# Grave's Disease....What test determine's it???



## nascardkmd (Jan 11, 2011)

Hi I am new here and was diagnosed with Hyperthyroidism. I have the same symptoms many of you have and I will say it's not fun at all. Some days I feel like I am going out of my mind. That's not like me at all so I know something's not right. I was wondering what tests determine whether you have Grave's disease or not??? My Tsh was .3 before being put on Tapazole. My Endo tells me I am in the early stages of Grave's?! My TPO was 13 back in June and my Antithyroidglobulin was < 20. I had a Thyroid Ultrasound and Thyroid Scan a yr ago and it showed small nodules on my thyroid. I am trying to learn as much as I can. Thanks for all your help. This is a great site!


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## GD Women (Mar 5, 2007)

nascardkmd said:


> Hi I am new here and was diagnosed with Hyperthyroidism. I have the same symptoms many of you have and I will say it's not fun at all. Some days I feel like I am going out of my mind. That's not like me at all so I know something's not right. I was wondering what tests determine whether you have Grave's disease or not??? My Tsh was .3 before being put on Tapazole. My Endo tells me I am in the early stages of Grave's?! My TPO was 13 back in June and my Antithyroidglobulin was < 20. I had a Thyroid Ultrasound and Thyroid Scan a yr ago and it showed small nodules on my thyroid. I am trying to learn as much as I can. Thanks for all your help. This is a great site!


Hello and Welcome to the Boards.

Well then, your Endo is no doubt correct - Graves' it must be.

TSH, FT-4 and FT-3, all three done together, can related if a person is autoimmune thyroid. If doctor is not quite sure, TSI antibodies blood test can confirm Graves'. 
Although, all four need to relate to autoimmune. Hyperthyroidism and Graves' have the same treatments, so no escapes there. 
If TSH, FT-4 and FT-3 have already been done, ask doctor/office for a copy of the tests with Labs reference range. Preferably test that were done before Tap 
(Tapazole).

I am assuming your doctor is monitoring your nodules for grow and changes. It sounds like you might be due for another extensive nodule test.

Chin up - it can get better or it can get worse. Lets hope for the better!


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## lavender (Jul 13, 2010)

Welcome!

TSI antibodies confirm Graves.

a Radioactive Uptake and Scan can help diagnose those nodules.


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## nascardkmd (Jan 11, 2011)

Thanks for your responses.Its been a yr since my last scan. He hasnt scheduled me for another one. Do u think I am due to have my nodules rechecked? My tsh was .3 before tapazole and ft4 was 1.43 and ft3 was 1.10. What r ur thoughts with my numbers? Does it sound like graves disease? Also without a biopsy how do they know if its cancer or not? Thanks for all ur help. Just trying to get as much info as I can.


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## GD Women (Mar 5, 2007)

nascardkmd said:


> Thanks for your responses.Its been a yr since my last scan. He hasnt scheduled me for another one. Do u think I am due to have my nodules rechecked? My tsh was .3 before tapazole and ft4 was 1.43 and ft3 was 1.10. What r ur thoughts with my numbers? Does it sound like graves disease? Also without a biopsy how do they know if its cancer or not? Thanks for all ur help. Just trying to get as much info as I can.


Need your Labs reference range for TSH and both FTs.

Does the doctor do routine physical examinations of your thyroid. 
If a gland or nodule that feels suspicious on physical exam a needle biopsy with the aid of an Ultrasound which improves the accuracy of the FNA, is just about the only way to distinguish thyroid cancer. However, FNA is not a 100%guarantee in detecting some cancers. The accuracy of this test in the evaluation of follicular cancer is quite poor. 
Please keep in mind that the risk of thyroid cancer developing in a cold nodule in Graves' disease is ~ the same risk as in patients without Graves' disease, namely about 15%.

Recent outcome of Graves' disease patients with papillary thyroid cancer - 2007 Sep
CONCLUSION: The results in this series of patients do not support the claim that thyroid cancer is more aggressive in Graves' disease patients than in euthyroid patients.
http://www.ncbi.nlm.nih.gov/pubmed/17766715

Basic Facts about Thyroid Nodules - Jul 7, 2010 
More than 95% of all thyroid nodules are benign (non-cancerous growths). 
http://www.endocrineweb.com/nodule.html


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## lavender (Jul 13, 2010)

Do you have the reference ranges for any of your lab work? it is very hard to evaluate anything without the ranges because every lab is different.

How long have you been on Tapazole? How long have you been having thyroid issues?

The scan can indicate if a nodule is more likely to be cancerous or not based on the characteristics of the nodule. I can't be more specific than that because I was not considered to be at a risk for cancer. However, there is no way to know for sure if you have cancer without a biopsy or in some cases surgery as some biopsies are inconclusive.


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## april (Feb 23, 2011)

Help? I went to see the endo today. I had a list of questions wanted to ask and I wanted to get my labs written down. I told her my hands and feet itched and she sent me to the lab right away. I never got to ask my questions. Endo called tonight and said I have a toxic liver stop methimazole. She insists on me have the radioactive iodine done. I told her I didn't want to. She said I can't take antithroid meds because of my liver and I have to do something. I'm scared. Does RAI cause cancer, stomach, breast etc...I am only on 5mg a day of methimazole how can my liver be toxic? Maybe it's not methimazole but something else, why can't I still take meth.? I also bruise really easy. I take ibuprofen and acetaminophen occassionally. I can't ask for another endo they are the only ones around.


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## Andros (Aug 26, 2009)

april said:


> Help? I went to see the endo today. I had a list of questions wanted to ask and I wanted to get my labs written down. I told her my hands and feet itched and she sent me to the lab right away. I never got to ask my questions. Endo called tonight and said I have a toxic liver stop methimazole. She insists on me have the radioactive iodine done. I told her I didn't want to. She said I can't take antithroid meds because of my liver and I have to do something. I'm scared. Does RAI cause cancer, stomach, breast etc...I am only on 5mg a day of methimazole how can my liver be toxic? Maybe it's not methimazole but something else, why can't I still take meth.? I also bruise really easy. I take ibuprofen and acetaminophen occassionally. I can't ask for another endo they are the only ones around.


April, there are many things that can cause damage to the liver and methimazole can exacerbate that or even cause it.

I had RAI and don't have a single complaint. You do have the right to have surgery if you would prefer that.

Your doctor apparently cares about you. And I don't blame you for being scared.

Let us know what you decide to do.


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## april (Feb 23, 2011)

Thank you for replying. The Endo I guess has been nice. She has called herself 3x since last monday. Even at 7:30 at night. I have 7 children some very small, will radiaoactive ablation affect them? I am having a lot of pain in my lower abdomen on both sides and in my back. Is this normal or is it my liver? I got some of my lab work from my primary doc. my Tsh was 0.006 range 0.450-4.500 and my free t4 was 3.63 with a range of 0.82-1.77. also I had a thyroid scan and uptake in 2005 and it was normal what does that mean?


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## Andros (Aug 26, 2009)

april said:


> Thank you for replying. The Endo I guess has been nice. She has called herself 3x since last monday. Even at 7:30 at night. I have 7 children some very small, will radiaoactive ablation affect them? I am having a lot of pain in my lower abdomen on both sides and in my back. Is this normal or is it my liver? I got some of my lab work from my primary doc. my Tsh was 0.006 range 0.450-4.500 and my free t4 was 3.63 with a range of 0.82-1.77. also I had a thyroid scan and uptake in 2005 and it was normal what does that mean?


If you have RAI, you will have to make arrangements to stay away from your children, pets and others like pregnant women and babies.

If you have the surgery, you will need some help around the house and w/ the children but that "may" be your better option. It depends on your circumstances and what kind of "support" you have on the home front.

I am praying for you. You cannot go on like this. Your children "do" need their mommy and if you don't make a choice here, you can become mighty mighty sick.

Thyroid storms are not a good thing,

Nor is liver failure. You "are" between a rock and a hard place; that is evident. Too bad we all can't rush in and help you but alas; cyber space is like that.


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## lavender (Jul 13, 2010)

wow, I just want to send you one big hug because it sounds like you are going through a lot!

I was in thyroid storm about a year ago, and I had the itching and abdominal pain. My liver levels were elevated when I was in storm, and the methimazole seemed to bring them down initially. Although I started having abdominal pain again a few months later. The docs never stopped my meds because I was scheduled for surgery that week.

I opted for surgery to remove my thyroid, and had to be pretty clear and direct with my endo about what I wanted. The reading I did suggested there was no increased cancer risk with RAI, but I still did not feel comfortable exposing my body to those toxic chemicals if I had any other option. I also did not like the amount of time I read that it can take RAI to be effective. Surgery was immediate in stopping my hyperthyroidism. RAI can take months and may require more than one treatment. I was not willing to go through that.

If you are truly not comfortable with RAI, I suggest being direct with your doc and asking to discuss other options. Let your doc know if you prefer surgery, and insist on a referral to a surgeon. It's your body, and you will have to live with the consequences.


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