KimberlyHello and welcome – We are fellow patients here, not doctors, so we are not allowed to recommend dosing changes or give other medical advice. However, here is some general information that will hopefully be of interest.
First, although there is some connection between the thyroid and eye issues, they can occur completely separate of each other. Some patients can actually develop eye problems *before* the thyroid goes out of whack – and others can develop eye issues long after treatment.
It’s not well understood why the TSI and TRAb antibody levels fluctuate. Some eye doctors do believe there is a connection between low antibody levels and the eye disease being in the cold/inactive phase. However, it’s just as important to look at physical symptoms. Are your eyes getting better, worse, or staying the same? When you get to the point where the eyes are no longer changing, that is an indication that you are in the inactive phase.
I have heard anecdotal stories from a couple of patients whose doctors believed that thyroidectomy would have a benefit in improving the eye disease. I just haven’t seen any good research on this, though.
Labs use different ranges for TSH, but in general, if your TSH is too high, but T3 and T4 are normal, this is referred to as “subclinical hypothyroidism”. Whether to increase your dosage of replacement hormone is a discussion that you will want to have with your doctor, considering how far out of range your labs are and how you are feeling right now.
Birth control pills will “bind” a certain amount of thyroid hormone that is circulating in the body, thus making it inactive. Therefore, if you have recently started on the birth control pills, this would be worth mentioning to your doctor.
It sounds like you are kind of stuck between two medical teams in two different countries. If there is any way that you can get them to talk to *each other*, perhaps they could agree on the best course of action for your situation.