Possible Euthyroid Grave's with Symptoms - Question and Answer Forum - Elaine Moore Graves' Disease and Autoimmune Disease Education

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Wednesday, February 08, 2012

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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.

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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.

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Possible Euthyroid Grave's with Symptoms

7/13/2010 5:53 PM

lilly

Joined: 12/2/2008

Posts: 3

Possible Euthyroid Grave's with Symptoms

Hello Elaine,

I am a naturopathic physician trying to muddle through my own confusing thyroid situation and was hoping you could help me.

For the past 5+ years, I have suffered from very typical hyperthyroid symptoms: excessive sweating, elevated heart rate, nervousness/anxiety, weight loss, light menses, mild exopthalamus (the "stare" was always present in pictures), hair loss. When tested, my TSH was always in the upper end of normal range (near 3), and my free T4 and free T3 WNL. At one point while in ND school, they tested my TPO and TG antibodies--TPO were slightly elevated. I worked on diet, adrenals, too selenium etc but nothing ever improved substantially.

About 8 months ago in desparation and struggling in my own practice due to my symptoms, I put myself on dessicated thyroid (1/2 grain bid) with the assumption that I could have a low-lying Hashimotos' type autoimmune process and that the thyroid medicine could possibly act as a decoy for the antibodies. It seemed like a long-shot due to my hyper symptoms to be taking thyroid medicine, but after a couple months, almost all of my symptoms resolved (or significantly improved). I felt so relieved and normal again. In the past 2 months, symptoms have come back with a vengeance. The dessicated thyroid is no longer working (or perhaps it never did but I was in a cyclical autoimmune process?) Recent testing shows negative TPO antibodies and a TSH on the low end due to the dessicated thyroid (free T4 and free T3 WNL)

Anyway, I am very confused. I have so many of the classic Grave's or HT Hashimoto's thyroiditis symptoms but the labs don't correspond.

I was thinking about having the TSI and Trab tests done. Can I do these on dessicated thyroid? Is it possible to have euthyroid Grave's disease that is symptomatic (not just the TED)? If so, would ATD or something else help?

I am going to purchase your book as well and have talked to many of my colleagues, but am stumped about what is going on....

Thank you very much,

Lilly

7/13/2010 6:31 PM

Elaine

Joined: 8/1/2008

Posts: 3174

Re: Possible Euthyroid Grave's with Symptoms

Hi Lilly,

Thyroid hormone resistance comes to mind. It can cause symptoms even when thyroid hormone levels are WNL but higher than what you optimally run. This would cause a normal TSH, and it could be that desiccated hormone has too high of a T3 to T4 ratio for you. Usually with thyroid hormone resistance, T4 replacement hormone alone is needed. The ratio of T3 to T4 in glandular products is slightly higher than what humans produce and in mild hyperT it can easily cause hyperthyroidism.

Another possibility is that you have heterophile antibodies that are causing a falsely elevated TSH. In this case you can try to have a TSH by dialysis test to remove interferences. People with subclinical hyperthyroidism can have hyperthyroid symptoms, although usually only beta blockers are used to keep symptoms in control.

As you know, there are several other disorders that mimic hyperthyroidism such as adrenal hyperplasia that you might want to pursue. I'd be interested in hearing what you figure out, but a hyperthyroid phase of Hashimoto's thyroiditis is also a good possibility, with again the desiccated hormone having too much T3 for you. Best, Elaine

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Possible Euthyroid Grave's with Symptoms

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