# My 1st Labs Ever/Graves Disease



## mexistamps (Aug 3, 2012)

My 1st Post. I ended up in the ER then ICU for 2 days. Heart Rate 175-225 for 2 days until I went to ER. One week later I see an Endocrinologist and after reviewing the lab work from the Hospital and touching my neck she says I have Graves Disease.

I'm on methemazole 5 pills a day.

Here are my labs and I'm just lost. Any help will be appreciated. I have a follow up appointment in 1 month. She advised I can choose any of the three options. Medication, Iodine Radiation or Removal.

T4 >30.0 (H)
TSH 0.01 (L)
T3 Total >800.0 (H)
Free T4 6.15(H)


----------



## Octavia (Aug 1, 2011)

Welcome, and you've come to a good place to talk with other people with Graves Disease. (I'm not one of them, but we do have several here.)

You appear to be VERY hyperthyroid, but it would be helpful to see the ranges that may have come with your lab results.

Again, I do not have Graves, but after spending a year on this forum and hearing many, many different stories, it seems that *most* people might advise you to have your thyroid removed, if given that opportunity.

I'm sure some of our Graves members will be along to share more insightful comments...


----------



## mexistamps (Aug 3, 2012)

Thank You for the warm welcome & your question.

TEST..........RANGE...............7/22/12	
T4..............4.5-12.9............>30.0 (H)
TSH............0.55-4.78..........0.01 (L)
T3 Total......60.0-181.0.........>800.0 (H)
Free T4.......0.89-1.76...........6.15 (H)


----------



## Andros (Aug 26, 2009)

mexistamps said:


> My 1st Post. I ended up in the ER then ICU for 2 days. Heart Rate 175-225 for 2 days until I went to ER. One week later I see an Endocrinologist and after reviewing the lab work from the Hospital and touching my neck she says I have Graves Disease.
> 
> I'm on methemazole 5 pills a day.
> 
> ...


Wow! You are lucky to be alive. And I sure am glad you are.










Thyroid Storm Symptoms
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001437

I will tell you what I think based on a world of experience. You are in the advanced stages of Graves' (as was I) and nothing worked except finally getting rid of the thyroid. I recommend surgery because even RAI did not work for me, I had to have RAI 3 times. That is how thyrotoxic my thyroid was.

However, we are not biased in our opinions and we will support you no matter what route you chose.

Have you had RAIU (radioactive uptake?) You should because if you have cancer, that would settle your options. It would have to come out. This should have been done before you started on antithyroid medication.

If nothing else, get an ultra-sound.

You were really really sick and I am so sorry. Are you on a beta-blocker? If not, it would be a wise move so your heart is not damaged.


----------



## jenny v (May 6, 2012)

Holy cow, I thought it was rough when my heart rate jumped to the 180's one time! How were you even conscious??

I agree that it sounds like advanced Graves and of the two people I've known with Graves, one had RAI and the other had hers totally removed. I don't think the medication is something you can stay on for the rest of your life because it can damage your liver. I may be biased because I'm hoping to have my thyroid removed because of Hashi's disease, but I would be leaning towards just getting the darn thing out and giving your body a rest.

Good luck!


----------



## webster2 (May 19, 2011)

Welcome! Wow, are you ever hyper. It is a wonder you are still here. I chose surgery, and am very happy a little over 1 year out and feel great.


----------



## adenure (May 7, 2012)

Hi!

Wow! Those are very hyper numbers, but I'm sure you know that! I have Graves (I was diagnosed after my 4th baby was born). My TSH was .01 as well, but my free T4 & T3 were not as high as yours. I was on methimazole 5 mg. daily for 7 weeks. It got my numbers normal and euthyroid in that time- my TSH to 1.28 and everything else in range. It was damaging my liver though (enzymes were 8 times the normal amount; I had a normal baseline before) so, I had to stop taking it. Fortunately, it got my thyroid eythyroid so I could have a TT 7 weeks ago today. I'm very, very grateful that I had the surgery and very grateful the methimazole got me stable in order to have the surgery.

Surgery especially is much more dangerous if you are not euthyroid. If I were you, I would give the methimazole a chance to get your hormones balanced, or at least closer to being balanced before deciding on RAI or surgery. Ideally, you should be euthyroid for both options, but especially for surgery as the body under goes a lot of stress during surgery which can cause thyroid storm. I would NOT go into surgery with your current numbers, and I can't imagine any surgeon/ doctor would suggest it at this point. I am very happy with my choice of surgery. I'm on Synthroid now- process of getting the dose right.

When you get your labs done for your thyroid levels, ask for a liver panel too just to be sure your enzymes are okay. It's a very rare possibility of having what happened to me happen to you (I think it's 1%), but it happens. I didn't have any symptoms like fever, sore throat, dark urine, yellow sking etc... I didn't try PTU as PTU is considered less safe than methimazole, so I went for the surgery. My endo. recommended RAI as he thought it the safer route, less invasive, but he did support my choice of surgery as my thyroid hormones were stable (they actually remained stable for 6 weeks while I waited for my surgery off of the methimazole) and my heart rate was normal.

Stay strong and take the methimazole. Monitor your levels and liver enzymes. Give the meds. a chance, then make your choice.

Alexis


----------



## JPGreco (Mar 2, 2012)

I have to clarify. Based on labs alone, you really can't be diagnosed with Grave's. Grave's is an autoimmune disease that requires the presence of antibodies, namely Trab or TSI (high percentage rate positive tests) as well as the physical presentation of symptoms.

The reason that this is vital is that the other possibilities is an unknown cause of a hyper state (can be temporary or permanent), another autoimmune called Hashimoto's (though often hypo, it can present as hyper), or it can be cancer.

Your labs are a lot like mine actually, and though I am "diagnosed" with Grave's, it was never actually confirmed. Though since cancer was ruled out, the treatment options become similar to all other issues.

You need an ultrasound of your thyroid and a RAI uptake scan to help rule out cancer. However, these tests alone aren't the actual diagnosis, they only provide images of what may look suspicious. After which, if something shows up, a fine need aspiration should be done, which is essentially a biopsy. However, this test is not 100% accurate.

Aside from your methimazole, you should call your doctor immediately and request a beta blocker. It helps lower your heart rate and has worked wonders for me. Before I was on it, my resting heart rate was in the 120's. Now its in the 70's after upping the dose several times over the last couple of months. I'm at a good point that I missed 2 doses and my heart rate didn't climb at all.

Good luck with it and feel free to contact me if you have questions. I will be away for a couple of days with no internet access so I won't be able to reply, but others are well versed in the subject matter as well.


----------



## mexistamps (Aug 3, 2012)

"


jenny v said:


> Holy cow, I thought it was rough when my heart rate jumped to the 180's one time! How were you even conscious??


I was very foolish to have waited from about 9pm on Friday evening to 11 am on Sunday morning. My heart was beating 175-225 all that time.

The paramedics & Emergency Room staff was asking for my pain level from 1-10. "I keep repeating it's not pain It's just some major discomfort." My chest is tightening up. I now understand why they were looking at me funny. I knew their was a problem when I went to a walk in clinic and the Dr. yells to the staff call "911"


----------



## mexistamps (Aug 3, 2012)

Wow, Truly Amazing responses. Again, Thank You!!!!

I'm currently on Methimazole (Tapazole) 10MG x 3 pills in the morning & 2 at night. Also Metoprolol Tartrate 50 MG 1 x morning & night.

I'm also a Diabetic and in the emergency room my sugar was 586 due to my thyroid issue. Also taking meds for Diabetes and Lisinopril for High Blood Pressure 5mg daily.

I will be asking for an ultrasound & an RAI uptake scan to rule out cancer. My health insurance is pretty good thru United Health Group but I also work for them and I know how to speed up the process. My endocrinologist said it was the fastest referral she's ever seen.

I did see a cardiologist in ICU he said I was very lucky. Had an ultrasound on my heart only, there was no damage to my heart.

I'm looking forward to my lab work to be done at the end of the month. I have an appointment with my endocrinologist on Sep 5, 2012. If my labs are not acceptable I will probably be requesting a surgery. My feelings might change as they did from yesterday.

I look forward to more responses and 1st of all Thank You.


----------



## Lovlkn (Dec 20, 2009)

You poor thing - those are some high labs.

I want to point out to you that as your thyroid levels fall you will fell some mental effects - they will subside as your hormones level out. Mine were so bad I ended up going into therapy for a few weeks and have been ok since.

I agree that they are likely trying to reduce your levels so they can proceed with further treatment.

I would suggest surgical removal.


----------



## Andros (Aug 26, 2009)

mexistamps said:


> Wow, Truly Amazing responses. Again, Thank You!!!!
> 
> I'm currently on Methimazole (Tapazole) 10MG x 3 pills in the morning & 2 at night. Also Metoprolol Tartrate 50 MG 1 x morning & night.
> 
> ...


Oh, man............................you have some challenges here but there is no question in my mind but what your BP and diabetes will be greatly improved once you get on track with the hyperthyroid issue.

You have a full plate but you can do this and look forward to living a very happy and "well" life. It will require careful management which will become your lifestyle.

We are here for you!


----------



## mexistamps (Aug 3, 2012)

I requested an ultrasound & an RAI uptake scan from my endocrinologist today. I have labs scheduled at the end of the month and an appointment with her on Sep 5, 2012. She said she wants to see my labs and after review she will order both of my requests.

What do you guys think.

Thank You for all for all of your help.


----------



## Andros (Aug 26, 2009)

mexistamps said:


> I requested an ultrasound & an RAI uptake scan from my endocrinologist today. I have labs scheduled at the end of the month and an appointment with her on Sep 5, 2012. She said she wants to see my labs and after review she will order both of my requests.
> 
> What do you guys think.
> 
> Thank You for all for all of your help.


Once again, I think you are fortunate to be alive. Those are "some" numbers.

If you get the RAIU which would be best, it would not be necessary to have ultra-sound. The only caveat would be that the meds (antithyroid) would skew the RAIU so twisting that all around and upside down; what do you think?

What does your doc think?


----------



## adenure (May 7, 2012)

I had to be off methimazole (I was taking 5 mg.) for at least 10 days before having the uptake scan.

Alexis


----------



## mexistamps (Aug 3, 2012)

Andros said:


> Once again, I think you are fortunate to be alive. Those are "some" numbers.
> 
> If you get the RAIU which would be best, it would not be necessary to have ultra-sound. The only caveat would be that the meds (antithyroid) would skew the RAIU so twisting that all around and upside down; what do you think?
> 
> What does your doc think?


Yes I am very fortunate. Every day I think of what the cardiologist said to me. "You are a very very lucky strong young adult man". When I walked out of Hospital ICU department a nurse also said "walking dead man" I didn't comprehend that statement at that time.

My endo recommended the RAIU she wants to see my labs then will take me off of methimazole in order to do the RAIU. She also said no problem with the ultra sound if I wanted it. She really appreciated my research I replied I had a lot of help. www.thyroidboards.com.

Thank You


----------



## mexistamps (Aug 3, 2012)

Good Morning,

I just received my new order for labs due at the end of this month. My Endo requested THS, T3 TOTAL, T4 FREE. I notice she didn't order a T4 Total. Do you feel I should request this test. How important is it? Should I request any others.

She also ordered a UA, Dipstick, Microalbumin, Random Urine w/Creat, Comp Metabolic Panel w/eGFR & Lipid Panel(Fasting Specimen).

Thank You for your suggestions,

Miguel


----------



## Andros (Aug 26, 2009)

mexistamps said:


> Good Morning,
> 
> I just received my new order for labs due at the end of this month. My Endo requested THS, T3 TOTAL, T4 FREE. I notice she didn't order a T4 Total. Do you feel I should request this test. How important is it? Should I request any others.
> 
> ...


At this time, I don't think Total 4 is necessary but somewhere along the line, FREE T3 will be but you have a ways to go before we concern ourselves with that!

How are you feeling?


----------



## mexistamps (Aug 3, 2012)

I feel a lot better. I'm still a little out of breath, raspy throat. Sometimes I'm just tired for no reason. But I'm on a Diet, Yesterday I walked 3 miles. I'm a fat guy currently at 237 lbs 5' 8" but my blood sugars are great since released from the hospital. My blood pressure is back to normal. I have not been normal in 6 months. Motivated and on the right track.


----------



## Octavia (Aug 1, 2011)

Good for you!!!


----------



## mexistamps (Aug 3, 2012)

I went to my Endo because I was not feeling well and she requested many labs. I did my labs Thursday Moring August 23, 2012. Here are the results.

Component	Your Value	Standard Range	Units	Flag
T3, TOTAL	198	76 - 181	ng/dL	H
T-4, FREE	2.0	0.8 - 1.8	ng/dL	H
TSH	0.01	0.40 - 4.50	mIU/L	L

1st week I was on 60 mg of methimazole since July 25 I'm on 50 mg daily. I'm also on Metoprolol 50mg (beta blocker) twice daily.


----------



## Andros (Aug 26, 2009)

mexistamps said:


> I went to my Endo because I was not feeling well and she requested many labs. I did my labs Thursday Moring August 23, 2012. Here are the results.
> 
> Component	Your Value	Standard Range	Units	Flag
> T3, TOTAL	198	76 - 181	ng/dL	H
> ...


Wow!!! The doctor did not think an increase in Methimazole is in order? How are you feeling? You sure are hyper!


----------



## miguel (Jul 18, 2011)

Your lab tests are very similar to mine when I was diagnosed, but I had thyroid under control with 45 mg of methimazole. How are you feeling?


----------



## mexistamps (Aug 3, 2012)

Since discharged from the hospital on July 24th. My chest feels tired and weak. I’m always out of breath. My throat feels uncomfortable. I will be seeing another endocrinologist on Thursday for a second opinion. I just saw my first endocrinologist on Wednesday of last week. She prescribed an anti acid for my chest breathing issues. I’m don’t feel I have an acid problem. So this made my decision to seek a second opinion. I feel cranky and sleepy all the time.


----------



## Andros (Aug 26, 2009)

mexistamps said:


> Since discharged from the hospital on July 24th. My chest feels tired and weak. I'm always out of breath. My throat feels uncomfortable. I will be seeing another endocrinologist on Thursday for a second opinion. I just saw my first endocrinologist on Wednesday of last week. She prescribed an anti acid for my chest breathing issues. I'm don't feel I have an acid problem. So this made my decision to seek a second opinion. I feel cranky and sleepy all the time.


When the hyperthyroid is not adequately controlled, myopathy of the muscles takes place and that includes the muscles supporting and contracting the lungs.

Myopathy from hyper.
http://www.medicalonly.com/2007/07/27/thyrotoxicmyopathy_hyperthyroidism

Advanced hyper.
http://www.ucsfhealth.org/conditions/hyperthyroidism/signs_and_symptoms.html

However, one must not assume the above. I say a chest x-ray or ultra-sound would be in order as well.

Let us know how you fare.


----------



## mexistamps (Aug 3, 2012)

Andros, Thank You for the information. I'm currently still on Methimazole 50mg daily. They did take an x-ray of my chest on Thursday but have not heard anything back regarding the x-ray. Will keep you posted.

Thank You


----------



## miguel (Jul 18, 2011)

Muscle pain is caused by hyperthyroidism, I felt extremely weak, tired and desperate. You should go to a different doctor and order the appropriate lab work.

Saludos tocayo.


----------

