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THE Q & A
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Welcome to The Q&A with Elaine Moore. Registered members are invited to ask any question of Elaine Moore on autoimmune diseases, Graves' disease, other thyroid diseases and subconditions, laboratory work, traditional and complementary medicine, triggers and environmental influences, thyroid and immune disorders in pets and animals, and other relevant areas of inquiry.
Each thread represents one question with one answer and will only appear at the time it is answered. Once answered, further replies cannot be made to the same thread since each thread represents only one question. A new thread will need to be started for additional questions.
Questions are answered solely by Elaine Moore, a medical writer and clinical laboratory scientist, MT, CLS, with more than 30 years of experience in immunology. Moore has also authored and edited over a dozen books in the area of health sciences and is an editor for McFarland Publisher's Health Topics Series.
Copying of any posts is prohibited without permissions.
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| Miikku |
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Joined: 6/27/2010
Posts: 1
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Hi!
I'm a 33 year old woman and I was diagnosed with graves' disease 1,5 years ago when I was suffering from hyperthyroidism. After this I have been on antithyroid drugs for 18 months and I have recently, on doctors orders, stopped taking my medication so the doctor can test if I am in remission. Since I have gone of my medication a month ago I have begun to have hyperthyroidism symptoms again(anxiety, nervousness, tremors, heart palpitation, increased BP, etc). My blood tests are "normal" at the moment, TSH 4.15 and T4V 18, both are in the upper level of the scale. So, the doctors are saying I'm more likely suffering from hypothyroidism, since the TSH level is very high, and shouldn't worry about it. What should I do? I can't get thru my day without beta blockers and I can't work or do anything. I'm feeling very sick and no one believes me.
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| Elaine |
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Joined: 8/1/2008
Posts: 3531
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Hi,
I don't think you're hypothyroid or in remission unless you had been on a very low dose of ATDs. It looks like you may have been on too high of a dose of meds and that caused temporary hypothyroidism. It's never a good idea to just stop meds like this when you've been on a moderate dose. But without knowing your dose, I'll explain how remission is tested for.
Ideally, you'd be on the lowest dose needed to keep your FT4 at least at mid-range. And at this point TSH generally remains very low. Over time the ATD dose is lowered always basing the dose on the FT4 level regardless of a low TSH. Once you're on a very low dose, like 1.25--2.5 mg methimazole, for at least 6-8 weeks, a normal TSH, like anything above 0.3, would suggest remission. If TSH on this dose was higher than 3.0 then subclinical hypothyroidism would be a good possibility.
If this protocol wasn't followed your thyroid hormone levels, FT4 and FT3, will eventually rise and your hyperthyroidism will return. If your TSH rose because of too high of an ATD dose (temporary hypothyroidism) it can take 6 weeks to accurately reflect what's going on now (current thyroid status). Best, Elaine
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TO USERS: Q&A posts are visible to all readers. Users can delete their own threads at any time. Users must provide information which is true and correct to the best of their knowledge as well as provide sources or references to any health / medical information if not taken from personal experience. All users including the moderator must behave at all times with respect and honesty. Advertising and self-promotion is not allowed. The moderator or site administrator has the right to ban users with or without warning for not following the basic rules of this site. All posts by default are not to be considered that of medical professionals unless otherwise indicated. As sole moderator, Moore has no conflicts of interest in the sponsorship of this forum.
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