normal to only have the rapid heart rate as a symptom with low TSH. It looks to me like my other tests are in range. My "good" endo told me I was now in a type of hyperthyroid that can transition out... I guess it flares with a cold - which I had a bad sinus infection and cough... and that it could go back to normal after a while.

I has been a full 3 weeks since my med increase.

To my understanding a rash indicates too much medicine... but if it's too much medicine why isn't my heart rate going back to normal? I feel a little shortness of breath too,when I talk, but I figured this is because my heart rate is in the 80's and 90's.

Thanks,
Candi


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## skimordiegirl (Mar 10, 2011)

Thought I would bump this up


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## skimordiegirl (Mar 10, 2011)

I have had graves since I was 19, I am now 30. A few weeks ago after a bad sinus infection and cough I started noticing a rapid heart rate and immediately thought it was from this candida diet I was doing (very minimal carbs if any).

I went to my GP with a resting heart in the high high 90's. He told me my heart was galloping and wanted to check my thyroid. My levels came back with a TSH at 0.04. my t3 free and free 4 were in very normal range. I was sent to my endo who said to increase my already low dose of methimazole to 2.5 mg a day. I decided against that and went with 2.5 mg twice a day and went to my old endo who said that was fine. I told her I had been experiencing the methimazole rash and she was a little concerned over the pain I would experience in my hands with the rash. She wrote a script for PTU 40 or 50 mgs, can't recall (whatever the lowest dose is I think).

Anyways I am still taking the methimazole since the rash comes and goes and no more hand pain. My heart rate started to go back into the 0's for just a few days and all seemed well. Then on Friday I started noticing the internal tremor feeling and new it was my graves. I also have for the past week been waking up in the middle of the night with a racing heart rate. I manage to calm myself down and it goes back to the high 80's *my normal is in the 60's range, since I also have very low bp 90/60 with no dizziness*

So I am scared that I am doomed basically. When my heart races I start thinking how my heart is going to stop beating or explode. That because of my very low BP that I will not be a candidate for a beta blocker (which my cardiologist says he doesn't want to jump onto anyways since my heart rate stays below 100 bpm)

Am I allergic to the methimazole if I am getting a raised red rash every couple of days?

Is 40 or 50 mgs of PTU equivalent to 5 mg of methimazole?

I don't understand why the small increase in meds hasn't helped lower my heart rate. I keep thinking there is something wrong with my heart. (I have a 24 holter monitor scheduled for this coming Monday and then an echo the next day on Tuesday.

Are there beta blockers or some kind of blocker that doesn't affect blood pressure. If my BP gets any lower I am sure I will get comatose (at least the chart would read that).

Very stressed  I just want to feel how I felt 2 months ago.


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## Lovlkn (Dec 20, 2009)

Sounds like your Graves has flaired up.



> my t3 free and free 4 were in very normal range.


Call the office and get the actual results with ranges and post them please.

I cannot comment on the drug conversions as I was only on Tapazole.

Have you tried a antihistamine for the rash? Works for alot of people.


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## Lovlkn (Dec 20, 2009)

I merged your 2 posts as they were bot lab related.

You seem to be having conflicting symptoms that go against your FT labs.

A rash isn't necessarily because of over dosage - although it could be from an increased dosage. The more Methimitzol you take the lower your Free's will go and you are already at bottom range.

Has anyone mentioned running a TSI and TPO antibodies to see what's happening? It seems to me that you are experiencing both stimulating (thus your symptoms and low TSH) and blocking (the low FT-3 and 4 ) antibodies.


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## Andros (Aug 26, 2009)

skimordiegirl said:


> I have had graves since I was 19, I am now 30. A few weeks ago after a bad sinus infection and cough I started noticing a rapid heart rate and immediately thought it was from this candida diet I was doing (very minimal carbs if any).
> 
> I went to my GP with a resting heart in the high high 90's. He told me my heart was galloping and wanted to check my thyroid. My levels came back with a TSH at 0.04. my t3 free and free 4 were in very normal range. I was sent to my endo who said to increase my already low dose of methimazole to 2.5 mg a day. I decided against that and went with 2.5 mg twice a day and went to my old endo who said that was fine. I told her I had been experiencing the methimazole rash and she was a little concerned over the pain I would experience in my hands with the rash. She wrote a script for PTU 40 or 50 mgs, can't recall (whatever the lowest dose is I think).
> 
> ...


Why have you not considered ablation after all these years? Have you had a recent ultra-sound or RAIU?

Glad you are seeing a cardiologist for after all these years there could be some heart damage. I hope not. Please let us know!


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## jenny v (May 6, 2012)

I'm with Andros, is there any reason why you're not considering ablation or removal? You've been on a big roller coaster and it's no fun to live like that.


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## skimordiegirl (Mar 10, 2011)

Thanks for the replies!

I had been doing fine with a minimal dose of methimazole for 11 years. It wasn't until recently after getting a sinus infection did I start getting symptomatic again.

I refuse to do TT because I don't want to go under anesthesia (phobia's) so have been thinking more about RAI. One of my endo's was under the impression that I was close to remission as she had me on 1.5 mgs and I was in normal range.

What can happen if I am blocking and stimulating with my antibodies?

I have elevated TSI, but also my TPOA (?) was so high it couldn't detect past 1000. I was told that my thyroid would eventually burn itself out and I would go Hypo.... so I was just riding the coaster hoping it would happen sooner than later. Honestly for 11 years I have been fine with symptoms not occurring at all on the meds up until this recent cold.

I switched from Methimazole to PTU this morning, so far no rash since I took it. The methimazole rash seemed to happen when I'd gone to far between doses.

I will be seeing the cardiologist tomorrow and then endo in another few weeks.

My biggest fear about the RAI aside from buldging eyes would be a rapid uncontrolable heart rate or going into thyroid storm from an increase in antibodies.

Thank you!


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## Lovlkn (Dec 20, 2009)

Do you have any eye involvement now? If so RAI is not a good idea.

Perspective... I had a TSI of 325+% and a TPO over 1,800 going into surgery. MY thyroid was a mess and my surgeon DX'd me with hashitoxicosis due to the condition of my thyroid.

I wonder if you system has been altered by your sinus infection - as Graves is autoimmune - and the destruction of your thyroid increased thus spiting out additional thyroid hormone - thus causing you to need more replacement.

With RAI the thyroid dies slowly and often multiple doses are required. With surgery it's one and done - instant hypo and then all you deal with is calibrating your replacement meds. While surgery has some risks of complications I would choose surgery again if I needed to address a thyroid issue.RAI to me sounds dangerous to the people and pets around you due to the possible exposure to radiation


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## skimordiegirl (Mar 10, 2011)

I have no eye involvement at all anymore. It went away years ago 

My heart rate has since decreased since upping my dose, except for in the middle of the night, it will wake me up racing.

How long are people and pets in danger after one takes the RAI? I thought it was gone after a few days?

Surgery really isn't an option for me because of neurological symptoms that I have which could worsen from the anesthesia.


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## joplin1975 (Jul 21, 2011)

I had RAI for cancer, not for ablation due to Grave's...that said, I had restrictions for a total of 10 days (100mci dose, which would be much higher than what you'd likely need), but the first three days were the most restrictive. During those days, I could not be within three feet of people or pets for more than one hour during a 24 hour period. They were most concerned with bodily fluids and so I closed off the guest bathroom and used that exclusively. I also needed to sleep alone (my cat was very upset about this!).

All in all, its a weird process and required changes to behavior, but it wasn't awful. Just weird. 

Qualification: lots of other people had significantly more restrictive directions, so I think it does depend on your doctor's/hospital's protocols and, to a lesser extent, your state's laws.


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## Andros (Aug 26, 2009)

skimordiegirl said:


> Thanks for the replies!
> 
> I had been doing fine with a minimal dose of methimazole for 11 years. It wasn't until recently after getting a sinus infection did I start getting symptomatic again.
> 
> ...


It could also be quite fearful to not take this in hand and stop the progress; that is my thinking. The damage from Graves'/hyper is severe and often permanent.

Keeping you in my thoughts and prayers for decision-making.

Do know that we will support you no matter what you decide.

You can only do what you think is best for you!


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## skimordiegirl (Mar 10, 2011)

Thank you for your replies!

Does damage from graves disease occur even when you are being treated, labs are normal and you have no symptoms?

I am most concerned lately because of my racing heart and waking up every night with it racing out of my chest. (waiting for my echo results)


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