[WendySue]

#1058886

Greetings fellow Graves Warriors!

I was dx with Graves back in May 2011, taking Tapazole, various amounts every 6 weeks depending on lab results.Started at 30mg with 50mg lopressor, Most recently was taking 10mg, just got bumped up to 15mg again because TSH dropped was .07, potassium was low, 2.9, chloride was low 94, resting BP high as is my resting HR. Doc changed BP med to Spironolactone-HCTZ 25mg, now also take potassium 20meq and Losartan Potassium 50mg. I had blood work done a week ago, I don’t have the numbers, but the receptionist said a number was high which indicated I had to start the Losartan Potassium for my high blood pressure in addition to the Spironolacone-HCTZ and potassium, need to get blood work redone in 2 weeks.

Had anyone else experienced anything similar with Graves?

At my last appointment, my endo said he was not optimistic about my chances of going into remission and wants me to consider Radioactive Iodine or surgery.

I prefer the ATD’s at the moment, even though I seem to be on a constant roller coaster ride, bouncing from Hyper to Hypo and back again.

I had symptoms for over a year prior to my dx, weight gain, adema in ankles, hands, tingling in fingers, tremors, shortness of breath walking up stairs, insomnia, muscle loss, hair was falling out, short term memory issues.

Currently, still have weight gain, it shifts I can gain 3-5 pounds in 3 days and lose it, very tired, had muscle and joint pain. Now that potassium number is coming up, the muscle and joint pain have diminished. Still having high BP, high HR. Just started the new meds.

Thoughts, comments and advice most welcome. Thanks for your time & support.

[1969mets1986]

#1170680

See a cardiologist, stat — if your heart rate stays like that, you can run into other cardiac problems.

I presented with a very high heart rate — when I got to the hospital (where they eventually dx’ed my Graves) they gave me a med to slow my heart down. I don’t know if they can give that to a patient routinely or only give it during a stat situation.

[Kimberly]

#1170681

Hello – Just a quick comment that it’s really important during the early stages of Graves’ treatment to make dosing and treatment decisions based on free T4 and T3 and *not* TSH. TSH can remain suppressed for quite some time in Graves’ patients, so using this as a benchmark early in the dosing process can end up sending patients into hypO territory. The latest guidance from the American Association of Clinical Endocrinologists and the American Thyroid Association notes that: “Serum TSH may remain suppressed for several months after starting therapy and is therefore not a good parameter to monitor therapy early in the course.”

It’s helpful to get hard copies of your labs, if you aren’t already doing this, to see where your Free T4 and T3 are right now. High blood pressure is associated with hyperthyroidism, so it would be interesting to see if you can see a correlation between your bp and your thyroid hormone levels.

Take care!

[WendySue]

#1170682

Good morning and thank you both for your replies to my post.

My most recent T3 uptake: 29, T4:9.4, Free T4: 2.7 with TSH .07, six weeks prior to this my numbers were T3 uptake:30, T4: 7.6 and Free T4: 2.3 with a TSH .05.

I was on 10mg of tapazole, now 15mg. I am most concerned though about the recent number swings in my potassium to below normal, chloride to below normal with calcium and renin in the high. From what I have been able to piece together online, hyperthyroidism can lead to RTA.

Has anyone else experienced this?

I am concerned about my kidneys, does anyone know if having my thryoid removed would resolve this matter or is it one of those things that happens because my body is more prone to it because of Graves, like those who develop TED?

Thanks for your thoughts, advice and opinions.

[Kimberly]

#1170683

Hello – I do know that hyperthyroidism and RTA can in rare cases occur together, but I have not had contact with any other patients who have experienced this. These would be great questions for your doctor.

As for the labs, make sure that you are looking at the “normal” ranges and comparing your own results to these ranges. Every lab uses slightly different ranges, so it’s important to get a hard copy of the lab results. The range should appear next to your actual results, for example:

T4 Free 1.2 (0.8 – 1.7 ng/dL)

Hope this helps!

[snelsen]

#1170684

Are you referring to renal tubular acidosis? (RTA)

[WendySue]

#1170685

Thanks for the replies, I am looking at the lab results, the last test the lab flagged potassium low, chloride low, calcium high and plasma renin high, TSH low.

Since I began this journey, I have never had this many numbers in the abnormal zone, my BP was normal to low and suddenly it is high.

I contacted my Endo and GP to ask what is going on, and flat out asked if I was experiencing RTA renal tubular acidosis. The response I got from the Endo office was that the doctor said no, if I wished to move my appointment up from April to discuss it, I could. I said no, I would keep my appointment.

I am just concerned about this and am trying to my best through education, diet and exercise to get my numbers in balance.

Thanks for the responses.

[snelsen]

#1170686

Kimberly-were YOU referring to renal tubular acidosis? (RTA) in your post.
I could not find the initial reference to it in prior posts, and still have no idea if this is the topic. I know about it only because I worked at a nephrology clinic at one time. Just wondering.
Shirley

[WendySue]

#1170687

Shirley, I am asking if anyone has experienced numbers such as this while hyPER and is it possible to develop Renal Tubular Acidosis if you have dx of Graves Disease.

From what I read online a renin test is used, I thought my numbers and symptoms might match this, and do not know if it is temporary, will go away when I am not hyPER.

Thanks for any and all insight.

[snelsen]

#1170688

I wanted to be sure that I had the right acronym with the right syndrome, that’s all.
Thanks, Kimberly

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