# Newly diagnosed with hyperthyroidism. Help please.



## davea (Feb 4, 2011)

Hi all, new here with questions please.
I am a 52 male in relatively good health.

I had a routine blood test done and my test results were out of whack.
T4 Free 2.41 (.82-1.77)
TSH <.005 (.45-4.5)

A recent test showed the T4 at 2.50 and no result for TSH. There was a T3 result of 10.3 in 2.2 -4.4 range.
I have some idea what these mean.

The endo doc says I am "hyper," however I show no symptoms other than muscle pain in my calves. He now wants to do a RAIU test and decide treatment from there.
After some reading on the forum and seeing alot of "I'm scared" and so forth, now I am a little concerned. I also see doctor second guessing going on.
Can someone explain what I should expect. Should I be concerned or put my faith in the doctor (who is supposed to be good) that he will treat me properly?

Thanks for any advice.


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## lavender (Jul 13, 2010)

Hi and welcome.

I think the best test for any doctor is how you respond to him. Do you feel like he is giving adequate attention to your symptoms/questions/concerns? Do you feel like he is following up with you or giving you the brush off? Do you feel like you are being pressured into any one treatment without being given any information about alternative treatments?

RAIU is an important test for someone who is hyperthyroid. It will help determine how overactive your thyroid really is and help determine if there is any possibility of cancer.

I am wondering if your endo has done any follow up bloodwork. TSH and Free T4 are pretty basic tests. When you are hyperthyroid, a Free T3 test is also very important to determine how hyperthyroid you are and how successful any medication you are taking is. Also, antibody testing is also important to help determine the cause of your hyperthyroidism. This includes TSI, TPO and Thyroglobulin.

Treatment options will depend on your diagnosis. If you are having relatively few symptoms, it makes sense to get the RAIU first. If you do start to feel any symptoms, it's important to bring them to your doctor's attention because a hyperthyroid can escalate rapidly and become toxic, causing heart problems and a whole host of problems in other body systems.


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## davea (Feb 4, 2011)

Hi Lavender, thanks for the reply.

I did much reading since my first post. I guess that other than suffering a heart attack, this is the most serious health problem I ever had. I am concerned by reading what you all have gone through during the course of treatment. The med adjustment sounds troubling.

I have narrowed down my immediate concerns as follows:

Radioactive medicine? Is this appropriate, I thought they did ultrasounds?

Why am I being treated for something I have no symptoms of?

My first appointment with the endo doc a few days ago took all of 15 minutes. Is thyroid disease really this simple? The posts on this forum don't indicate this. I have considered another doctor, however my pcp is in a medical group with only three endo docs, I could strike out after three.


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## Andros (Aug 26, 2009)

davea said:


> Hi all, new here with questions please.
> I am a 52 male in relatively good health.
> 
> I had a routine blood test done and my test results were out of whack.
> ...


Hi there!! Absolutely get the RAIU. You are hyper; that is evident. But what is not evident is whether you have cancer or not. Males are more likely to have cancer and it also happens that cancer and hyper are bed fellows.

Here is credible information about that.

men more likely to have cancer than women
http://www.umm.edu/endocrin/thytum.htm

And this; Scroll down to table 2
http://www.aafp.org/afp/2003/0201/p559.html

Are you taking a Statin? Are you sleeping well? Losing hair, dry skin, increased intestinal motility. Losing or gaining weight? Eyesight okay? Goiter?

Welcome to the board. Let us know when you have the RAIU set up.

Your doctor is on it; please do as he suggests.


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## davea (Feb 4, 2011)

Thanks you much!

My RAIU is about two weeks out. 
I also had a TSI test done 2 days ago. I think the results take a week or so.? True? or not?

I'll be back with more info.

Info: Take a Statin. Sleep ok, hair has thinned for years, not coming out in clumps, Skin slightly dry from winter weather, intestinal activity normal,slight weight GAIN, eyesight ok, no goiter.
Where are symptoms, it's just weird.


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## Andros (Aug 26, 2009)

davea said:


> Hi Lavender, thanks for the reply.
> 
> I did much reading since my first post. I guess that other than suffering a heart attack, this is the most serious health problem I ever had. I am concerned by reading what you all have gone through during the course of treatment. The med adjustment sounds troubling.
> 
> ...


Makes me wonder about your heart-attack. Many of us have had the same from untreated hyper. Also mitral valve prolapse and other damage to the heart.

When did you have the heart-attack?

Personally, I don't think thyroid disease is simple. The more I learn, the less I find I actually know.


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## Andros (Aug 26, 2009)

davea said:


> Thanks you much!
> 
> My RAIU is about two weeks out.
> I also had a TSI test done 2 days ago. I think the results take a week or so.? True? or not?
> ...


Statins cause tendonitis and tendon rupture. http://www.statinanswers.com/effects.htm

When you said "calves", I knew immediately you were on statins but had to confirm.

Yes, TSI takes some time. Please let us know the results of that. You should have none.

TSI (thyroid stimulating immunoglobulin)

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

The symptoms are there (somewhere!) Rapid heart beat, agitation, nervousness, tremor, fatigue, weight loss or gain (many of us have gained), trouble concentrating, perspiring, heat intolerance, low ferritin, low testosterone, rapid pulse, funny looking finger nails and toe nails, slow wound healing, dental/gum problems, high cholesteral, high blood pressure, high glucose.

Will be anxious for your TSI and also hopefully the 2 weeks will fly by and you will be getting that RAIU.


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## davea (Feb 4, 2011)

The heart attack was in April, 2010. I had an angioplasty and a stent put in (70% blocked). I 100% believe that if there was a connection here my pcp would have told me. I will also inquire about the leg pain, interesting.

Thank you for all your info. I will be in touch when I get my results.
It is nice to hear the "layman" side of the thyroid story and be able to diagnose and relate to all of this. Not that I will rely on a layman's diagnosis, but to have all this information available and ready to present or suggest to the doctor.

Also, does that TSI test really take a week, or are "they" withholding results from me? Hmmmm?


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## Andros (Aug 26, 2009)

davea said:


> The heart attack was in April, 2010. I had an angioplasty and a stent put in (70% blocked). I 100% believe that if there was a connection here my pcp would have told me. I will also inquire about the leg pain, interesting.
> 
> Thank you for all your info. I will be in touch when I get my results.
> It is nice to hear the "layman" side of the thyroid story and be able to diagnose and relate to all of this. Not that I will rely on a layman's diagnosis, but to have all this information available and ready to present or suggest to the doctor.
> ...


I do believe TSI takes about a week. That is the "chatter" on the street!

It is always a good idea to have some credible information to arm yourself with.


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## lavender (Jul 13, 2010)

I honestly do not know how long it takes to run a TSI test, but a week seems like a reasonable amount of time to wait for bloodwork results. TSI is useful for determining if you have Graves disease.

As for the RAIU, this is a test to measure the activity of your thyroid. A lot of people confuse it with RAI, which is radioactive medicine that is given to "kill" or ablate a sick thyroid gland. I was personally averse to having RAI, but did get the RAIU scan when it was suggested. It can be useful in detecting possible cancer, which would determine your course of treatment. RAIU does involve taking a very low dose of radioactive iodine-123, which is a slightly different form that radioactive iodine-131 that is used in RAI. Iodine-123 can be administered in much smaller doses than iodine-131, and the dose is similar to the amount of radiation you would get from a dental x-ray. I personally did not have a negative reaction to the RAIU and think it was helpful for my surgeon to have the results when I ultimately had my thyroid removed.

As for your lack of symptoms, I personally was unaware of how much my thyroid was affecting my overall health until it was very severe. I had to be hospitalized because my thyroid levels shot up very quickly, made me very sick, made my heart race, and gave me chest pain. I was kept in the hospital and given all the cardiac tests because the docs were concerned about the risk to my heart. Looking back, I can see that I was having obvious hyperthyroid symptoms for at least 6 months prior to my hospitalization, but that there were related symptoms going on for years before I was diagnosed.

My initial symptoms were all heart related, but I had no idea that this related to my thyroid, and my PCP did not catch on either until I was really sick. Specifically, I had a racing heart and really uncomfortable heart palpitations that were making it hard for me to sleep for months. When I went to the doc about this, she ran an EKG, which showed a slightly irregular heart rhythm that she had seen on an EKG of mine in the past. She did not think it warranted any further testing or treatment despite a family history of early heart disease in my family. I insisted she run a thyroid test, which showed that I was slightly hyperthyroid, and even then she missed the connection between my thyroid condition and mounting symptoms until I needed to be hospitalized.

Looking back, I have had various tests done on my heart over the past 5 years because of various heart related symptoms I was having and concerns about my family's history. No one ever connected these symptoms to my thyroid until I was very sick. Also, I have always had very low stable cholesterol levels until about 6 months prior to my hospitalization, when they shot up into a higher risk category that prompted my insurance company to suggest I go on cholesterol meds.

I believe this was all connected to my thyroid. But, regular thyroid testing was not a part of my routine medical care. And I saw a PCP who did yearly physicals and who I thought was pretty thorough. From what she told me, hyperthyroid conditions are just more rare and not something they are on the lookout for. In my opinion, this could make it very easy for a doc to totally miss the connection between thyroid disease and heart issues.


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