[emmtee]

#1059149

I’ve been on 60mg daily of methimizole for about 4 months now. A week ago, I had another blood test – It had been 8 weeks since my last one. This one included a metabolic panel in addition to the regular TSH/T-4/T3 tests.

I got a call from my endo’s office a couple of days later – surprising since it usually takes a week or more to get the call. The nurse said my creatinine was higher than before, and my Dr. wanted to recheck it, so I had to have another blood test today. She also said my thyroid hormones are down in the hypo range now, so I needed to reduce my methimazole to 40mg daily.

I’m relieved that the test results reflect how I’ve been feeling. I’ve been really tired lately, but I blamed that partly on the crazy sleep schedule I’ve been keeping. I’ve been staying up late, but I was making up for it by sleeping late. Even so, I’d get tired throughout the day and need to lie down. My other symptom is the weight I’ve been putting on. I started gaining slowly after Christmas and it was actually beneficial for a while, but lately it’s been coming on faster and my clothes don’t fit any more.

I’ve had other symptoms as well – maybe releated, maybe not. I have a home blood pressure monitor, and I check my BP daily when I take my meds. For a couple of months now, it’s been indicating that my heartbeat was irregular. It only happened occasionally at first, so I eliminated cafeinne from my diet and that seemed to help. Lately, though, it’s been irregular about 80-90 percent of the time. Also, I’ve been on metolprolol for years, so my pulse has always been pretty low – even when I was hyper, it was in the 60’s and 70’s. Lately, it’s been in the 40’s and 50’s. In the few days that I’ve reduced my methimazole, I’ve seen some improvement – it’s been irregular less than half the time.

I’ve also had some weird muscle pains for the last month or so. It started out as a leg cramp one day and a pinched nerve in my neck another day. Then I started to have the same kind of pains in other parts of my body – my back, my torso, my foot, my arm, etc. The pain was usually triggered by some sort of movement: reaching, stretching, or even just rolling over in bed. A couple of times, though, it came on when I was perfectly still. I have the pains about every other day.

I also have kind of a bad back (bone spur and thin disk) that has been worse lately. I had to see my GP last Monday to get a new BP medicine prescription. (My old GP moved out of state, so I’m seeing one of her associates who I’ve seen once before when my old GP was out.) I told my new GP about all of the symptoms I’ve been having and I was a little disappointed in her response. She recommended stress reduction techniques and getting more sleep, and gave me instructions for some stretching exercises for my back. It’s a good thing I had the lab order from my endo. I think my blood test results explain just about all of the symptoms I’ve been having.

I picked up a copy of the test results today. It seems that my pituitary gland has finally woken up – big time. From my first test last September to my last one in April, my TSH had stayed steady at <.006 (normal is .450 - 4.50). Now in the last 8 weeks it jumped up to 12.7. My T-4 is down to .19 (normal .82 - 1.77) and my T-3 is down to 1.2 (normal 2.0 - 4.4). Hopefully, my creatinine goes down in the new test. It’s just a bit out of range now – I even found some info online that mentioned a slightly wider normal range, and it’s still within that.

[Bobbi]

#1172530

One thing to keep in mind, emmtee, is that the range of normal for any of the items on a blood test list is determined by the specific lab involved. The way one lab does the testing–the materials used, etc.–can give it a different range of normal than that of another lab using different techniques or materials. So going online and finding a different range of normal doesn’t make your test results normal. For the lab you used, your results are abnormal.

It isn’t unusual for us to get muscle cramps at this stage of treatments. Hyper levels of thyroid hormone are bad for our muscles. And your GP’s advice was good advice. I got a lot of help from the cramping by doing gentle stretching exercises throughout the day. It helped to “work” my muscles before they were strong enough to tolerate exercise, and it alleviated some of the tightness and cramping. Just be sure that you don’t “bounce” when you stretch. Bouncing will stress the muscle, not relax it. And if you get a cramp in your calf, stretch out the muscles by extending the leg and heel.

[Darcy43]

#1172531

Muscle cramps are the WORSE. I started taking potassium also (either by drinking orange juice or eating a banana – natural way) or popping the daily recommended dose of a potassium pill, along with magnesium, once a day. Check with your doctor of course, but that, along with drinking tons of water and staying hydrated so my electrolytes stayed on point, was the only thing that gave me relief, with the stretching also. It stopped them completely. Good luck.

[mvk]

#1172532

Muscle cramps were my first symptoms and of course I didn’t put anything together till a couple months later when the heart palpitations started. I am a little over 2 months post RAI and some days I still have muscle cramps in my legs but it is not as bad and not consistent for weeks. I did stretches faithfully for weeks and it did make it feel better but it took a long time for it to go away. I’m going to have my second set of labs next week and hope they look a bit better. I am off my betablocker for the most part now. I weaned myself after my last doctor visit and have only had to take it once since. It is amazing how much more aware of my body I am. The things I used to ignore, I am much more conscious of now. I’m eating bananas as well. I have NEVER been a banana person but I’m getting better and drink lots of water. The doctor told me no Curves yet. I was disappointed but I listened. It doesn’t take much to get my heart rate up these days. I just hope that part gets better soon so I can exercise again. I also had my cholesterol done for my PCP last month and my HDL’s were down 20 points. I’m sure it is lack of vigorous exercise but for now “it is what it is”. Good luck!
mvk

[Kimberly]

#1172533

Hello – Hopefully, your next set of labs will be done fairly soon. Dosing with ATDs is part art, part science. You want the dose dropped enough that you don’t go further into hypO territory, but not so much that you bounce back hypER again.

I would definitely ask your doc how quickly she plans to re-test on this new dose. Although it takes several weeks to know whether a dose of replacement hormone is right for you, patients often respond *much* more quickly to changes in ATD dosage.

It might also be helpful to keep a symptom log during this period and call your doctor’s office ASAP if you don’t start to see some relief from the cramping, palpitations, weight gain, etc..

Take care!

[emmtee]

#1172534

Bobbi wrote:

One thing to keep in mind, emmtee, is that the range of normal for any of the items on a blood test list is determined by the specific lab involved. The way one lab does the testing–the materials used, etc.–can give it a different range of normal than that of another lab using different techniques or materials. So going online and finding a different range of normal doesn’t make your test results normal. For the lab you used, your results are abnormal.

My lab’s creatinine normal range is .57 – 1.00, and according to Medicine.net, normal levels are approximately .6 to 1.2 for men and .5 to 1.1 for women, so that’s really close to the normals for my lab – maybe just a tiny bit broader. I tested at 1.08, so I’m right there at the top of the Medicine.net normals and just beyond normal for my lab. Either way, I know it’s something that needs to be rechecked. My eGFR was 61, and the normal was <59. I've actually had slightly elevated GFR several years ago when I was taking a daily prescription anti-inflammatory. I do take a lot of Excederin for migraines and I've been taking a lot of Advil lately because of my back pain. I'm trying to stick to Tylenol (and not very often) right now to see if that helps.

Oddly enough, my sodium was a little below the normal range, and my chloride was exactly at the bottom of the normal range, so maybe I need to eat more salt?

Bobbi wrote:

It isn’t unusual for us to get muscle cramps at this stage of treatments. Hyper levels of thyroid hormone are bad for our muscles. And your GP’s advice was good advice. I got a lot of help from the cramping by doing gentle stretching exercises throughout the day. It helped to “work” my muscles before they were strong enough to tolerate exercise, and it alleviated some of the tightness and cramping. Just be sure that you don’t “bounce” when you stretch. Bouncing will stress the muscle, not relax it. And if you get a cramp in your calf, stretch out the muscles by extending the leg and heel.

That’s good to know that this is normal. I love stretching and usually do a little even before I get out of bed in the morning. Unfortunately, these stretches also tend to trigger the muscle cramps, so that makes me a little wary.

My muscles are in such sorry shape right now. I don’t think any of the weight I’ve gained is muscle. Most of it seems to be fat in my lower abdomen. That’s where I had surgery, so my insides are pretty messed up. On Saturday, I actually went swimming at my sister’s house. It was a real milestone because I had had open wounds for a year and a half and wasn’t allowed to swim or take a bath in all that time. Anyhow, it was nice to swim, but I got winded really quickly. Also, lifting my head out of the water hurt my neck.

Kimberly wrote:

Hello – Hopefully, your next set of labs will be done fairly soon. Dosing with ATDs is part art, part science. You want the dose dropped enough that you don’t go further into hypO territory, but not so much that you bounce back hypER again.

I would definitely ask your doc how quickly she plans to re-test on this new dose. Although it takes several weeks to know whether a dose of replacement hormone is right for you, patients often respond *much* more quickly to changes in ATD dosage.

It might also be helpful to keep a symptom log during this period and call your doctor’s office ASAP if you don’t start to see some relief from the cramping, palpitations, weight gain, etc..

Don’t worry – my endo is on top of it. On Monday, I picked up my test results along with the lab order for Monday’s test and a second lab order for my next test to be taken in 4 to 6 weeks. My next lab order is also for the TSH/T-4/T-3 and the Comp. Metabolic Panel.

BTW – I had the same lab tech this week that I had last week. I was chatting with her about my test results (which I was carrying with me) and she told me that she has Graves’ disease too. She had been taking 90mg of methimazole at one point, so I feel a lot better about my old 60mg dose.

That’s a good idea about keeping a log. I already keep a log of my weight (started in 2010) and my BP (started last fall.) I showed my GP my BP log with all the irregular heartbeat notations and she just said not to get hung up on the numbers – to go by how I’m feeling. So naturally, I’m now “feeling” palpitations all the time. :rolleyes: I don’t know if I was ignoring the feelings before or if I’m panicing now. The thing is – my mother was recently in the ER with atrial fibrulation, and when her pulse evened out in the 40’s, they had to keep her in the hospital a couple of days. When I have the same kind of symptoms, my doctor says not to worry about the numbers. :rolleyes:

I’m really happy with my endo, but I really feel like my GP could have done more. With the symptoms I told her about, along with the weight gain, I would have at least expected her to order a blood test, or if I had mentioned that I had the lab order from my endo, she could have asked to be copied on the results.

[Bobbi]

#1172535

Hi, emmtee:

I guess I wasn’t completely clear. I wasn’t trying to “interpret” your lab results by saying they were “abnormal.” Sometimes I have had individual lab results that were somewhat outside of the normal range, i.e. abnormal, and my doctor told me that it wasn’t really a problem. Other times, however, the results have been outside of normal, and my doctor felt it was indeed a problem, even if they are only slightly “off.” I suspect it involves the “whole person” issue. What is going on? What are the symptoms? What is being treated, and what are the side effect issues of those treatments? Just looking at lab numbers in isolation may not give an adequate picture for making an interpretation.

[Author]

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