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Hi. I was diagnosed with Graves disease and TED back in September 09. I started on Tapazole and was allergic and then switched to PTU and seemed to be okay. My t3 and t4 levels has been in the normal range since about November 09. But my TSH is still suppressed. I just took a blood test this week and my T3 is on the low side (just below the normal range), T4 normal and TSH was at .03 (up from .02 at the last test in May). I feel pretty good for the most part and much better then I did when this started. I am having trouble losing weight, but that sounds pretty standard for the ATDs despite easting well and exercising. My eyes are still not back to normal, but they are better then they were in December and January. I was just wondering if anyone has experienced the suppressed TSH and how long it can last for.
Some patients do experience a real lag in TSH response, especially early on in treatment (believe it or not, you still qualify somewhat as a patient that is early on in the treatment process), and for that reason we usually suggest that you always have a full thyroid panel done until your levels stabilize (sounds like you’re doing that), so you and your doctor can compare your T4, T3, symptoms, and TSH, to help determine what your next course of action may be.
There are theories as to why the TSH takes longer to respond, but nothing conclusive has been proven. We DO know that TSH represents more of a "running average" of levels, in other words, it takes into account thyroid hormone levels over several WEEKS, rather than moment to moment, but there is something "special" about travelling from extreme hyperthyroidism back to normal levels that can result in what you’re experiencing, which is a longer lag in rising levels than one would expect based on the normal T4/TSH feedback loop. Some suggest the pituitary kind of "went to sleep" when it comes to thyroid hormone levels while it was producing so little TSH for so long, and it takes a while to "wake up" again, but that’s not a scientific statement. The doctor may want to test your pituitary to make sure it’s functioning properly.
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