# hyperthyroid symptoms still but "normal" labs?



## corgimom (May 18, 2014)

I've been on a hyperthyroid journey since last November. At this time, my labs have been normal for the past few months, but I still feel all the same symptoms that started this over six months ago.

Basically, I'm wondering if it's possible to feel so crummy, even with "normal" lab results. Does it normally take a few months (at least) to start feeling better? Did messing around with medication prolong this nonsense?

Here is a (not so) brief acccount of my journey. FWIW, I'm a 43 year old woman, working full time and going to school. No prior or concurrent medical issues. Thank you so much in advance if you had the patience to read through all this!

Around the beginning of November 2013 I began feeling shaky, weak, constantly woozy (vertigo as if I were on a boat), fatigued, and muscle twitching in all parts of my body.

On Nov 21, 2013 the tachycardia started with resting heart rate about 150-160. Went to the emergency room and had a full cardiac workup. Everything was normal with my heart so they admitted me for further testing. Attending physician did thyroid tests (TSH, FT3, and FT4) which showed hyperthyroid (I don't have these lab results). I also had an ultrasound which showed nothing unusual. I started propranolol (10mg when needed) and was referred to an endocrinologist.

I saw the endocrinologist the following Monday, Nov 25.

*11/25/13 labs *

ESR (sed rate) = 7 (0 - 20)

FT4 = 1.81 (.56 - 1.66)

FT3 = 4.9 (2.3 - 4.2)

TSH = .01 (.35 - 4.00)

Thyroid Peroxidase AB = 1 (<9)

Thyroglobulin AB = 2 (<4)

I started methimazole (5 mg 2x/day), and I felt better within a few hours of my first dose. The vertigo subsided greatly and I had more energy the next day. Went back for more labs a few weeks later.

*12/11/13 labs *

FT4 = 1.15 (.56 - 1.66)

FT3 = 3.4 (2.3 - 4.2)

TSH = .01 (.35 - 4.00)

Doctor said to keep taking the methimazole. I continued to feel pretty good for a few more days but then the symptoms came back a little worse. I had labs done again on Dec 17:

*12/17/13 labs*

FT4 = .77 (.56 - 1.66)

FT3 = 2.1 (2.3 - 4.2)

TSH = .54 (.35 - 4.00)

I felt absolutely awful over Christmas. I continued to take the methimazole, but it really wasn't working anymore. I was so fatigued and weak that I barely got off the couch for over a week.

I started to slowly feel better and by New Year's Eve I felt well enough to go to a party. Shortly thereafter I began to feel normal. The doctor had me stop the methimazole at this time.

I did not like this doctor. She was very pushy about having RAI or surgery, and she and I did not communicate well. I found another endocrinologist and she did labs again on Jan 10:

*01/10/14 (different lab):*

FT4 = .75 (.75 - 1.95)

FT3 = 2.5 (2.3 - 4.2)

TSH = 7.1 (.5 - 4.7)

This doctor suggested that even though the numbers show I was swinging over to hypo, if I continued to feel good then we'll just monitor it until my next labs on Feb 17. I did feel pretty good during this time.

*02/17/14 labs*

FT4 = 1.05 (.73 - 1.95)

FT3 = 3.5 (2.3 - 4.2)

TSH = 8.5 (.5 - 4.7)

The doctor prescribes Armour (.25gr/15mg), presumably based on just the TSH, and I took it for two days. I then began to feel the hyper symptoms coming back, especially the vertigo and fatigue. It wasn't too bad until about the first or second week in March. I started taking my left-over methimazole, but it was no longer helping. I did this without consulting my doctor, which I know is a bad idea and I won't do again! I felt really bad over spring break, but began to feel better after a week or so.

I saw her again at the end of March and she said to stop taking the methimazole for at least a week to have labs done, which I did on April 7.

*04/07/14 labs*

FT4 = 1.15 (.73 - 1.95)

FT3 = 2.9 (2.3 - 4.2)

TSH = 3.6 (.5 - 4.7)

Ferritin = 17 (10 - 220)

She also did a full CBC/metabolic panel/iron panel/folate/B12 on April 7. Everything was normal, except my ferritin is on the low side. She OK'd me to start on iron supplements (25mg w/500mg of vit C).

We agreed to have thyroid labs done again in May.

By early May, I was feeling horrible. My vertigo is constant, with the feeling of being on a boat coupled with feeling "heavy" as though something is pushing down on my, or too much gravity. I'm fatigued, and my muscles feel weak, achy, and twitchy. I'm still struggling with my heart rate, taking a beta blocker when necessary. I started feeling physical anxiety, like too much adrenaline all the time.

*05/08/14 labs*

FT4 = 1.24 (.73 - 1.95)

FT3 = 2.9 (2.3 - 4.2)

TSH = 1.6 (.5 - 4.7)

Cortisol AM - 15 (not sure of range)

She also tested my AM cortisol level to see about adrenal function (it was normal).

At this time, she told me that she doesn't think it's my thyroid still causing my symptoms. This has caused a lot of worry on my part, because I deal with a bit of medical/health anxiety. However, I just can't believe that this isn't somehow still my thyroid, unless it never was? I'm really perplexed.

It's now May 17, and I'm still dealing with all of these symptoms. Fortunately, throughout all of this I have managed to miss very little work and got through the last two semesters of school. I feel lucky compared to many who are suffering.

I now have an appointment with a neurologist to check out the muscle weakness, twitching, and vertigo. This is to assuage my fears about a more serious neurological problem.

This is my first post, so thank you again for any advice or for just reading!


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## Andros (Aug 26, 2009)

Welcome and I hate that you are having such a horrific time of it. Have you considered having your thyroid removed? Have you had any antibodies' tests and have you had RAIU (radioactive iodine uptake?)

As long as the antibodies have a target to attack, they will remain very very busy! How are your eyes and do you have a goiter?


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## corgimom (May 18, 2014)

Thank you so much for your reply and thoughts!

We did discuss having my thyroid removed back when everything was fluctuating. But since it's leveled out (even though I'm symptomatic) the doctor doesn't think my thyroid is giving me trouble so no more talk of surgery.

Antibodies (Peroxidase and Thyroglobulin) were tested back in November and were in range. No RAIU, just the ultrasound back in November. Also no goiter, and I don't think my eyes are having any issues.

It's a puzzle!


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## visc (Feb 22, 2014)

I'm having the same trouble!!

Twitching muscles, paresthesias, palpitations, fatigue etc.

I don't have a cue why. But a few hunches.

I have reflux disease so maybe I'm not getting all the nutrients I need.

I don't exercise and sit almost all the time.

My doctors said they will wait and watch, but they have nothing for me.

Could be a virus that my body is chasing... I did get chicken pox when I was a kid. Thats notorious for living in nerve cells.


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## visc (Feb 22, 2014)

Do come back and tell us how the neuro went and what you might be doing after your visit.

I'd love to hear back from you!

Good luck


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## corgimom (May 18, 2014)

Will do! Thank you!


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## Andros (Aug 26, 2009)

The thing is, you have indicated that you feel crummy. I did too when I was on Tapazole (anti-thyroid med) and I thought I was just trading one problem for another which happened to be true. I did not have one nice day while on Tapazole.

Then I got rid of that thyroid and while it took some time to recover fully (about 18 months); life is good and I mean really good.

Whatever you decide; yay or nay............................just know we don't sit in judgement. We are here to be supportive of you during your difficult time with this horrid autoimmune disease. The older I get, the more I realize that there is no such thing as a right decision. ROLF!! We just have to do what we think is best. Bottom line!

I wonder how high your antibodies were and if you have the ranges provided by your lab? If you do, can you post them?


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## Lovlkn (Dec 20, 2009)

> *12/11/13 labs *
> 
> FT4 = 1.15 (.56 - 1.66)
> 
> ...


Now back to your first lab's -



> *11/25/13 labs *
> 
> ESR (sed rate) = 7 (0 - 20)
> 
> ...


*You absolutely have a thyroid issue - you were hyper in December and were over medicated to hypo. YOur body is having difficulty recovering - then your new doctor gives you replacement hormone, making you hyper again.*

*This is your problem - you do not have some neurological issue - your thyroid hormones have been moving rapidly since December - Moving thyroid hormones can cause alot of mental issues - like you are experiencing. *

*Ask for the one test they have failed to run - TSI. Please post the results when they run it. Also ask for a Vit D test. I had all sorts of muscle issues when I was first diagnosed due to being hyper then hypo - much like you.*

I


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## corgimom (May 18, 2014)

Thank you, Lovlkn! That is great information, and confirms what I suspected about the medication. Why is it so hard to find a doctor that knows this?!

I will ask for the TSI and vitamin D test and keep you posted.


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## txspring (Apr 3, 2014)

I feel as though I am in a similar situation (in some ways) so I want to follow this thread. Corgimom, I hope you get things figured out soon!


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