[Anonymous]

#1020283

After 30 some odd years of being in good health, taking no medication of any kind, I found myself in a whirlwind of doctors, tests, treatments, and medication! I don’t really know when the symptoms started but over a period of time I keep checking my blood sugar, decreasing caffeine, making sure I ate right and got plenty of sleep, I finally admitted to myself I just wasn’t “right”. I did develop a goiter and high blood pressure (had always prided myself in having better BP than coworkers half my age)…the high BP finally did it. The doctor gave me a beta blocker and sent me off to the endo, the endo did blood tests and a scan and freaked, we discussed it and I decided on RAI (done about 10 hours of research on net prior to my endo visit and was sure I already had a Dx, LOL) He put me on medications and iodine drops. When the first round of medication was through the med bottle said no refills and so I threw them away and my appt wasn’t until the following month…the endo freaks, I have been doing that to docs a lot lately, said I should have taken them for a while and then tapered off…more blood tests latter…I was fine no rebound. I then fell and broke my arm and messed up my shoulder and was off work for 8 wks now I am taking ongoing physical therapy. oh, this freaked the endo but a bone scan showed it had nothing to do with GD. The TED is still a problem but it has lessened. I smoke and know I need to quit but I have tried before many times and never takes…I read a lot about using Welbutrin to help with quitting but also it says it can react with beta blockers. Any one have any impute on using Welbutrin? The only thing I am taking now is Innopran XL 1X per day, my BP is still not back to normal, but the endo is good with it. My last appt tests were TSH 0.010 (what is this?)and free T4 2.040 (down from 4.400 on 4/6/2006) should I be concerned about T3? I have gained weight 144 up from 120. But I believe a lot of that is muscle from the phy therapy. I need to work on my mid-section, getting a bit of a gut, but the endo says no exercise…what’s that about? What is he waiting for? I can’t get a real answer out of him. I have read a lot of posts and feel that my concerns are minimal in comparison. I just don’t know what to look for now, I am a believer that you must be active in your treatment, but the only way is to stay informed and insist on a role along with the doctors.

[Anonymous]

#1076577

Hi mjm,

You’d be surprised how familiar your story is — for the most part, we’ve all been very healthy individuals, and this is a *rude* awakening.

Sorry, I don’t know much about Welbutrin and its effectiveness — maybe you’ll get a response from someone who has used it. As a former smoker, I would say that *anything* you can do to successfully quit will be worth it.

The two thyroid levels you talk about work on a “seesaw” principle. Let me explain. T4 is the thyroid hormone that the thyroid pumps out into the bloodstream. Our body converts that T4 into T3 when we actually need to use it, but there should be a “constant” level of T4 in our bloodstream available (that’s why they call it “free”). Other hormones can sometimes bind to the T4 and make it unavailable for conversion, so that’s why they test only the free T4. TSH stands for Thyroid Stimulating Hormone, which comes from the pituitary gland and is a “messenger” of sorts to the thyroid. The thyroid responds to the level of TSH in the blood in order to know how much thyroid hormone to release (usually). It’s supposed to work this way: if the TSH is HIGH, it’s telling the thyroid to please release lots more T4, and if the TSH is LOW, it’s telling the thyroid to please STOP releasing so much T4. This is why they should ideally be opposite — if one is out of range and high, the other should be out of range and low. With Graves’ Disease, our feedback mechanism is messed up because the antibodies to our thyroid mimic TSH and make the thyroid believe it needs to put out more T4, but we can still count on the TSH figures to tell us what IT sees in the bloodstream.

Just so you know, it’s typical for the TSH to take a while to rise after the T4 drops, because they each measure a sort of “average” and the TSH measures a longer span of time.

The reason behind restricting your exercise is that, while you are hyperthyroid, your heart rate and blood pressure are typically high, and excess thyroid hormone can also affect the electrical impulses to the heart. That could result in erratic heart rhythms, which could result in heart failure. Exercising strenuously could aggravate or bring on something like that.

You’re so right, we must be proactive and take part in our care. Your complaints may seem minor compared to what you see here, but they’re indications that you have a way to go yet before you can say things are “right.” Graves’ should come along with a “patience gene,” because it takes a LONG time to recover. We need to understand that and look for improvements, not instant wellness.

Remember, the people here are typically those who have either just been diagnosed, or those who have an unusually difficult time getting regulated. It can look like “every” Graves’ patient is miserable, when that’s just not so.

Wishing you luck! One of the best books available on Graves’ is the one that was compiled using posts and answers from this very Board. It’s called Graves Disease: In Our Own Words, and you can find it on Amazon.

Stick around ~ we’re glad to help every step of the way.

~Ski
NGDF Assistant Online Facilitator

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