[adenure]

#1059068

I’ve been off methimazole for 2 weeks. So, my TSH after those two weeks around noon was 1.14 (normal is .35-4.00). It has slipped from 1.46 which was the day I had to stop the methimazole due to the liver problems. Two different doctors ordered the TSH on the same day, so I had it redone (along with the T3 and Free T4 and TSI) about 5 hours later. That test came back with a TSH of 0.71! How is it that it dropped that much in 5 hours? I’m confused. My T3 and free T4 are going up again as well. Again, they’re trying to differentiate Graves from postpartum thyroiditis. They’re willing to test my levels every week to see what direction TSH is going. If down, they are willing to think it’s Graves. I have surgery scheduled for June 12th if my levels continue to go down. Here’s the email from one of the endo’s…

The thyroid scan is very good at determining thyroiditis or graves except in one situation. In the recovery of a thyroiditis there can be “high” activity of the thyroid. You can think of this as all the cells were damaged by the thyroiditis event, then come back extra strong for a short period of time. If the scan is done as the cells are at the end of the recovery phase, you will see an increased activity which can look like graves, since graves also has high activity, often the gland has a slight patchy appearance (uneven uptake). Your thyroid has this type of appearance. The elevated uptake in the recovery phase is often found if the thyroid hormone levels have come back to normal or are improving, typically 6-12 weeks out from the thyroiditis event.

I also saw the recent TSH level and do not think it is a significant change. All we can say is that it is still normal. You are correct, if you have graves, the TSH will continue to drop the further you get out from stopping the methimazole. If you do not have graves, the TSH will remain in the normal range now.

I agree with your concerns, remove the thyroid if you have graves, do not remove the thyroid if you do not. Your TSI antibody was found to be positive which goes along with graves, but it can also be positive in thyroiditis. The thyroid peroxidase antibody is also associated with both.

I think monitoring your thyroid labs weekly is a reasonable idea, as time is the best way to tell exactly what you have.
I will order another tsh and free t4 for you in 1 week.

I don’t know what to think. Do you all think June 12th is a “safe date” to have my thyroid out? They don’t have anything sooner. I worry about getting out of range before then and not being able to do anything about it. I’m still waiting for instructions on prepping for surgery should I need it. Trying to stay positive.

Alexis

[adenure]

#1171920

The doctor emailed me and told me it can be lab variations/ calibrations- that makes sense.

So, one week at a time with weekly thyroid level testing with a surgery date of June 12th if my TSH continues to go lower each week. Well, it’s a plan anyway!

Alexis

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