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  • Empowered
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    Hi all – I am a 36 year old woman.

    After my daughter was born 10 years ago my thyroid went hyper. At the time they thought I had Graves Disease, but an uptake test showed that my thyroid took up like no iodine. They decided it was post partum thyroiditis and that it would pass, which it did a few horrible months later. During this time they did an ultrasound which showed many nodules. They biopsied the largest one and it was fine.

    Immediately following all this my thyroid went hypo. I was on Synthroid for several years and eventually my thyroid normalized it’s levels again so they pulled me off Synthroid and I have been fine since.

    Until maybe 6-9 months ago… All of a sudden I would have these instances where I Would feel like I was choking when eating certain foods. This had only ever happened once before and that was when I originally went hyper. I went to my doctor who said I had a very diffuse thyroid and ran bloodwork and referred me to a new endocrinologist.

    Though my labs were fine (TSH .80, Thyroxine-Free 1.2, T3-Total 108) I still experience the following symptoms (ALL of these are out of the norm for me with a recent onset) – Some of them are hypo, some of which are hyper:

    Fatigue
    Sluggishness
    Increased sensitivity to cold
    Constipation
    An elevated blood cholesterol level
    Depression
    Nervousness
    Insomnia
    Breathlessness
    Trembling hands

    The new endocrinologist basically said, regardless of my symptoms and goiter and family history (an insane family history of thyroid disease from both my mother’s and father’s sides) that he basically felt this was all no big deal. He did decide to do an Uptake & Scan though to see “what the thyroid was doing”.

    My 4 hour uptake was 28%, my 24 hour was 57% though I had no cold nodules… I figured surely this shows that something is going on and at this point we should at least try some treatment, but my doctor’s secretary (he didn’t even have the decency to call me himself) called and said, since the labs are fine he doesn’t really care about the uptake and he wants to do nothing. He also brilliantly told me that all my symptoms are “functional”, i.e. I am just imagining them.

    So for anyone that’s made it through my ridiculously long post, I just want to know is this the common protocol? Labs are okay so we do nothing regardless of the scan, size, nodules and symptoms?

    I feel like I am losing my mind and being ignored by the doctor who is supposed to help me and I just don’t know what to do. Any advice would be greatly appreciated.

    Bobbi
    Participant
    Post count: 1324

    Many of the symptoms that you included are more symptoms of hypO, than hypER. And you are, according to blood work and the interpretation by the doctor, neither hypo, nor hyper.

    Uptake does not define hyperthyroidism. Blood tests do. People who are hyperthyroid with high uptakes are not sicker than people who are hyperthyroid with low uptakes. All the uptake test provides is an indication of whether or not RAI is appropriate; and the scan portion of the test shows whether there is overall thyroid activity (diffuse) or whether the problem might be related to nodules.

    None of this means that the symptoms that you are suffering are all in your head. There can be lots of conditions that will create any number of the same symptoms that we get with thyroid malfunction. What you need to do, since you DO feel lousy, is now get your doctor to explore other possible causes of your problem.

    snelsen
    Participant
    Post count: 1909

    Gosh, I sure am sorry that you feel this lousy. No apologies ever needed for the length of your post. As you said, the list of symptoms represent hyPO and hyPER symptoms. And, as you also said, your labs are within normal range. Just as an additional comment, all labs differ with their range, and they not listed in your post. But as you also stated, the endo has told you, and you know they are in a normal range. In your situation, it would be really hard for an endo to resume thyroid supplement, given your labs.

    But the person and your symptoms count, too. And unfortunately, many of them, without changing thyroid labs, can represent many things. So this IS a big deal for you, for you don’t feel well. **I think it super good that you have the baseline labs.
    I suggest that you ask your primary care doc,t he one who referred you, to repeat the labs in one month to see if there is a trend. If all your symptoms get worse, try to differentiate them in hyper and hypo. Take your pulse and record it.
    I guess, in your situation, I’d make a plan for further action, and think about everything listed below. You sound very well informed about “our” disease called Graves’.
    1. Begin to consider that all of this may not be thyroid related, so if you have not had a good physical, that is probably a good idea. I say this, for I would not want some other diagnosis to be missed, simply in your best interest in wanting to feel well again, get back to being you again.
    2. Think about other stuff going on in your life.
    3. You may know this, but an elevated cholesterol can be associated with being hyPO. Having said that, so does diet, exercise and weight.
    4. I suggest you make an appointment with another end. Will your GP be willing to make the referral, if you need to have one. If you can do this, I would make it AFTER you have your second set of labs. It usually takes that long to get an appointment with an endo,anyway.
    5. Although the endo did a good job with tests and labs, it seems he falls down in the area of looking at you as a person who has distressing symptoms, many of which do represent hypo/hyper Graves’. If you feel he has been dismissive, and it does seem that you are not interested in going back to him, I really encourage you to find another endo or have your GP work along with you to gather information.

    As Bobbi said, many symptoms on your list sound hyPO, and you do know from your own experience with hypo, that you felt bette when you began your Synthroid. But it could be something else, as Bobbi suggested. So you are in the position of seeing a good doc who will evaluate you, do a differential diagnosis of what to rule in, to rule out, and to consider, the reason you feel so crappy all of a sudden.
    It is my impression, as a layperson and a Graves’ patient, that you do sound hypo. If your heart rate is normal, rather than rapid, your BP is fine, that speaks for hypo also. But my whole message is that you need a compassionate doctor
    who will work with you to get you healthy again.
    Shirley

    adenure
    Participant
    Post count: 491

    I don’t have too much to suggest that Shirley hasn’t mentioned. A complete physical and labs sounds like a good idea. I know the frustration of being told you just have an anxiety issue. The first doctor I saw about all of this sent me home with a paper bag to breathe into and told me I probably have an anxiety/ panic disorder :/ Turns out I do have hyperthyroidism (based on bloodwork)- now we’re trying to figure out between Graves & post partum thyroiditis (I am fortunate to have a great endo)… my labs show antibodies, but I’m awaiting a scan referral… anyway… it is a long process, and I hear you on the distressing symptoms- it IS scary, and no it’s not in our heads!!! Stay strong and positive and maybe start from square 1 with a complete physical and labs. Keep us posted.

    Alexis

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