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 3/8/2010 1:27 PM
 

  THANKS ELAINE FOR YOUR RESPONSE,

 YOU ARE SAYING THAT PROBABLY I HAVE HIGH BLOCKING ANTIBODIES WHICH CAUSE MY FT4 TO BE ON THE LOW SIDE, EVEN WITH TSI OF 190; I DON'T WANT TO BECOME HYPO (MY TSH WENT DOWN FROM 1.56 TO 0.95). MY QUESTIONS ARE:

1) SHOULD I STOP THE PTU TOTALLY, OR SHOULD I INCREASE IT BACK? (I'M TAKING NOW 8 MG EVERY THIRD DAY VS. EVERY OTHER DAY BEFORE THE TEST)

2) HOW CAN LOWER THE TSI, SO I CAN GO TO REMISSION?

 3) MY MAIN CONCERN IS THE EYS; WHAT CAUSES THE EYES TO BULGE?

THANK YOU

RITA

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 3/8/2010 3:34 PM
 

Hi Rita,

Your labs suggest blocking antibodies and they would prevent your TSI from causing hyperthyroidism. If you have significantly higher amounts of blocking antibodies than TSI you can also move spontaneously into hypothyroidism. 

People with high levels of both stimulating and blocking TSH receptor antibodies are at high risk for TED. Both of these antibodies contribute to TED.

So your goal, as you mentioned, is to reduce them. ideally, you'd be on block and replace therapy, using a higher PTU dose along with replacement hormone. This way you'd have PTU helping reduce antibody production and you'd be avoiding hypothyroidism. Hypothyroidism encourages thyroid antibody production.

Other ways to reduce thyroid antibodies include avoiding all environmental triggers including excess dietary iodine, aspartame, cigarette smoke, and allergens and vaccines and by adding 200 mcg selenium daily and antioxidant vitamins and flaxseed oil. Stress reduction techniques can also help, and adequate hydration is also important.

If block and replace is out of the question, I'd use the 8 mg every other day instead of every 3rd and avoid eating too many goitrogens since they can contribute to low thyroid hormone levels. Best, Elaine

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