[applegreen72]

#1059593

I went to my primary doctor complaining about weight loss and after all the blood test, he told me i have hyperthyroidism. Was sent to do a thyroid update test and he just says my hyper is due to graves disease. I didn’t have the full report but my blood work is as follows:

3rd gen tsh: 0.004 (range: 0.350-5.500)
3rd gen tsh reflex: 0.003 (0.350-5.500)
T4 free: 1.65 (range: 0.80-1.80)
T3 free: 434.2 (range: 230.0-420.0)
thyroid peroxidase ab: 2068.4 (range: 1.0-60.0)

my pcp is going to prescribe 10mg methimazole per day and will due for a blood work in 5 weeks time. i have not started on the medication yet.

should i go to endo for another review?

thanks and desperate for some advise please.

note: i do not have symptoms of difficulty sleeping or hand tremor. but have high blood pressure and rapid heart rate.

[Kimberly]

#1176022

Hello and welcome!

Keep in mind that we are fellow patients here, not docs, so we are not allowed to interpret labs or give medical advice.

Some general practitioners are comfortable treating Graves’ patients, but for *most* new cases, patients do end up seeing an endocrinologist at least for an initial evaluation and subsequent followup.

Your general practitioner should be able to give you a referral, or you can check out the “Looking for a Doctor?” thread in the announcements section of the forum.

If you are looking for a quicker appointment, either having your GP call the endo’s office directly or asking to be placed on the endo’s cancellation list can sometimes help you cut through the long wait times.

Take care — and please keep us posted!

[snelsen]

#1176023

Since you have elevated BP now, and a rapid heart rate, I’d call the doc who prescribed the ATD, report this info. Since it is the weekend, then one day before a holiday, I am sure Monday will be crazy at that office. I think the important thing for you right now is to record those two vitals. If your heart rate is above 120 resting, or hovering around that range, it is worth a trip to an urgent care center. That is not a safe heart rate, and probably should be treated. He/she may want to start you on a beta blocker. **How high is your BP?
As Kimberly said, and i am repeating, there are not doctors on the forum, just wonderful facilitators and us regular folks who have been through this darn disease.
I think the suggestion to see an endocrinologist is a good one, but that takes a long time, and the heart rate and BP need attention, or at least reported.

I also suggest if you endo has suggested beginning your ATD, that you not hold off on starting it (: Cause you do have a diagnosis of hyperthyroidism by your doctor.
Shirley

[vanillasky]

#1176024

Hi and welcome!

Did they test your TSI? I would be interested in knowing your range of antibodies.

[adenure]

#1176025

Hi,

I agree with Shirley. I would start the methimazole as soon as you can. You have been diagnosed with hyperthyroidism and your labs do reflect that. The methimazole will get you going in the right direction and help you to start feeling better. It will definitely help your heart rate as well. When I started methimazole, my heart rate hovered around 100 and could get up to 120 walking around the house. Once I started methimazole, it went back to my normal resting, in the 60’s. I was on 5 mg.

When you have your labs drawn, ask to have a liver panel just to check your enzymes. Sometimes (rarely) methimazole and PTU can cause your liver enzymes to rise quite a bit. That happened to me and I had to stop the methimazole at my 7 week labs (I didn’t have the typical symptoms of elevated liver enzymes like sore throat or dark urine or jaundice or fever). The medicine is powerful though as my my thyroid levels were normal within that time. I had a thyroidectomy 6 weeks later (about 6 months ago) and am doing pretty well now (I’m on Synthroid).

Good luck to you.

[Bobbi]

#1176026

Hi, applegreen:

Blood tests which show elevated levels of thyroid hormone are a definitive indicator of “hyperthyroidism.” It does not matter what the cause is at this point in time; it needs to be treated. Inasmuch as your gp prescribed a medication which will interfere with the thyroid’s ability to make new hormone, taking the med, while waiting for an endo (if that is what you choose to do) is a good idea.

[applegreen72]

#1176027

Hi all
Thanks for the response.

I’ve since started on the methimazole 10mg daily since Sunday. I did not encounter any side effects at this moment but have read that the side effects could kick in after a week. I also do not feel any difference since taking this medicine. How soon will I see any effects?

@kimberly: will look for an endo while on medication and see how my blood test goes in 5 weeks time.

@snelsen: my heart rate at resting is around 80-90. my blood pressure usually hovering around 149/93 to 163/92.

@vanillasky: no TSI done. only the above stated.

@adenure: i saw my lab work order. only tsh and wbc. no liver panel which I am nervous about.

@bobbi: yes i am on medication now.

Really appreciate all your input.

[Kimberly]

#1176028

Hello – For patients who have Graves’ disease (as opposed to thyroiditis, which is a different condition that can temporarily cause hyperthyroidism), anti-thyroid drugs like methimazole start working right away to block the production of *new* thyroid hormone. However, the body will generally have to burn off its existing excess stores before you really start to see some symptom relief. This can take up to a few weeks.

An endocrinologist should be able to help you get you a definitive diagnosis of Graves’ disease vs. other issues that cause hyperthyroidism (such as thyroiditis or overactive nodules). This is generally done via antibody testing (TSI or TRAb) or via a radioactive iodine uptake/scan that gives your doctor a picture of how the thryoid gland is using iodine.

Take care!

[Author]

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