# 7 weeks post RAI, already on Synthroid?



## Tosca (Jan 14, 2011)

I think my original thread has scrolled off, so I'll briefly introduce myself again. I was diagnosed with Graves about 3 years ago, took methimazole successfully for a little over a year and went into remission. Late last fall I started to have symptoms again, had a new scan and uptake showing 60% at 24h, down from 100% the last time around. Idecided to do RAI, which I had on Feb 3.

I got 14 MCi, a dose the radiologist calculated to try to save me some thyroid function since I expressed that preference when he asked. I felt pretty good afterward though I had periodic surges in my heartrate and hand tremors for a couple of weeks. I was still taking 25 mg of atenolol twice a day until last week, when I cut it down to just one at night.

I had my labs drawn last Friday and saw the endo on Tuesday. My TSH is still low, 0.01L, but up from my previous of <0.01L. Free T4 is 1.1. (nl range 0.8-1.8) and Total T3 is 87 (nl 76-18). I have actually been feeling really "normal", and only now have been able to recognize how really abnormal I'd been feeling for quite a while.

My doc said it was time for Synthroid since I'm at the low end of the range for T3 and T4. He prescribed 125 mg/day, which I started yesterday. He also told me to stop the atenolol, but I still kind of feel like I need it at night. No effects so far from the Synthroid. I redo my labs and go back to the doctor in 3 months.

Based on what I'm reading from others here, it seems like my thyroid responded pretty fast to all this. I'm hoping this doesn't mean that my radiologist's attempt to save some normal thyroid function isn't happening, but both he and my endo warned me that it's not an exact science. I can deal with it either way as long as I don't actally go hypo in the meantime.

The endo did tell me something that surprised me, that he would eventually follow me with TSH alone after I've stabilized on my Synthroid dose. I don't like that idea but will cross that bridge when I come to it. He also told me that if my weight stays stable I will probably be able to stay on the same Synthroid dose for a long time but that sometimes menopause, which is probably just around the corner for me, causes fluctuations requiring adjustment.


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## Andros (Aug 26, 2009)

Tosca said:


> I think my original thread has scrolled off, so I'll briefly introduce myself again. I was diagnosed with Graves about 3 years ago, took methimazole successfully for a little over a year and went into remission. Late last fall I started to have symptoms again, had a new scan and uptake showing 60% at 24h, down from 100% the last time around. Idecided to do RAI, which I had on Feb 3.
> 
> I got 14 MCi, a dose the radiologist calculated to try to save me some thyroid function since I expressed that preference when he asked. I felt pretty good afterward though I had periodic surges in my heartrate and hand tremors for a couple of weeks. I was still taking 25 mg of atenolol twice a day until last week, when I cut it down to just one at night.
> 
> ...


Only time will tell about the RAI. It just depends on how much of that 14 MCI your gland grabbed up. As pointed out, it is not an exact science.

I would like to comment on a few things. It would be best to find a doc who will run your FREE T3 once in a while. You can not fine tune a patient to the euthyroid state (where you feel fully recovered and well) going by TSH alone. I think you know that which was the reason for your alarm.

Also it would be best to be getting your labs every 8 weeks right now. I have been euthyroid for years so I get my labs quarterly but this in not the good choice when trying to titrate the patient to a good place for him or her. Too long in between and you suffer.

Your doctor also started you on a pretty high dose for the first time out on this. Most get started on 50 mcg. to 88 mcg..

If you stay on the Attenol, you will be masking some of your symptoms of possible over dose.

The good news is you are feeling better and we all aim to help you keep it that way.

Let me know what you think of my comments.


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## Tosca (Jan 14, 2011)

Thanks for weighing in on this for me, Andros. I am not entirely comfortable with waiting 3 months for my next appointment, but I think that it's probably necessary, given how hard it is to get an appointment with any endo in my area who takes insurance. When I went to schedule the 3 month appointment right after I saw the doctor, they had no slots open until July in the office nearest me. For an office further away, there was one appointment open in late June, so I got that. If I couldn't have taken it, I would be out of luck until at least mid-July.

I can still have the labs done sooner if I want to and just call him to talk over the results. I'm also seeing my primary care doc in May and they will likely rerun some of tests then. I doubt that either one of these docs will run free T3. They do what they do, and unless there's a problem they'll stick to it. If I am having trouble getting the right dosage in the long run, I'll have to find a specialist at one of the academic medical centers in the city, and that is likely to take months to get an appointment, too.

But so far I feel fine, no symptoms from the Synthroid so far and I'm only using atenolol intermittently. I'm keeping my fingers crossed.


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## Andros (Aug 26, 2009)

Tosca said:


> Thanks for weighing in on this for me, Andros. I am not entirely comfortable with waiting 3 months for my next appointment, but I think that it's probably necessary, given how hard it is to get an appointment with any endo in my area who takes insurance. When I went to schedule the 3 month appointment right after I saw the doctor, they had no slots open until July in the office nearest me. For an office further away, there was one appointment open in late June, so I got that. If I couldn't have taken it, I would be out of luck until at least mid-July.
> 
> I can still have the labs done sooner if I want to and just call him to talk over the results. I'm also seeing my primary care doc in May and they will likely rerun some of tests then. I doubt that either one of these docs will run free T3. They do what they do, and unless there's a problem they'll stick to it. If I am having trouble getting the right dosage in the long run, I'll have to find a specialist at one of the academic medical centers in the city, and that is likely to take months to get an appointment, too.
> 
> But so far I feel fine, no symptoms from the Synthroid so far and I'm only using atenolol intermittently. I'm keeping my fingers crossed.


See if you have this in your area and you can use code 1234 as per Mary Shoman on About.

HealthCheckUSA

http://www.healthcheckusa.com/


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## Tosca (Jan 14, 2011)

A belated thanks for the testing link, Andros.

I haven't checked in here in a while but things are going very well for me. I feel great, much better than I thought I would. Only now, because of the difference, do I realize how bad I was feeling being hyper before.


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## Andros (Aug 26, 2009)

Tosca said:


> A belated thanks for the testing link, Andros.
> 
> I haven't checked in here in a while but things are going very well for me. I feel great, much better than I thought I would. Only now, because of the difference, do I realize how bad I was feeling being hyper before.


We are all glad to hear that you are feeling much better! Hard to believe but this thyroid stuff is insidious and we do build up a high tolerance level to what ails us as a coping mechanism.

Thanks for popping in and please don't be a stranger. As they say, "It ain't over 'til the fat lady sings!"


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