# would you start T4 with these labs?



## Scanders (Sep 9, 2015)

I had my labs rechecked yesterday, and saw endo today. TSH--2.07 (.4-4.5); FT4 0.9 (.7-1.5); FT3 2.1 (1.7-3.7). I'm a little cold and scattered, and I think I have some increased neuropathy in my feet. In other words--I've felt worse with similar labs, but I think I might be able to feel better. Endo said in my case she may be willing to prescribe 25 mcg of levothyroxine if I felt strongly about it. (I'm currently not on any thyroid meds, and have been off methimazole since May 2016, with just a short period on this year for a minor flare of Graves, and stopped again this May.) I'm a little worried about a major stressor wreaking havoc (I may become a Graves statistic with divorce, and I think I'm more stressed that I'm not especially stressed about it) and causing a flare, and my eye surgeon has been waiting for stable labs before he will do the final corrective surgery from my TED. The labs are low, but they are stable.

I'm thinking maybe I ask for the script, and wait to see what the eye doctor says in a few weeks? I hate to rock the boat if I could finally get my eye fixed so the lid will close. But if he doesn't want to do it yet, maybe try the levo to see if I improve? Or just wait until next labs? I must have some thyroid function left, and I suppose that rising TSH could still call my thyroid to produce a little more hormone? Thoughts? (Yes, I'm still a bit unfocused with my thinking--ditzier than I like to be sure...)

Thanks!


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## joplin1975 (Jul 21, 2011)

Have you had your antibodies tested recently? What about a thyroid ultrasound?


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## Scanders (Sep 9, 2015)

No ultrasound. She doesn't see need as diagnosis was clearly Graves. Last trab was done in July: .93 (<=1.75). She's only ever run trab for antibodies.


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## Lovlkn (Dec 20, 2009)

If it were me- I would take the offer of 25 Mcg to help release hypo symptoms.

Your issue is you will need to test frequently to make sure the Graves antibodies do not flare and make you hyper.


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## Scanders (Sep 9, 2015)

Thank you. I think I will get the script, then see if the eye doctor is ready to do the final corrective surgery before starting the med, since that's in just over a week. He's been delaying while waiting for thyroid levels to stabilize, and I really don't rock the boat too much if we're finally moving forward with this. If he's not ready yet, then I might as well start it. Although, there's this major life stressor sort of hanging out there, as well, but I'd like to think I manage stress all right and wouldn't see a flare from that. (Just found out about the "girlfriend" a few weeks ago.)


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## Lovlkn (Dec 20, 2009)

Have you considered having your thyroid removed?

Looks like your doc keeps you mostly hypo on the MMI - my endo did the same thing. One day on Tapazole I spiked hyper ( after 4.5 years) so I decided I was ready for the "permanent" solution to the thyroid issue.

The best thing I can say about having a complete total thyroid removal is - it is alot easier to stabilize on med's because you don;t have the diseased thyroid spitting out random amounts of thyroid hormone.

Stable thyroid hormone levels will do you the most good regarding your eye's


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## Scanders (Sep 9, 2015)

I've thought about it, My endo has said pretty much the same thing you've said verbatim as far as the ease of managing meds versus a thyroid that is susceptible to the whims of the antibodies. That being said, there is a possibility that I could remain in remission, or that my thyroid has finally "burned out." Other than 3 months this year on a tiny dose of MMI, I've been off since May 2016. But I will give TT serious consideration should I have further flares and I think (no, I know) my endo would be all for it. But now--this is just my thyroid left to it's own devices.


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