[Kimberly]

#1063373

Hello and welcome to the boards! We *all* sometimes struggle with whether a particular symptom is related to our Graves’…or whether it it’s due to hormones, aging, or something else entirely. The only way to know for sure if our thyroid levels are off is to get blood work done.

Keep in mind that dosing with Methimazole is part art, part science. Your doctor will start you off on an initial dose based on the severity of your hypERthyroidism. After a few weeks, most patients will see their levels fall, and when this happens, the doctor will reduce the initial dose to try and keep the patient out of hypO territory. It can take some trial and error to find the “sweet spot” that will prevent you from being hypER…without making you hypO.

One thing to watch for is whether your doctor is making dosing decisions based on TSH instead of Free T3 and Free T4. TSH can remain suppressed for months (or years) in many Graves’ patients. Some docs see a low TSH and don’t reduce our initial doseage quickly enough because they assume we are still hypER…when in reality the Free T3 and Free T4 might be in the normal range, or even on the hypO end.

Symptoms of hypO vary from person to person, but a few of the common ones include fatigue, joint pain, weight gain, slow pulse, hair/nail changes, intolerance to cold, and constipation. If you notice these symptoms in between appointments, definitely let your doctor’s office know, and they should be able to work you in for an earlier set of labs.

Finally, you will read this often on these boards, but if you can keep a symptom log with *very specific* symptoms, that can help get to the bottom of any issues. For example, “my heart rate is 120 beats per minute” is more useful to our doctors than “I’m not feeling well.”

Best of luck on this phase of your journey…please check back and let us know how you are doing.

[shellym]

#1018221

this is my first post here. I was diagnosed 3 mths ago with gd. I’ve been on methimazole since then and I was feeling wonderful up until yesterday. How do I know if it’s the GD or if I’m just having hormonal issues as in any 30yr old mother of 4. I becamo tired this weekend and now I have that feeling of blah back. I’m also weaker than I have been. I feel paranoid because I have been searching online and I truly dont’t want all the non sense back from 3 mths ago. Any input would be helpful and very appreciated.

[Bobbi]

#1063374

Hi, Shelly:

First of all, it might help to understand that the methimazole only interferes with the production of "new" thyroid hormone. The thyroid, however, also stores hormone. So, until the stored supplies of hormone are used up, it is difficult for a blood test to register whether or not you are on the correct dose of the medication. Once you’ve been on it long enough — and it’s likely you have by this point — then the dose of the medication may have to be adjusted until the correct dose for YOU is found.

But since you are on the drug, and you’ve been feeling pretty good, it is unlikely that you will find yourself back in the bad old days of too much thyroid hormone. Methimazole does typically work very well to eliminate hyperthyroidism.

That said, one of the psychological hurdles we face as patients is the fact that just reestablishing normal levels of thyroid hormone typically does NOT make us feel normal again. We have to spend weeks, more often months, AT normal levels of hormone for our bodies to heal properly from any damage that being hyperthyroid caused. One of the problems caused is muscle loss. We actually lose muscle, especially in the large motor muscle areas, which is why we feel so weak. When we start to feel well again, and want to get back to our lives — EVERYTHING in our lives — just how weak we got while hyper becomes very apparent. So, when your doctor tells you it’s ok to do whatever you want, including exercise, take baby steps. When I began exercising after getting appropriate treatment, it was determined at the gym that I had about eight percent (yes 8%) of the normal strength of a woman my age in my arms and legs. I’d lost lots of strength. The muscle typically does come back slowly, but it needs to be strengthened over time by exercise. So, what I’m saying essentially is that it is very common not to feel normal when those blood tests register normal. But over time, we do regain our health again.

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