# from hyper to hypo (I think)



## needanswers (May 4, 2013)

Hi everyone,

I just wanted to post an update and see if anyone can offer any advice. I was diagnosed with Graves in May 2013 and started on tapazole at that time. I can't remember all of my labs or uptake, but I think that if my memory serves me, my uptake was about 70%. My first untreated bloodwork had free T4 in the 70s, down to 50s with a bit of meds, and then after a month or so on 5mg was down in the 30s (reference range 9-23). Free T3 was also elevated. Doctor raised my dose to 10mg and saw me again two months later. At that time, Free T4 was down to 9.9 (7.2-21) and Free T3 down to 3.9 (2.9-6). Liver enzymes were elvated at ALT 55 (4-43). He decided to cut my dose to 5mg daily and see me three months later for bloodwork. Bloodwork at the beginning of December after three months showed Free T4 at 9.2 (7.2-21) and Free T3 at 3.6 (2.9-6), and for the first time a detectable TSH at 0.63 (0.3-5.6). ALT was normal at 15. He cut my dose again down to 2.5mg daily and told me that my bloodwork showed thyroid levels that all are low normal. He said to try this for 4 months and do bloodwork at that time, and then he'll look at cutting it down further and weaning all together if all goes well. My Anti-TPO antibodies were only tested on the first visit and were 85 (<35), so high, but not terribly high.

I am having lots of hypo symptoms now which he dismisses: major hair loss, dry skin, exhaustion, constipation, dizziness, etc. I don't think that I can make it like this until my appointment in April, or at least I don't want to. This brings me to my question: Am I hypo, and if so, is it common practice to continue with tapazole? Also, if my Frees are low, than shouldn't my TSH be high? How will my Frees ever come up on tapazole if my TSH remains low. I am afraid of dropping even more hypo. Has anyone been able to get out of the slump?

Any insight would be great!


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## Andros (Aug 26, 2009)

Sadly, there is a lag time between the TSH and the FREES! Are you considering a permanent solution or will you chose to continue on as you are?

Has your doctor discussed your options w/you?

I hope you feel better!

Hugs,


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## needanswers (May 4, 2013)

Andros, what do you mean that there's a lag time between the TSH and the frees? In talking about permanent solutions, do you mean ablation or surgery? My doctor seems to think that I'm on my way to remission. If my levels don't climb after the wean off completely, then he doesn't think I need treatment. Does that sound right?


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## HotGrandma (Sep 21, 2012)

I did 18 months on Methimozole. It was a sentence too. I went severely hypo. Didn't feel it until it felt like I got hit by a bus. Studies have proven that treatment with ATD needs to be 18 months or longer to acheive remission. Only to discontinue when the antibodies are in range. When I went extremely hypo with a reduction my body ever so slowly did climb out of that hypo hole. I stabilized on 1.25 mg per day for the last 6 months. In the beginning it seems like it takes a lot of meds to start reducing the levels. In the end it seems like it takes hardly any meds to move the levels.

The antibodies are in control here. Since there is no treatment for the antibodies they continue to attact as long as the thyroid is stressed. That's why it takes the 18 months or longer. Its a slow ride so take it easy. Slow and steady wins this race.


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