[GLo22 July 6, 2012 at 10:46 am Post count: 13]

#1059184

Hello. Looking forward to my next/first lab test for methamizole. I’m confused about what changes we are looking for? T4 to come down and TSH to increase?

If the results are an improvement what would happen next? I hear there is a maintenance dose? I am feeling much better Thank goodness. I am very lucky.

Thanks for any info about what comes next and what to look for in my tests.

[Carito71 July 6, 2012 at 11:19 am Post count: 333]

#1172777

Hello.

That is an excellent question. I have the same question myself.

What dose of Methimazole are you on? How long have you been on it?

I’m on my 3rd week on it. I’m on a 30mg/day dose. I had labs done at the end of my 2nd week and it did not show big changes in my #s. The changes it showed are probably lab error. My TSH was still <0.006, the FT3 went from 11.5 to 10.0, the FT4 went from 3.40 to 3.79 (it increased).

From what I’ve read, the TSH will take time to increase. Hopefully the FT3 and FT4 will be lower. In your case you said you are feeling better so hopefully that will be the case. I, on the other hand, when they took the labs mentioned above, I was feeling pretty sick without improvement. I’m feeling a little bit better today and I’m seeing my new Endo next week (I had to change Endo Drs). I’m hoping that if he orders labs that my #s have hopefully gotten better.

I’m glad you are feeling better. Wish you the very best on your labs.

Good question. I’ll be back to read.

Caro

[KimberlyOnline Facilitator July 6, 2012 at 12:28 pm Post count: 4294]

#1172778

Hello – First, I would encourage you to get a hard copy of your labs, so you can see where your Free T4 and T3 are compared to the “normal” reference ranges – and keep track of them over time.

One issue to keep in mind as you start this process is that it’s important for your doc to make dosing and treatment decisions based on free T4 and T3 and *not* TSH. TSH can remain suppressed for quite some time in Graves’ patients, so using this as a benchmark early in the dosing process can end up sending patients into hypO territory. Eventually, the TSH will start to rise back into the “normal” range. The latest guidance from the American Association of Clinical Endocrinologists and the American Thyroid Association notes that: “Serum TSH may remain suppressed for several months after starting therapy and is therefore not a good parameter to monitor therapy early in the course.” As T4/T3 start falling into the “normal” range, it’s common to reduce the dose to keep the patient from becoming hypo. We’re fellow patients, not docs, so we can’t speculate on what dose reduction might be appropriate for a particular person.

The best scenario is if you can get your doctor to give you a lab slip for your *next* set of labs at each appointment. Then you can have bloodwork done in advance of your next appointment. The down side is that this does require separate trips to the lab and to the doctor’s office. However, this allows you to spend your time with the doc actually looking at your labs and being able to ask questions, rather than having to decipher a phone message after the fact as to how to adjust your dosing.

Hope this helps!

[GLo22 July 6, 2012 at 1:01 pm Post count: 13]

#1172779

Hi Carito,

Sorry your labs did not show a great improvement. I think I am also very lucky in that my disease was caught early in it’s process thanks to my recent pregnancy. My labs are pretty low compared to what you are looking at. I’m soooo sorry. I hope you feel better soon….this has been a journey for me. I’m sure for you too.

My t3 was down fifty points after one week( around 300 to 250) and my t4 down .5 (2.5 to 2)…..

Wishing you feel better soon and that both of our labs come back better:)

[Carito71 July 7, 2012 at 9:50 pm Post count: 333]

#1172780

GLo22,

I’m so glad things were caught early for you. I’ve been telling my sister to check her thyroid so that she doesn’t’ have to go through what I’m going through if she has the same condition.

The good news is that Thursday afternoon I started to feel better. Friday and today I felt the same so maybe my #s are starting to come down.

Thank you! You too!

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