# Hyper to Hypo



## mjcrollard (Jun 22, 2012)

Hi, I have been reading this board for a few months now. It has been such a huge help and blessing, but this is my first post.

I was diagnosed in November 2011 with Graves. Wasn't happy to learn of this disease, but glad to have a name to how yucky I was feeling. The Endo I saw laid out my options and I have chosen to try controlling this with meds first and was prescribed 15mg of methimazole (2 pills in AM and another in PM). I know it will take time to get the meds dosed correctly so I am prepared for that.

I had been feeling pretty good, but in April things changed....the symptoms really ramped up shaky, horrible anxiety, inability to sleep out of fear, panic, weight loss. I was at a loss of what to do. I was unable to get in contact with my Endo (long story, no direct number, no one would give it to me and I couldn't get any help) I eventually made an appointment with my GP but in the meantime I added an afternoon pill so I was taking 20mg. (I know I shouldn't self diagnose or prescribe, but I was freakin' out) I started feeling better, was able to sleep and less anxiety then I started gaining weight and was so tired I could barely function. Labs taken and turns out I am a bit on the Hypo side. Meds now 10mg.

I probably just need to vent and maybe get some reassurance. It is hard to feel like I am, but I know many of you have been here and can relate. I seem to get nervous and panicy in the evening and sleep is elusive. There are many nights I am afraid I won't wake up. I have had EKGs and and echocardiogram and things look okay. But the worry isn't going away.

I do have an appointment with a new Endo in August, he usually only sees diabetics and thyroid cancer so I am not sure if he will be excited about seeing me. My GP pulled a couple strings. He is the only one in the county in which I live.

I have new labs scheduled for next week and am hopeful they are better than last month. I know we are not supposed to focus solely on the TSH number, but in looking at the FT3 and FT4 they are on the low side.... why do you suppose my TSH is so high (relatively speaking).

I did start tracking my symptoms and have found I experience more hyper feeling symptoms during menses. Is this normal? Any insight would be greatly appreciated.

Thanks for this forum!!!

TSH FT3 FT4
(.3-3.0) (2.3-4.2) (.7-2.0
Nov 29, 2011	0.28 ****************	0.9
Jan 26, 2012	0.12 3.6 1.2
Mar 14, 2012	1.44 3 0.7
Jun 20, 2012	16.9 2.9 0.6


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## Lovlkn (Dec 20, 2009)

You have been hypo since your March 14th labs, and are hypo as of your last lab.

Mid range on FT-3 an dFT-4 is what your goal should be.

Your doctor is not doing a good job - speak up and tell them how you want to dose. Sad to say but that's what it's going to take.

Ignore the TSH - dose only by your FT-3 and FT-4 tests.

If I read you lab results it looks like you had a FT-4 of .9 in Nov with a range of (.7-2.0)?? That is low range which means your doctor dosed you off of a low TSH. Did they run any antibodies tests on you?


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## mjcrollard (Jun 22, 2012)

Thanks for the reply. I swear my mind holds no information which is driving me crazy. If my FT3 and FT4 are on the low side does that indicate hypo? Is it high on FT3/FT4 and low on TSH that means hyper? What if one (FT3 or FT4) is on the high side one on the lower side? Does that happen?

I have not had antibody tests run. Is it TSI and TPO I should ask for? May have the letters out of order, still trying to master all this new lingo.

Would very much like to feel a semblance of normal in my daily life.


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## Lovlkn (Dec 20, 2009)

mjcrollard said:


> Thanks for the reply. I swear my mind holds no information which is driving me crazy. If my FT3 and FT4 are on the low side does that indicate hypo? Is it high on FT3/FT4 and low on TSH that means hyper? What if one (FT3 or FT4) is on the high side one on the lower side? Does that happen?
> 
> I have not had antibody tests run. Is it TSI and TPO I should ask for? May have the letters out of order, still trying to master all this new lingo.
> 
> Would very much like to feel a semblance of normal in my daily life.


Yes to all the above. Sometimes TSH and the FT-3 and 4 do not match up to hyper or hypo. Then you would use the Ft-3 and FT-4 to dose as TSH can lag or be impacted by antibodies. I for one have NO TSH when properly medicated due to antibody involvement, even 8 years post op. I am so blessed to have a DO that accepts that.

In my opinion a doctor who diagnoses you on TSH alone is stupid, you need the TSI to confirm Graves. At least they are running the FT-3 and FT-4 on you. Most Graves patients also have TPO which is the hashi's antibody but also a marker for thyroid inflammation. I have both - both were high and my thyroid was destroyed upo removal so the surgeon diagnosed me with hashitoxicosis - both hyper and hypo happening at the same time.


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## Andros (Aug 26, 2009)

mjcrollard said:


> Hi, I have been reading this board for a few months now. It has been such a huge help and blessing, but this is my first post.
> 
> I was diagnosed in November 2011 with Graves. Wasn't happy to learn of this disease, but glad to have a name to how yucky I was feeling. The Endo I saw laid out my options and I have chosen to try controlling this with meds first and was prescribed 15mg of methimazole (2 pills in AM and another in PM). I know it will take time to get the meds dosed correctly so I am prepared for that.
> 
> ...


Your TSH is higher because the Frees are lower. You really are not in a good place by the numbers.

It really would be good if you got some antibodies' tests are these are the culprits at work and these antibodies are binding, blocking and stimulating which can give a false impression with the "numbers!"

The tests below would be good.....................(and really, you should have an ultra-sound.)

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism. 
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), 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/

Most of us opt out and either get RAI or surgery. The anti-thyroid med seems to keep the patient on a constant roller coaster ride. Just take it one day at a time and see what happens.

Hopefully your new doctor will be a help to you! And it would be good if you were on a beta-blocker to protect your heart!


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## sjmjuly (Mar 23, 2012)

I am like Lovlkn. I feel much better when my TSH is almost nothing. I have Hashi's and those damn antibodies throw everything off. I read in an article that Andros had that a doctor didn't dose from labs and in fact, if you had antibodies, he really didn't want to run tests at all! Since antibodies screw up everything, he dosed by how the patient felt and by body temperature. I take my blood pressure and temp every morning. 
I am on NatureThroid (3/4 a grain) and don't pay any attention to my TSH anymore. I only "look" at my Free T4 and mainly go by my free T3. It was a year of total hell and it's been 4 months since I was diagnosed. Just starting to feel like my normal, stubborn self again!


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