[LillyL]

#1060432

TSH
Abnormal
My results 0.06
Normal Range 0.27-4.2

T4 Free
My results 15.9
Normal Range 10.5-20.0

T3 Free
My results 5.5
Normal Range 3.5- 6.5

I am 54 and have was diagnosed with Graves about 3.5 years ago.taking 5 MG Tapazole 5 days per week and 7.5 MG 2 days per week.
do you think I am in remission?
I can not lose weight and I am so frustrated. I have too many symptoms to list the worst at this time may be foot pain. I am sleeping with a sleeping aid.
Will I ever get off the Tapazole? It has been about 3.5 years?
Is it damaging me? I really hope I can get off the Tapazole and lose some weight and live a normal life.
What are your thoughts from your experiences?
Thank you for your help. I am just so frustrated.
Lilly

[snelsen]

#1182567

Hi Lilly,
I know that you, like many of us, have been dealing with this for a while.
You seem familiar with your labs, and the TSH is suppressed, indicating that you may have too much thyroid hormone, but as you can see, your other labs are within range.

I took a look at your prior posts and it appears that over time, you have chosen to manage Graves’ with ATD, not RAI or surgery.

Regarding weight, it seems to be an ongoing issue for women. In other posts, Kimberly has had excellent advice in that area. Generally, as you already know, portion control and exercise and activity are the “answers.”
Clinically when someone is hyPO they are inclined to gain weight, be sluggish, etc. And with hypERthyroidism, generally people can lose some weight, but it is not a good weight loss, for it is frequently muscle, and hyperthyroidism is not a healthy place to be.

As I recall, you have several autoimmune issues going on. Maybe a good idea to make an objective and subject list of stuff going on, and see a good internist. Or perhaps an orthopedic surgeon about your foot.

Regarding sleep, that is another universal problem. When you say sleep aids, I am not sure if you are referring to meds, or to devices for sleep apnea.
Sometimes people can have sleep apnea and not know it.

Regarding remission, I guess it is defined by feeling totally fine, having labs within range, and moving on with life with no thyroid issues. Kimberly can speak to this, for I don’t have any idea of the incidence of remission. My guess is not much. I continue to subscribe to the fact that once we have Graves’, we always have Graves’. And even with a defined remission, it can and may recur again.

Sorry you are having such a hard time. I have gained a few pounds for the first time in my life, and it is humbling and frustrating. Especially in my belly. So i am doing the portion stuff and the walking regimen. Harder for you if your foot hurts, so I encourage you to address that soon.

Not sure how recent your labs are, but perhaps you should check with the endo or another doc on how to proceed with your meds. Or perhaps consider the other treatments other than ATD’s.

Shirley

[connypie]

#1182568

hi guys,a question please.i know that different labs have different ranges.because mine showed t4=12.8 as High.can there be such a wide difference in ranges?and my labs were shown as t4 not free t4.is it the same or not? puzzled.

[Kimberly]

#1182569

@LillyL – Shirley gave you some good “food for thought”. The best predictor of someone who will go into a lasting remission is antibody testing (TSI and/or TRAb). Patients with high antibody levels will likely relapse if the medications are removed.

The most common stats I’ve heard on remission on Anti-Thyroid Drugs is 30-50%. There was a recent study out of Sweden that put remission rates a little higher, around 58%:

(Note on links: if you click directly on the following link, you will need to use your browser’s “back” button to return to the boards after viewing, or you will have to log back in to the forum. As an alternative, you can right-click the link and open it in a new tab or new window).

http://www.thyroid.org/patient-thyroid-information/ct-for-patients/vol-7-issue-5/vol-7-issue-5-p-3/

This study also found that large goiters and being a current smoker reduced the chances for remission.

We’ve heard at several recent patient education events that being on anti-thyroid drugs long-term is a viable option, as long as there are no side effects. (And the good news is that for Methimazole/Tapazole, side effects most commonly occur during the first 90 days of therapy; that’s not the case with PTU, though). However, pursuing a “definitive” therapy (RAI or surgery) is certainly an option as well.

[Kimberly]

#1182570

@conniepie – Different labs can use different testing materials and techniques, so it’s definitely important to use your own lab’s range when interpreting your results.

Free T4 measures the amount of T4 in the body that is not bound up by proteins, and therefore available for the body to use. The latest medical guidance prefers Free T4 testing over Total T4.

Hope this helps!

[stargazer]

#1182571

I am a 68 yr. old female who had RIA 12 yrs. ago. I have recently been having issues with going Hyper again and I have had to lower my dosage of Synthroid for the first time in years. Its frustrating trying to find the right dosage all over again. My question is, why is this happening to me now? I have changed my diet and its the only thing that I can think of that would have a possible impact on my levels. 9 months ago I came down with a systemic yeast infection (candida) because of all the high doses of antibiotics and steroids I have taken over the years..most of that due to my Graves disease and thyroid eye disease. For the last 9 months I have gone gluten free, dairy free, soy free, yeast free, sugar free just to name a few of the things I have given up in order to control this yeast infection. I use a lot of coconut and olive oils and I now eat a lot of spinach, kale, and other green and cruciferous veggies daily as well as lots of almonds, macadamia nuts,pecans and walnuts. Could a large amount of any of these food items have anything to do with my thyroid levels? I also have read that sometimes candida and hyperthyroidism can go hand in hand…could that be my problem? The one good thing that has happened however is that all of my lab tests have been coming back showing significant improvement…such as cholesterol, insulin levels, triglycerides, etc have all been lowered to the point that I am considered super healthy. Now I just have to get my thyroid levels regulated. Thank you for any info you can give me in this regard. Stargazer

[Kimberly]

#1182572

Hello – I don’t have much knowledge about candida, but I do know that it’s *not* unusual for the dose of thyroid hormone replacement to need tweaking over the patient’s lifetime. It’s actually good that you are getting levels checked periodically. One concern is that as patients age, the need for thyroid hormone may decrease – and if the meds aren’t reduced accordingly, this can increase the risk of hip fractures.

I know that it’s frustrating to have to go through this rollercoaster process *again* to find the “sweet spot” of meds – but it sounds like all of your other health indicators are fabulous!

[bigad]

#1182573

Kimberly wrote:

The most common stats I’ve heard on remission on Anti-Thyroid Drugs is 30-50%. There was a recent study out of Sweden that put remission rates a little higher, around 58%:

This study also found that large goiters and being a current smoker reduced the chances for remission.

Do you think the US has lower remission rates due to a short term use of atds (6 – 18 months) vs. longer term use?

@Kim- have you heard of any studies that reported reduced chances of remission after you show signs of TED?

[Kimberly]

#1182574

bigad wrote:

Do you think the US has lower remission rates due to a short term use of atds (6 – 18 months) vs. longer term use?

That could certainly be the case, although I believe that this review of prior studies out of the UK influenced the ATA/AACE recommendation of 12-18 months of therapy:

(Note on links: if you click directly on the following link, you will need to use your browser’s “back” button to return to the boards after viewing, or you will have to log back in to the forum. As an alternative, you can right-click the link and open it in a new tab or new window).

http://www.eje.org/content/153/4/489.full

It looks like they only looked at one study that went much past 24 months (42 months) on ATD therapy, and that one resulted in a slight benefit in terms of reduced chance of relapse.

As for chances of remission and TED, many (not all) ophthalmologists believe that high antibody levels are specifically correlated with active TED. And we also know that high antibody levels reduce chances of remission. But I haven’t seen any studies that looked specifically at TED and chances of remission.

[bigad]

#1182575

Good points- thanks Kim!

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