[geostyv]

#1059266

Hi All,

I am a long time reader, first time poster. I am a late 30s white male and I have been diagnosed with Graves’ and Hashimoto’s because I guess I am a born overachiever! I have been reading these boards and have found them very helpful and supportive. I have read the literature from thyroidguides.net that was posted in the announcements and that was the most helpful thing I think I’ve read on the internet. THANK YOU!! for posting that (I think it was Kimberly).

I started having heart palpitations last March and my GP ran labs and, sure enough, TSH <.001 (nonexistent). He than ran TPO and TSI, as well as uptake and sure enough graves antibodies 3x normal and uptake 37%. I have been on metroprolol since April, which has helped. I have been asymptomatic since late May (a palpitation here or there but nothing like before). In July my endo ran Free T4 and a new TSH. Free T4 came back normal and TSH was up to .02, still low. So he said I am mildly hyperthyroid due to Graves and recommended RAI. My symptoms are no doubt mitigated by the beta-blocker but I feel good so it is hard to take the drastic step of RAI. I have opted for methimazole for now with new levels to be taken in about six weeks. A couple of questions for anyone who is willing to share their experience: 1. He put me on 10 mg in the morning and 5 mg at night. Is that a low, medium, or high dosage? 2. I understanding that the less intense your symptoms the more likely you are to into remission. True/False/Not Sure? 3. I understand being male makes you less likely to go into remission. True/False/Not Sure? 4. I’ve looked and I can’t seem to find anything on whether there is a difference in disease course, presentation, effects, etc between men and women. Any ideas? Any opinions: since I have a low TSH but normal FreeT4 I guess that makes me subclinical hyperthyroid brought on by Graves. Am I being prudent by resisting RAI for now. Thanks for all the hard work invested in this forum and all the posts. It has helped and made me feel less alone. Good luck to all!

[Kimberly]

#1173739

Hello and welcome to the forum. The guidance document that you pulled from thyroidguidelines.net actually has some great info on subclinical hyperthyroidism. The guidance notes that treatment is recommended for patients who are experiencing hyperthyroid symptoms. (See page 25 of the PDF document / page 617 of the journal article).

Statistically, the patients with the highest likelihood of remission are female, have low antibody levels, small goiters, and mild disease. These are just statistics, though – we have a moderator on this board (James) who has been in remission for 9+ years.

In terms of dosing, every patient is different depending on their circumstances, but I started on a dose of 15 mg/day of methimazole, which was cut in half after a few weeks.

There isn’t a ton of info out there that is specific to men. However, I’ve heard that men who get thyroid eye disease tend to have a higher risk of more severe complications. Also, a presenter at last year’s conference in Boston noted that men tend to have a higher failure rate for RAI than women do.

Hope this helps!

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