[DianneW]

#1072824

I’m not sure I understand either, if it’s true that your daughter’s thyroid hormone levels are all normal, so I think the first question you should ask your daughter’s endocrinologist is whether her thyroid hormone levels are indeed normal. Graves’ Disease generally is diagnosed partly from blood tests that reveal an excess of thyroid hormones T4 and T3, with a corresponding low reading of the pituitary hormone TSH (thyroid stimulating hormone). The TSH has an inverse relationship to the amount of circulating thyroid hormone. When the patient has too little, the TSH rises in order to stimulate the thyroid gland to produce more thyroid hormone. When there is too much, the hypothalamus senses this and orders the pituitary to shut down its production of TSH so that the thyroid won’t produce as much thyroid hormone.

In Graves’ Disease the immune system produces antibodies that act like TSH and cause the thyroid to produce too much hormone, bypassing the normal hypothalamus-pituitary-thyroid axis, so the TSH production shuts down, becomming extremely low. At diagnosis most Graves’ Disease patients have a TSH that is nearly undetectable, with Free T3 and Free T4 readings that are significantly above the normal range. Often the thyroid gland is enlarged (called a goiter).

If the thyroid hormones are only slightly elevated, the patient might not have too many symptoms. Early symptoms might include an elevated heart rate (especially with exercise), increased appetite, excitability, trouble sleeping, irritability, warm moist skin, weight loss, etc.

Sometimes Graves’ Disease (with normal thyroid levels) on the basis of Thyroid Eye Disease. Could this be the case for your daughter?

The bottom line is that the reasons for your daughter’s diagnosis will have to be explained by a doctor who has all of her test results and understands the rationale behind the diagnosis. From the information you’ve given it’s impossible to say. I know it’s difficult to wait until you can get in to see the endocrinologist, but I’d advise you not to worry too much yet. If she does have Graves’ Disease it is quite treatable, and to further address what might be your fears as a parent, that diagnosis would not affect her ability to have children or significantly affect her lifespan once successfully treated.

I’m not sure how much information you already know about Graves’ Disease or I would be happy to give you more information. There are a number of basic books on autoimmune thyroid disease that you can probably find at your local library; among them, "Your Thyroid, a Home Reference", "A Thyroid Sourcebook", and more specifically about GD, "Graves’ Disease: In Our Own Words" taken from this Bulletin Board.

While you’re waiting for your daughter’s appointment with the endocrinologist I suggest you request a copy of her lab tests, specifically those containing her thyroid levels (and make it a habit to do this whenever her blood is taken). This way you will always know more than just that her levels are "normal" or "not normal". Of course the doctor is always the best source of information regarding the test results, but doctors were not all created equally, and sometimes you’ll want more than one opinion, especially as you begin to learn which doctors you have more faith in.

I hope this is of some help to you.

Best wishes,

[hyperm]

#1072825

HI there,

It is indeed baffling however perhaps there has been some form of test which has indicated an autoimmune disease present? mY friend has had half her thyroid removed because she had 3 large cysts on her thyroid however has no thyroidism and has been told that she needs no medication or follow up etc.. which baffled me really too.?

I would ask the endo to explain – perhaps there has been antibodies in her blood etc even though her levels are fine but it is something which could possible flare up in the future?

Sorry not much help.

M x

[swillis]

#1019604

Hello,

I am a father of a 16 year old daughter who had oral surgery last week. On a follow up visit to the surgeon he notice her thyroid was enlarged which put us into action. Our physician sent her in for blood work and a scan and were able to rule out cancer last Friday. However other tests were still pending. Today I received a phone call from our physician who told us blood tests revealed she has Graves Disease and that we should see an endo. The physician told me that it is a bit odd because my daughter’s hormone levels are all normal. My daughter has not displayed any signs and she is feeling fine (in fact she is never sick). She is very athletic, eats well and maintains her weight, strength etc. Eight months ago a regular physical did not reveal any problems. We are trying to make an appt. with an endo but I know so little about Graves and do not know what questions to ask etc. Of course my stomach is in knots as is my wife’s. What questions should I be asking? Where should I be going to understand?
Thanks in advance
S

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