[Elaine76]

#1060058

I have been visiting this site for many months since my diagnosis last April. I have suspected hypothyroidism for years, but I was dealing with a doctor who only ever tested by TSH (which was 11 in 2008) and she told me it was due to my birth control pill. I wish I would have listened to my gut then and ran! FYI – she is no longer my physician.
The hyper symptoms came immediately after I delivered my second son in January of 2012. To make a long story short, I was diagnosed with graves’ and hashimoto’s disease in April of 2012. My endo, who I really liked, is leaving her practice to focus on diabetes at a local diabetic clinic. I was given my medical records to take to a new endo and as was looking through her notes I noticed a few things that caught my attention. On one visit in May 2012, she states that my graves’ antibodies came back negative, but hashi’s antibodies are positive. Another visit in July 2012 she states that both graves’ and hashi’s antibodies are positive. My antibody labs were drawn in April of 2012 and are as follows:

TSH – .01 (0.35-5.50) Flagged as low
Free T4 – 3.23 (0.80-1.80) Flagged as high
T3 Total – 227 (60-181 Flagged as high
TPO – 75 (0-35) Flagged as high
Anti-thyroglobulin Antibody – <20 (0-40) Not flagged
TSI – <1.0 (<=1.3) Not flagged
TRab – <1.00 (0.99-1.75) Not flagged

My nuclear scan results from last year are 4.7% at 4 hours and 12% at 24 hours. I do not have the ranges for the scan.

So does it look like I acutally have graves’ disease? Just when I thought I was starting to understand this disease, I feel more confused than ever!!

Any thoughts anyone would like to share would be much appreciated, I may not be able to get into see the new endo until December!!

Latest labs from 6/10/2013
TSH 1.86 (.35-4.01) the lab recently changed their ranges
Total T4 – .78 (.61-1.37)

Thank you,
Elaine

[Kimberly]

#1180023

Hello and welcome! We are fellow patients here, not docs, so we aren’t allowed to speculate on a medical diagnosis. Graves’ is the most common cause of hyperthyroidism, but there can be other causes as well, such as thyroiditis or overactive thyroid nodules.

Antibody tests are highly accurate, but not 100%. And you really need the ranges for the uptake test in order for that information to be useful. There should be some additional info accompanying the test with the ranges and notes from the doc who did the interpretation.

Hopefully, you have found a new primary care doc. Are you currently receiving some sort of treatment? I would recommend having a doctor keep a close eye on your levels until you can get in to see the endo in December. You seem to be swinging from one extreme to another – and you definitely don’t want to take a chance of going hypO if you don’t take any action until the end of the year.

If your general practitioner calls another office directly, that can sometimes help cut through the waiting process. You can also ask to be placed on a cancellation list if your schedule is somewhat flexible. If you’d like to look for other endos in your area, you can check out the “Looking for a Doctor?” thread in the announcements section of the forum.

Take care – and please check back to let us know how you are doing!

[Elaine76]

#1180025

Thank you for your response Kimberly. I will find out what the ranges for the scan are. I did find a wonderful MD in 2009 and have been with him ever since, he is going to be following me until I get in to see the new endo. I was initially started on 50mg of PTU twice a day and 20mg of propranolol three times a day. Two months ago, she lowered my dose of PTU to 25mg twice a day and 20mg of propranolol twice a day. I have been feeling pretty good, but do have days where I am more tired than others.

The final report of my scan reads:
A nuclear scintigraphic I-123 uptake and scan was performed as requested. The patient was administered 186 microcuries of I-123 as an oral uptake. The 4-hour and 24-hour uptakes were low at 4.7% and 12.0%. This is considered to be compatible with decreased uptake suggesting possible supression as a result of hyperthyroidism per history. Close correlation with the patient’s thyroid blood chemistry would be suggested.

The thyroid scan was performed. Images were obtained in the AP as well as the RAO and LAO projections. The right and left lobes appear to be symmetric. The thyroid isthmus is identified. There is heterogeneous activity seen in the right as well as the left lobes. No hot or cold nodules are identified.
Impression:
Decreased uptake at 4 and 24 hours suggesting glandular suppressiion probably a result of the patients hyperthyroid state.
Close correlation with the patient’s thyroid blood chemistry would be suggeted.
Normal scan as demonstrated.
No substernal extension is identified.

I will take a peek at the looking for a doctor thread – thanks again Kimberly! I will post the ranges for the scan as soon as I get them as well as my ultrasound results.

God Bless!

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