[Tkiv]

#1060503

How do you know if this is your situation?

Hi everyone, I am new and I am so grateful to AZGravesGuy’s thread and wish him all the luck in the world. It gives hope when you can see the success grow from the pain. I highly suggest new people take the time to read his thread.

There was so much information there and it made me wonder…how do you know if you are subclinical hyperthyroid.

I was diagnosed with Graves at age 51 – 11/11/2010.
I had RAI -3/25/2011

I have to say it’s been a road that hasn’t gotten better yet and most recently my anxiety, shoulder pain and throbbing leg bone pain caused me to have my levels checked 7 weeks ago. They were –
TSH – 0.011 (0.45-4.5)
FT4. – 2.02. (0.82 -1.77)
FT3 – 3.7. (2.00-4.4)

My doctor adjusted my synthroid dose from 88mcg to 75 mcg.
The first two weeks I felt terrible. I had a terrible headache every day, with nausea. My digestion felt like it just shut down. But, on the good side, after 6 days the anxiety coiled in my chest went away. So did the leg bone pain. But after almost 7 weeks…I still have a lot of symptoms and don’t feel well.

I see my doctor next week. So many of my symptoms are emotional and never easy for me to discuss. I am taking information from your site to show her. It will help me talk..

My levels are so close to normal I just wish I could feel better. My TSH is the only one that’s off. I’m afraid to have another dose change since the last one put me out of commission for a couple weeks.

Thanks for listening and thanks to AZGravesGuy’s thread I don’t feel so alone.

Terry

[WWWI2]

#1182989

Hi Terry,

Your numbers before the Synthroid dose do seem to put you into hyperactive territory based on your numbers. But the cause may have been simply too high a dose.

I’m not entirely sure what you are asking specifically with regards to subclinical HyperT. Is it because of the symptoms? or because your numbers where hyper?

Since you have Graves, and even after RAI you still have Graves. One hope with RAI is that once the thyroid has been radiated the antibodies calm down. But the antibodies, if they are still highly active, can be the source of some of the distress you are experiencing.

Also, the fact that some of the symptoms went away with the lowered dose but some didn’t might suggest that you may want to investigate alternatives in medication like natural discected thyroid with your doctor. NDT offers both T3 and T4 hormones, where as Synthroid is only T4. I’ve read that somewhere around 25 percent of people seem to respond better to NDT. But be aware that not all endos want to prescribe it for various reasons and it’s a bit of a political hot potate for some, so your doc may or may not be amiable to it. But it might be worth your time to do some reaserach.

WWWI

[Tkiv]

#1182990

Hi WWWl,

Thank you very much for your reply. It has been difficult since my numbers are relatively close to normal but I still don’t feel well. Mostly warm all the time very fatigued weepier than normal and terribly anxious. I’ve been trying to figure out why I still feel like I do. I guess I really don’t understand how the Graves antibodies can affect me. After RAI I just expected to be fine, once I started synthroid. With such a small adjustment in my synthroid dose 7 weeks ago and still feeling poorly I was thinking maybe there was something else going on (that’s why I was thinking maybe subclinical hyperthyroid).

When I see my doctor (she is not an endo but I do like her) I’m sure she will want to do a recheck, but I will also ask her about NDT. Is there any other testing you would recommend?

Thank you again WWWl, I am so appreciative of all the information and support available on this site.

Terry

[Kimberly]

#1182991

Hello – The difference between “subclinical” and “overt” hyperthyroidism depends on your labs. In both cases, TSH is below normal. However in subclinical hyperthyroidism, the T3/T4 test is within the normal range. With “overt” hyperthyroidism either T3 or T4 (or both) are too high.

It would definitely be helpful to document a complete list of symptoms before your next appointment and try to figure out if they are more on the hyper vs. hypo side. Although there can be some overlap, unexplained anxiety is more commonly associated with hyperthyroidism.

We tend to hear mixed reviews of desiccated products like Armour – some patients believe that they improved quality of life, while others found that it made their hyper symptoms worse. I’ve also heard a few stories from patients whose antibody levels increased while on desiccated products, although I haven’t seen any specific studies on this.

Take care – and keep us posted!

[Tkiv]

#1182992

Thank you Kimberly, I will do that.

One thing I always forget to mention is my digestion. I have a very difficult time with certain foods. But it seems to change on a regular basis. Some days kefir will be fine, and other days I’m in pain. Same is true for certain carbs and fats. I have always wondered if my thyroid affects this. When I change doses, I definitely notice it. I drink a lot of water to help with the discomfort and pain, but I remember AZGravesGuy recommended an autoimmune diet book. Do Graves patients need to follow a more controlled diet.

Thanks Kimberly,

Terry

[Kimberly]

#1182993

Hello – We’ve heard from patients who have used various dietary approaches (vegan, gluten-free, paleo, anti-inflammatory, low iodine, eliminating food sensitivities), but there just isn’t a lot of good research to determine if one of these approaches is better than the others for Graves’. In general, though, it’s important to follow the dosing instructions with replacement hormone and avoiding soy/calcium/iron supplements within 4 hours of taking the meds. Many patients also choose to minimize their intake of processed foods with unpronounceable ingredients and instead focus on eating whole, unprocessed foods.

Some believe that goitrogens (broccoli, Brussels sprouts, cabbage, cauliflower, etc.) can make hypothyroidism worse…although these foods would have to be consumed in fairly large quantities in a raw state to have an impact.

It might be worth going back to your primary care doc with a list of your GI symptoms, just to rule out whether an underlying issue might be causing (or at least contributing to) this.

Take care!

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