[Ski]

#1073812

First, the future for any Graves’ patient who receives treatment is VERY bright. We get there. It happens slowly, but we get there.

Second, nodules are typically not a part of Graves’ Disease, so I can’t help out with that part of your question.

ATDs have about a 40% chance of providing remission, but they are typically effective in a higher percentage of patients. Let me explain. A patient must be able to discontinue the meds and continue with normal thyroid hormone levels for a period of time (months, at least) to say they have attained remission. That’s the 30% to 40% figure, and remission is typically attempted anywhere from 12-24 months after beginning ATD treatment.

Patients typically do respond to ATDs, and with proper monitoring, some can stay on a very tiny maintenance dose that keeps their thyroid hormone levels inside the normal range. That’s not attaining remission, but it’s still an effective way to keep your thyroid hormone levels under control. As long as they don’t experience any of the serious (but rare) side effects of the ATDs, some patients have stayed on them for many years. If you find yourself having trouble with elevated liver enzymes or low white blood cell count, you may need to discontinue the meds and decide upon a different treatment choice. The problems typically go away as soon as the patient stops taking the meds.

If all of your values for thyroid hormone (TSH, T4 and T3) are now falling within the normal range, then it’s quite possible you’ve got a natural remission happening. I believe I went in and out of symptoms for years before I was finally "full blown" and diagnosed. That’s great, it gives you more time to do research and figure out your preferences for the day when you need to make a decision. The antibodies come and go for reasons no one truly understands, so trust that they will be back, but rejoice that they have gone. ” title=”Very Happy” />

Remember though, having your levels fall within the normal range is one thing, being at YOUR normal point is another. If your levels are fluctuating, even if they stay within the normal range, that can still be tough on your body. When our thyroid hormone levels fluctuate, that is a signal to the body that something is not right, and the body removes support from the "non-essential" functions (hair and nails first) in order to preserve energy to fight the problem ~ EVEN if you are within the normal range ~ so if you find that you still do not feel well, even though your blood tests fall in the technically "normal range," you may want to pursue some level of treatment just for the purpose of having thyroid hormone levels that are STABLE.

[Chelsun]

#1073813

Thank you for your response. I’m interested in the hair and nail comment, just of late my nails have become brittle and breaking and today I noticed more of my hair falling out. My endo who left me a message to say my counts are coming back into the normal range, also left the message that if I was still having symptoms it could possibly be something other then my thyroid and I should see my GP again. UGH! I’m not sure that is such a great answer. To me it doesn’t sound as if he understands the whole Grave’s disease, however he has been highly recommended. (Washington DC/Northern VA area).

As far as my antibodies those are still high the TSI count 371 was on the last labs with the TSH count of o.35. Could the high antibodies be effecting me, although the other counts are normal?

Chelsun

P.S. I also have noticed over the last 10 or so days that when walking down stairs my upper thigh muscles feel like jelly. This is new. Other symptoms, diareahea and weight lost have stop, although I have not put on any weight. I went from 145 to 119, currently 122lbs 5’8". Have a whole closet-full of different size clothes ” title=”Razz” />

[Ski]

#1073814

The effects on your hair and nails could easily be caused by the thyroid levels, though keep in mind that as your levels move into the normal range, they’re still moving, which is also interpreted by the body as an emergency state. The resources will come back to your hair and nails when the levels are stable, not just normal.

The jelly-like thigh muscles could easily be caused by the hyperthyroidism, and you could be just feeling now the effects of damage done earlier, so you don’t have to think it means you’re "getting worse," just that it’s now reached a point where it’s obvious what you’re feeling.

From what I understand, your antibody levels do not necessarily equate to "how sick you are," that is supposed to be absolutely measured by your thyroid hormone levels. That’s the level to watch. The fact that there are many antibodies may or may not mean that you’ll feel worse.

Even doctors who have had experience with GD patients have some misconceptions about our treatment, so that’s something to consider, but the bottom line is that you will be having a long relationship with this doctor, and if you have any reason to feel less than comfortable, it’s a good enough reason to locate one with whom you WILL feel comfortable. It doesn’t mean they’re not good doctors, they’re just not OUR best doctor.

[Chelsun]

#1019743

I have recently been diagnoised with Grave’s disease. After 4 months of chronic diarreaha,lost 25 lbs. tremors, etc… my GP started running thyroid function labs on me, he initially thought I had anxiety and IBS because of the extreme stress I was under and put me on Zoloft and Ativan, which I’m still taking. Anyway, TSH count came back 0.075, so he sent me to an Endo, who sent me for an uptake scan, this came back high and they also discovered a cold area/nodule. Endo did other labs which are Anti-thyroid perioxidase 77.3 (high) and TSI 371(high), however Free t4 1.14 (normal) and free t3 3.20 (normal). Nodule has been biopsied with the following results Negative for malignant cells, specimen consists of benign folliular cells, hemosider-lade macrophage, colloid and blood. This pattern is consistent with non-neoplastic goiter with cystic dengeneration. This was done with an ultrasound which shows enlagred gland with miled inhomogeneity and dominant mass left upper lobe corresponding to the cold areas seen on scan. There are hypoechoic lesions bilaterally and the mass itself measuring 22x18x16mm.

Ok, heres the questions, my latest labs are showing my TSH as coming back up 0.35, so my endo thinks it I could be going into remission. My symptoms have becoming less, but what is the likely hood I’m really going to have a complete remission? Before these labs My endo and I talked of me having Total thyroid removal, because I do not want RAIU and he indicates the medications only work in approx. 40% of the patient. (Comments on this, please) The nodule even though FNA says benign, I’m still concern because of the follicular cells, I have read that these cells are hard to determine to be benign or malignant. Now I don’t know what I should be doing I’m very confused. I did get a second opinion, the 2nd endo recommended the RAIU, but I’m really not interested in doing that.

Can someone please give me some advice on my current situation. Should I just wait it out and see if the Grave’s is really going into remission or should I have surgery. Is the nodule actually benign and ok to leave or should I have it removed. What does the future hold for someone with Grave’s disease. :” title=”Question” />

I appreciate any advice I can get.

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