# Hyperthyroid again. What next?



## Clair (Jun 6, 2017)

Hello all. I am a 41 year old woman and have just received initial thyroid test results as follows:

TSH .006 (range .45 - 4.5)

FT4 4.78 (range 0.8 - 1.7)

My doctor said she didn't run T3 or FT3. I will pick up results to confirm that tomorrow.

I have dealt with hyperthyroidism (Graves) in the past. My first diagnosis was at 19 and I did block & replace for 18 months with Tapazole and Synthroid. My primary symptoms at that time were fatigue, migraines, tremors, and dramatic weight loss. I tolerated BRT very well and went into remission. I was diagnosed a second time at 26. My primary symptoms then were heat intolerance, fatigue, occasional high and irregular heart rate, muscle weakness, and infertility. I also developed some bulging in my eyes.The endo I was referred to wanted to do RAI. I was in the midst of trying to get pregnant and also felt reluctant to do RAI and so I went back to my former doctor and did BRT again (this time with PTU). I became pregnant during BRT and weaned off of medication and went into remission again.

So here I am again. My symptoms this time are heat intolerance, muscle weakness, and irregular and high heart rate. Everything else, including my BP, is normal (actually moderately low). I also get migraines, but I always have. They have, however, worsened in the last year. I have also actually gained weight. But since having my child almost 13 years ago I have gone through regular periods of weight gain and loss. My problem is when the weight gain comes, I go to the gym and I can't tolerate any cardio. I do lose weight rapidly, but my heart rate goes so high with very little activity and then it stays high for a prolonged period of time. Anyway, I suspect I have been hyper for a while and in denial about it.

I am picking up a referral for more thorough thyroid testing and an ultrasound tomorrow. But I feel like I already know where this is headed. Is it worth it to try Tapazole/PTU or BRT again? Am I delaying the inevitable? I am completely resistant to RAI, but should I be considering thyroid removal? Can you tell me about your experiences with surgery or if anyone has successfully won the thyroid battle with meds alone? I have to say, I am terrified of permanent side effects like long term fatigue, and vain as it may sound, weight gain.


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## Lovlkn (Dec 20, 2009)

Welcome to the board!



> TSH .006 (range .45 - 4.5)
> 
> FT4 4.78 (range 0.8 - 1.7)


You are EXTREMELY HYPER!!!!



> Am I delaying the inevitable?


In my opinion - Yes.

You should contact a surgeon who is experienced in thyroid surgeries. I for one am not a fan of RAI. Get on Tapazole and talk with a surgeon - you are living proof that remission does not last.

I for one wish I had thyroid surgery sooner. I was on Tapazole for 4.5 years because of people telling me NOT to remove my thyroid. I had small kids so opted for surgery. The idea of taking a radioactive pill horrified me - an the idea of having to do it a 2nd time or a 3rd time was beyond my comprehension.

Surgery was a piece of cake - stabilizing on replacement med's was more the challenge - but knowing what I know today and having the strength and focus to find doctors willing to work with me - I have not one regret.


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## Clair (Jun 6, 2017)

Thank you for the information. I am picking up my referrals additional thyroid function tests and an ultrasound tomorrow. I assume I need to wait to have those tests before doing anything else. If I am extremely hyper, do I need to worry about anything in the short term as I get everything lined up? I have an HMO so it will be referrals, tests, and referral to an endo. My doctor did not mention putting me on any medication at this point - only the additional tests.


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## Lovlkn (Dec 20, 2009)

Yes - you could possibly have a thyroid storm or heart attack.

Whomever ran these labs should call in an antithyroid medication such as Tapazole or PTU and Propranolol.

If you have any issues at all - bring these labs to the emergency room.


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## jenny v (May 6, 2012)

Ugh, it stinks that Graves has reared its ugly head again for you! I had swings like that and it's exhausting. I would call the doctor's office back and demand a prescription to hold you over until the referral gets worked out. You want to protect your heart and most surgeons won't consider surgery while you're very hyper.


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