# Sub-clinical Grave's;have questions



## angeleyes527 (Oct 22, 2010)

Hi everyone, this is my first time here and am hoping to find some answers.

I have been diagnosed with Grave's Disease and am told I am subclinical. My Endo is really pushing the RAI Ablation and I have decided to start off with Methimazole.

I recently mis-carried and although the doctors do not believe it is related they say that they cannot rule it out completely.

I am nervous about all the side affects either treatment has-but feel that if I start the methimazole and do good then we can try again sooner to get pregnant than waiting longer after the RAI. And if the antidrugs don't work then I can always do the ablation later.

Has anyone had good experiences on methimazole?


----------



## mommyjewel (Aug 14, 2010)

I was on the Methimazole for about 4 weeks. My free T3 and free T4 was about triple what they should be. On the meth my free T4 came back down to normal and my Free T3 was double what it should be. I developed an allergic reaction on the meth and had to be switch to the PTU.

From what I read PTU is the drug of choice if you are pregnant or get pregnant because the meth can cause birth defects.

I am not sure what they mean by sub-clinical.

I am sorry for your loss.


----------



## mommyjewel (Aug 14, 2010)

I just wanted to add that the PTU is harsher on the liver


----------



## greatdanes (Sep 25, 2010)

I was subclinically hyper 1.5 yrs ago, and about a month ago I found out I was no longer subclinical but hyper with an undetectable TSH, and high 3&4. Did they test for the graves antibody(TSI)? I would not accept a dx of graves unless the antiboy markers for graves has been completed. I was only on 5 MG OF METHIMAZOLE for 3 weeks and it brought my ft3 and ft4 to the low side of normal. I am no longer taking it(no need, even with the tsh still low) and am awaiting lab work to see if it threw me hypo, as my symptoms feel like it. All I can tell you is that the doctors won't tell you everything so it's good to do your OWN research. TalK with others who have had it all. I honestly don't understand why some endos want to suggest RAI off the bat. I had a friend who walked out of her endo's office b/c everytime they visited she suggested RAI even when her numbers were in range(she wasn't even on meds). This same endo(I had several friends who went to her b/c we all had military ins, and she was the only available endo in the area) told a few of my friends they should have RAI if they had benign nodules, she made no sense whatsoever! But, I digress...

If you were my sister, I'd suggest going on ATD'S first before doing RAI. I have heard a few good stories from ppl who had the RAI, but unfortunately I've heard/read more negative results. As it stands, you are subclinical which means meds aren't needed until your FT3&4 rise, and that may not happen for several months to several years, you just never know. RESEARCH!!!

:hugs:


----------



## greatdanes (Sep 25, 2010)

mommyjewel said:


> I was on the Methimazole for about 4 weeks. My free T3 and free T4 was about triple what they should be. On the meth my free T4 came back down to normal and my Free T3 was double what it should be. I developed an allergic reaction on the meth and had to be switch to the PTU.
> 
> From what I read PTU is the drug of choice if you are pregnant or get pregnant because the meth can cause birth defects.
> 
> ...


Subclinical means when you have a low TSH but normal ft4 and 3. Sometimes this could be a sign that it's a pituatary problem, but of course the dr's never investigate that either.


----------



## lavender (Jul 13, 2010)

Welcome to the boards. I am sorry to hear about your miscarriage, and I hope you can find some help for your thyroid so you can feel better and have a healthy baby.

I have read that pregnancy could trigger Graves, and that being hypothyroid can cause a miscarriage. So, it does seem possible that the two are related and that maintaining healthy thyroid levels will be essential to carrying a pregnancy to term.

I have a friend who miscarried, was told that she is very slightly hypothyroid and that may have had a part in the miscarriage. She was put on synthroid when she got pregnant again, had a healthy pregnancy, and the baby is a year old now. From what she said, she was actually kept slightly hyperthyroid through the pregnancy, and went off the synthroid the moment she gave birth because it made her pretty miserable.

About five years ago, I tested with a really low TSH. I think my T4 was normal at that time, and the doc murmured something about being sub-clinical hyperthyroid, but did not pursue any treatment, and I was not referred to an endo. This past April, I again tested with a low TSH but normal T4. Within a month, my Graves was in full force, and I was admitted to the hospital for thyroitoxicosis. I was on methimazole for several months, but never felt really good on it, which could have either been from the high dose I needed or the severity of my Graves. I have heard that some people are able to tolerate it and find that they eventually go into remission, but this was not the case for me, and I decided to have my thyroid removed.

From my understanding, Graves can wax and wane for years and may go into remission. I am glad to hear that you have an endocrinologist looking into all of this, but would not let the doc pressure you into RAI if you are not ready for it. Especially if you want to get pregnant again soon. With RAI, the recommendation is that you wait at least a year to get pregnant, and surgery is an alternative if your thyroid ultimately must go.

You may not have to make a decision right now if your case is not that severe. Antithyroid meds may work for you, and you will never know if you do not give them a shot. I would suggest talking with your doc about PTU though because from what I was told, methimazole should not be taken during pregnancy.

Looking back, I wish I had medical care to follow up on my thyroid 5 years ago, but I would never go back and have my thyroid removed/ablated then, even knowing how bad it eventually got. I think I needed to go through everything I did to feel good about having something as drastic as surgery.


----------



## desrtbloom (May 23, 2010)

If you have been diagnosed with Graves (which I agree you need to make sure they do a full thyroid panel) do not exercise. Graves taxes the heart and you can have a heart attack.

I was on Methazimole 20 mg for 90 days along with Propanolol (for racing heart and palpatations) preparing me for a total thyroidectomy. Honestly, I was so sick that I don't believe anything I was experiencing was specifically from the Methazimole except for some skin irritation, bumps on my arms, but not itchy at all just raised bumps. I did well on it. My g/f took Methazimole for 18 months and her Graves has been in remission for years.

Again, request a complete thyroid panel to make sure that you do have Graves and you are not just hyperthyroid. There is a difference. Also, if you aren't being treated by an endo, I would suggest finding a good one in your area and treating with an endo versus a regular doc.

Good luck!

Patti


----------



## AngeInBoston (Oct 14, 2010)

Hi Angeleyes, I feel like I know you from a different Board, but perhaps it's a coincidence. I'm so sorry about your miscarriage, I lost a baby at 10 wks 5 yrs ago, and was terribly griefstricken, I found a miscarriage board that helped me tremendously. I'm hypothyroidism but never considered if that could have contributed, the Drs just told me it was a fatal flaw in the baby.

Anyway, sorry I'm not able to contribute much else on your problem, I'm still learning all about Pediatric Graves for my 11 yr old, and hoping it won't cause her fertility problems in the future.

Welcome to the Board, and best of luck!
~Ange


----------



## lavender (Jul 13, 2010)

I did a lot of reading about fertility issues and Graves when I was getting diagnosed because I really want to have a child in the next 5 years, and I was worried about the consequences of my illness/treatment. Based on everything I read, as long as graves is treated, thyroid levels are eurothyroid (in the normal range) fertility is not affected. From my understanding, there is a narrower range of normal during pregnancy, and thyroid labs are more closely monitored.


----------



## AngeInBoston (Oct 14, 2010)

Yes, even though I'm Hypo, they did monitor me and make adjustments during my two previous normal pregnancies. In fact, I've learned so much more than I ever knew about being Hypo in just these past two weeks than I ever knew in 25 years that I've had it and just been blindly taking my little pill every night and getting occasional blood tests. Now I will pay better attention to my symptoms.


----------



## Andros (Aug 26, 2009)

angeleyes527 said:


> Hi everyone, this is my first time here and am hoping to find some answers.
> 
> I have been diagnosed with Grave's Disease and am told I am subclinical. My Endo is really pushing the RAI Ablation and I have decided to start off with Methimazole.
> 
> ...


Welcome to the board and I too am very sorry for the loss of your wee one.

It looks like you are in good hands here. I have been following the thread and as you now know, we have a great group here.

They have rallied to your aid quickly and are offering some very good experience and advice.


----------

