# Should I be concerned?



## inkoherent (Jun 23, 2015)

Hi everyone,

A quick history of my recent medical issues: had a bad case of sciatica in September 2014, MRI found a disc herniation at L5/S1, symptoms improved significantly around January 201, perhaps helped along by physiotherapy. However I started twitching all over my body around February/March 2015 and soon freaked out about whether it might be something serious. Saw a neuro who assessed that it isn't ALS/MND based on strength tests and visual examination but not an EMG. Might still get an EMG soon to put my mind at ease. Throughout this whole episode (for the past half year or so), have been dealing with anxiety over the slow recovery and my health in general, and will soon be starting therapy (CBT specifically).

Anyway, regarding thyroid issues - a doc that I saw at the end of May ordered a bunch of blood tests and my TSH was 0.445 (range 0.65-3.7) while free T4 was 16.2 (range 8.8-14.4). Also tested for sodium, potassium, chloride, creatinine, calcium, albumin and vitamin B12; these were all within range although some were at the edges of the ranges. A second test that was done last week came back with TSH 0.599, free T4 14.6. Based on these results I've been prescribed Carbimazole 5mg daily for 8 weeks, at which point I am to see the doctor again.

Since my free T4 levels are just slightly above the range, does the dosage of Carbimazole sound typical to you guys? And might the T4 levels explain my symptoms, which have more recently grown to also include trembling in the fingers, fatigue, weakness/soreness in the knees and legs?

Thanks in advance.


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## joplin1975 (Jul 21, 2011)

I think it would be really good to get a free t3 test, too. And a thyroid ultrasound as well as antibody testing (TPO, TSI, and Tg/TgAB). That information would be helpful to a answering your question.


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## Andros (Aug 26, 2009)

SUGGESTED TESTS
TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin and Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/
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TBII
http://www.ncbi.nlm.nih.gov/pubmed/9364248
http://en.wikipedia.org/wiki/Anti-thyroid_autoantibodies
(Copy and paste into your browser)

Blocking TRAbs (also known as Thyrotropin Binding Inhibitory Immunoglobulins (TBII)) competitively block the activity of TSH on the receptor. This can cause hypothyroidism by reducing the thyrotropic effects of TSH. They are found in Hashimoto's thyroiditis and Graves' disease and may be cause of fluctuation of thyroid function in the latter. During treatment of Graves' disease they may also become the predominant antibody, which can cause hypothyroidism.

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/
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Welcome!

Yes; Carbamizole is typical for you present hyper. However, you must insist on RAIU (radioactive uptake scan) and the antibodies I am listing.


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## inkoherent (Jun 23, 2015)

Thanks for the replies! Unfortunately I hadn't researched thyroid conditions before the doctor's visits so I didn't ask about getting additional tests done - will do so at the next opportunity. But the blood test last week included a test for "TSH Receptor Antibodies", with a result of 0.5 (range 0.0-1.5 IU/L) - not sure if this means anything to you experts.

Also, a few additional bits of info if anyone has any other thoughts - I'm 34, male, with no known family history of thyroid issues. Other symptoms I've been experiencing are weight loss (which I had attributed to poor appetite due to anxiety), frequently feeling cold, nausea (which I also chalked up to anxiety) and general "fogginess" (had linked this to insomnia, which I've had for a looong time).

Thanks again!


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## Lovlkn (Dec 20, 2009)

A liver function test is usually run prior to beginning any anti thyroid medications. If yu have not had one you should request one as a baseline


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