[Ski]

#1073804

You’re on the way! You want your TSH to rise, by the way. TSH is an inverse relationship to T4/T3, so when T4/T3 is too high, TSH will be too low, and vice versa. At this point, though, and for the next couple of months probably, the T4/T3 numbers are what you want to be looking at. TSH gives you a picture of a sort of "running average," and it can take a while to jumpstart after you’ve been hyper, so for now, look at your T4/T3 to know where you stand.

ALL the symptoms of hyperthyroidism take a while to subside. Take it easy, treat yourself with kid gloves right now.

[grekson]

#1073805

Right I do want the TSH to rise.Running average is intresting concept and as the T3/T4 goes down should I expect TSh to go up?Will I be normal again sleeping without pills ever?The last blood test was 1 week ago so these levels could be even lower.I want to reach 300 for t4 as soon as possible.By the way if I don’t sleep is that detrimental to my levels?I know my heart rate will rise and I am taking metropolol but I am concerned.

[grekson]

#1019741

My TSh is still .006 or 5 but my t4 has decreased from 777 to 453 and t3 has also decreased simmilarly.Maybe in a few weeks TSh can go down as well?I still have severe insomnia though.

[Ski]

#1073806

Yes, as your T4/T3 levels come down, your TSH level should rise ~ but it may not be an exact match at first, since the TSH is released (as I mentioned) in response to a running average of your levels, and also because sometimes it is slow to respond after having been so low for a long time.

Lack of sleep will not change your thyroid hormone levels ~ it’s not the best circumstance for your body, but it has no effect on your thyroid hormone levels at all. The sleeplessness should get better as your levels improve. In the meantime, just get whatever rest you can and try not to stress over it (just makes it worse). Remember that laying in your bed and relaxing is nearly as good for your body as real sleep.

[DianneW]

#1073807

Something else to keep in mind about the TSH is that it can remain as low as it is right now even when your other thyroid hormone levels have normalized. For some people it can remain there for a few months or longer before it catches up and becomes consistent with your Free T3 and Free T4. This occurs uniquely in Graves’ Disease patients. Until a few years ago doctors believed the pituitary gland sort of "went to sleep" when we had been hyperthyroid for a long time, but this didn’t happen with everyone. More recently it was discovered that this only occurs with patients who have high levels of TBII antibodies. When the TBII antibody levels decline, the TSH levels rise.

The practical implications of this are that for Graves’ Disease patients, doctors have to monitor Free T3 and Free T4 levels rather than the TSH during the early days of treatment before the TSH is able to function normally.

So for right now, don’t worry too much that you have a low TSH. It will probably begin to respond as time goes on. Also, you will find you’ll be able to sleep normally again when your Free T3 and Free T4 get closer to normal. I know it’s difficult to keep waiting, but you’ve made it this far, and you’re getting so close! Don’t get discouraged now!

[grekson]

#1073808

I am quite encouraged now.You know I even began calculating and estimating my decreases.According to my calculations I went down by 11.6 points per day in my t4 since I started taking Methimazole.And at first it was just 1 pill 10 mg and I am tall 147 pound guy.Now the doc prescribes 2 pills so rate of decrease could accelerate.By March I should be around 230 with my t4 if the rate of decrease stays but who knows I might be even below 175 by March taking 2 pills.Its encouraging for sure

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