# Graves or Hashi's? Hypo now!



## abremer (Jul 14, 2010)

I had my labs drawn on July 8 again and here are my results:

July 8, 2010 Labs: 
Free T4: 0.8 (range 0.8-1.8) 
Total T3: 96 (range 76-181) 
TSH: .39 (no reference or range available)

Lowered PTU to 12.5 mg odd days, 25 mg even days (alternating). Propranolol 5 mg (twice daily).

Saw my Endo today and she says that according to my tsh that I look a bit hyper still but according to my T4 and T3, I look like I'm going hypo. This is a new endo and I had always had Free T3 and Free T4 run. I see she did a Total T3... Is there a difference?

She said that I am on a an extremely low dose of PTU and in normal circumstances, she'd have taken the patient off to see what happens with the levels but since it seems my levels are maintaining and I have come this far that we'll keep dropping the dose for now. She had suggested lowering my PTU to 12.5 mg daily for the next 6 weeks and I requested to alternate days (12.5 mg on one day, then 25 mg on the next day, etc) as in the past, when dropping my PTU, my levels usually go up and I'm willing to take as long as it takes to achieve remission even it means moving slower than usual. So, she agreed to it. The past 3 weeks, I had been skipping my morning dose of PTU once or twice a week due to feeling extremely tired some days and extreme joint pain.

What is your opinion? Do you think this is the right route? I always hear "slow and steady wins the graves race". Also, she noticed my thyroid felt a little swollen (enlarged, mushy) but said it could be something viral so we'd ultrasound it on my next visit. I asked if it's possibly i'm going hashi now and she said it's always a possibility but we'd have to wait and see.... WAIT AND SEE??? ARGH. What could be causing my thyroid to get enlarged now? Could it by that I'm too hypo? Should I go off the PTU for a day or two and then start on my alternating doses? Any advice is appreciated. I'm so confused after today's visit.

I had mentioned to the endo about my joints hurting from day to day in different areas (especially my hands) and mentioned that I've been extremely tired/fatigued to a point I can't function, I've gained 5 pounds in 5 weeks (pound a week) but haven't been really eating a whole lot of junk. I don't mind the weight gain as I needed it after losing so much weight last year when I had the storm.

Now, also, I am wondering if it would be okay to start excercising? Such as jogging? or working out again? I've held off due to my heart rate going up but now that I seem to be going hypo, do you think I could start again? I was considering seeing a cardiologist for a stress test first, do you think that would be the better route to go?

Sorry for all the questions at once but this has been a crazy journey and I just want to be normal again... whatever that may be. My endo did mention that my body seems confused as to what normal is. I mentioned being hot sometimes or being extremely cold other times when everyone else is the opposite. My hands have been very dry and some days my face is dry and other days, it's so oily. It's always one extreme or the other... no middle ground here. And her answer was, it sounds like my body is confused and trying to metabolize to what normal is. So what does that mean?

Do you know how long will it take for my thyroid to shrink again once my levels come back up with my Free T4 and Free T3?explode

Thanks so much for all your advice and your patience with my many many questions!


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## Lovlkn (Dec 20, 2009)

First thing you need to do is completely ignore your TSH for dosing purposes and dose according to your Free T4 and Free or total T-3

If you are not having any heart issues you might ask about lowering your propranolol meds as well as they are commonly given in the beginning to control heart issues but once thyroid levels are in range many times it is discontinued.


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## Andros (Aug 26, 2009)

abremer said:


> I had my labs drawn on July 8 again and here are my results:
> 
> July 8, 2010 Labs:
> Free T4: 0.8 (range 0.8-1.8)
> ...


In addition to the good advice Lovlkn has offered, I think it is very important and I really mean this, that you get a radioactive uptake scan. Cancer can cause hyperthyroid and cancer also causes the thryoid to grow. So..............cancer "must" be ruled out..................or in. Hopefully not the latter.

Also, what antibodies' tests have you had?

Any of these?

TSI (thyroid stimulating immunoglobulin),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/understanding/conditions/thyroid.html


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## abremer (Jul 14, 2010)

Hi, I have had the tests done to find out that I tested positive for the antibodies for Graves. I found out I had Graves after surviving a thyroid storm last year. I had no clue I had a thyroid issue. My endo mentioned a radioactive uptake scan.... what exactly is it and how does it work?


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