# Graves Disease and question about T4



## jumpingbean (May 29, 2012)

Hi all, this is my first post here. It's so nice to see a forum dedicated to thyroid issues, especially Graves Disease! Too bad we need it. Anyway, I recently requested to be tested for hyperthyroidism and got two numbers back from my doctor. My TSH was .006 and the T4 was 3.81. The nurse didn't specify which number the T4 was (free or total T4) but I assume it's free T4. Any ideas? She didn't even want to give me the numbers; she just said "Your thyroid is overactive" and wanted to leave it at that. I have an appointment with the doctor on Thursday so I'm sure I'll find out then what the numbers mean. My symptoms are overall fatigue, weight loss and inability to gain weight no matter what I eat, anxiety, irritability,brain fog, insomnia, and heat/exercise intolerance. I tried to walk yesterday and only made it one mile. I felt and looked as if I'd just run a marathon. I'm 38 years-old and am at my wits end with this condition as I've had it for about 11 years. Just wanted to say "hi" and vent. Thanks for reading.

Edited to add that feeling out of breath/breathlessness is another annoying symptom! I can barely talk to someone without getting out of breath, never mind walking up a flight of stairs. Anyone else?


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## JPGreco (Mar 2, 2012)

I feel your pain. I'm a Grave's sufferer myself.

Anyways, what we really need is the ranges of those two tests to see how far out of range you are. Also whether its free T4 or not. The low TSH is a sign of hyper as well as a high T4 (both free and total). What you really want to see though is the free T3 as this affects your body the most. Also, you want to test for antibodies as Grave's is an autoimmune. You may only be hyper and not have Grave's. As it is I'm not clinically diagnosed, my blood work only suggests Grave's.

You need to have a full thyroid panel done. Also, if you're in the USA, Doctors cannot refuse to give you the lab results. That includes copies of all labs and such.

Best of luck


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## webster2 (May 19, 2011)

Welcome! I hope you will get your answers soon but until then, you might want to lay off the exercise. Anything that raises your heart rate can be very dangerous with hyperthyroid and Graves.

It is a great idea to get all of your lab results in hard copy to refer to.

You have come to the right place for answers and support. Hang in there!


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## jumpingbean (May 29, 2012)

Thank you both for the great info. and words of encouragement. I will get a copy of my labs on Thursday when I see my doctor. I have a feeling he will want to do the RAI but the nurse said we could try medication first. I took PTU a few years ago and after that, my thyroid levels came back within the normal range until I went to the doctor last week. I will mention that to him when I go. Thanks again!


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## JPGreco (Mar 2, 2012)

If medication can control it that's great, especially if you are only hyper and don't actually have Grave's. If not, hey, whatever, a lot of people have had the RAI or surgery.

I'm at that bridge now actually, finding out options between the two.


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## webster2 (May 19, 2011)

I hate to be a downer but, my experience has been that to get the Frees tested, I have to be adamant...they can test anything they want but I want Free T3 tested most importantly.

This whole experience has made me rethink a doctor's appointment. I prepare my questions in advance, know what I want for testing, and on one occasion told the doctor "thank you and good bye" and left the office. I knew what she was offering was not working for me, and I was correct. I feel pretty darn good now!


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## Andros (Aug 26, 2009)

jumpingbean said:


> Thank you both for the great info. and words of encouragement. I will get a copy of my labs on Thursday when I see my doctor. I have a feeling he will want to do the RAI but the nurse said we could try medication first. I took PTU a few years ago and after that, my thyroid levels came back within the normal range until I went to the doctor last week. I will mention that to him when I go. Thanks again!












Will be looking forward to lab results and ranges when you get them.

Meanwhile, here are some "suggested" tests. Plus RAIU (radioactive uptake scan.)

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism. 
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/


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