[Ski]

#1063232

Hi John,

Typically, if we were hyperthyroid before we took RAI, it can take six weeks just for the body to flush out the thyroid hormone that was in your system on the day you took it, so January is not "too late" to be tested, though I completely understand your concern. To be completely frank, you may not have gone hypo by that point, so you wouldn’t want to start taking replacement hormone if you don’t need it yet. At the six week mark, you will probably begin to have some sense of the effect it has had on you, and things may change quickly after that, so do get some guidance from the doctor on how to proceed in the event you suddenly feel as if you’ve dropped too low.

It’s pretty normal to feel a little depressed ~ lots of things can play into it, and it may be the shift of chemicals in your bloodstream, but could be other things as well (just coming to grips with everything that’s going on, for instance). Some people do use anti-depressants during this time, and they can help, but they take time to build UP in your system, so it’s something you may want to discuss with your doctor to see if they believe it would be worth it for you.

There is the potential that you may feel even more hyper for a few days ~ this occurs because the thyroid cells that are destroyed will release their stored thyroid hormone all at once (we call it a "dump" of thyroid hormone). It can happen at different times for different patients, and some never experience it (I was one of those), but it’s good to be aware of the possibility. The most common timeframe I’ve heard is about 2 weeks after RAI. If you are on beta blockers, sometimes the doctor will recommend taking a little more of the beta blockers on those days, but don’t do it without instructions from the doctor.

My favorite advice for getting your dose "dialed in" (once you are measured in hypothyroid territory) is to have a standing order at the lab. It can take a while for the replacement to build up in your system, so starting sooner will ultimately result in a shorter curve required to get back to normal. Keep a list of classic hypothyroid symptoms handy, and go to the lab when you can say you’re feeling 3 or 4 of them regularly. Remember that, at first, your TSH may well remain suppressed, and your T4 will be a better way to see where you stand, so make sure the lab is running both levels. After you’ve stabilized, for the most part, TSH is much more sensitive, but T4 is more helpful at the very beginning.

Once you’ve started taking replacement hormone, make sure you take it in the same way each day. Not necessarily at the same exact time, but same time of day, on an empty stomach, wait 45 minutes to an hour to eat, wait 4 hours to take mineral supplements. You need to wait 6 weeks after beginning or changing a dose in order for your test results to accurately reflect the way your body is responding to that dose, so it can be time-consuming to "dial in," especially since your dose needs to be changed by small increments as you’re going through the process. Any change in your dose is likely to trigger some symptoms, which are related to the *shift* in thyroid hormone, rather than to the *success* of your dose. Our body is finely tuned to thyroid hormone levels, which (in a normal person) do not change as much as they do when we’re being treated, so it is trained to react to any large change in thyroid hormone as if our body is in an emergency state which requires protection. For that reason, during those times, you may notice your hair falling out a bit more than usual, and you may notice that your nails get brittle. These things will correct once your levels are stabilized, and should resolve completely once your levels are NORMAL and stabilized.

You should also know that it’s "a little better every day," not "all better one day." When your levels reach (and remain) at a normal level that works for you, THAT’S when your body can begin to heal, so know that you still have healing to do, even after your test results are good.

Also remember that the normal range is VERY wide, simply because many people feel well at different points along the range. If you don’t know what your "normal" was before you were sick (and almost none of us did), then you have to rely on your own feelings as you reach that point. A symptom diary can help your doctor zero in on where you might need to go in order to feel completely well.

So, it’s a long road, but you’ve begun. Congratulations on the new child, how exciting! ” title=”Very Happy” />

Let us know any questions you have as you go through this, glad you found us!

[jfouts1979]

#1018202

Hi everyone. I took my dose of RAI on 11/30/2010 at 2 pm.

This was after I tried taking Tapazole again after Graves recurred in me 2 years after the first time I had it. This time, the Tapazole caused some liver issues to develop.

I took a dose of 17.7 mCi.

My wife is pregnant. I have been staying at my parent’s place since Tuesday. I’ll be going back home tomorrow (Saturday), but realized I will need to stay 10 feet away from her for 11 days from the 30th of November.

I feel a little bit different emotionally today, not sure if it is from the RAI, or just from the stress reduction that came after finally deciding to take the RAI. Is it normal to feel a little bit depressed? Is this due to changes in levels of T4 in my blood and changing TSH?

My appointment to follow up is on Jan. 10th – is that too long to wait to start taking Synthroid?

How long does it normally take to get the correct dose of Synthroid, and what are any pointers?

John

[jfouts1979]

#1063233

Thanks for all of the information. I really appreciate it. You know, a lot of people I know simply do not understand everything. They think I am just complaining that I am exhausted all the time. It is nice to have a support group online to talk about the way I am feeling, and to get answers.

I have 3 more questions, hoping you can help – you seem to know a lot!

1.) I drink alcohol sometimes, and I drink caffeine often. Since the thyroid controls metabolism, and I am in the process of killing mine off (4 days post RAI now), what does that mean for caffeine and alcohol? These will be processed the same way as before once I am stable on Synthroid? I own a winery, so I will continue to drink at least small amounts of wine. I am hopeful to cut back on caffeine. It never did very much good while I was hyperthyroid. Just make me feel shaky. It always made me feel like at least I was trying to do something about my fatigue. Ultimately it probably just caused more fatigue.

2.) I am fully prepared to start eating a more healthy diet. I have been moving toward this for a year now (a healthier diet). What are some of the best things to eat to help with converting T4 to T3? I want to feel normal again as quickly as possible. I am not even sure I know what normal feels like. Will iodine still cause any remaining non-damaged thyroid cells to convert T4 to T3? I am really hoping I made the right decision with the RAI. I guess it is too late to turn back now. Is there any stem cell research out there regarding thyroid research?

3.) Regarding a multivitamin, is it safe to take one? I used to take a Men’s Health Formula "One A Day" vitamin, but stopped it around 9 months ago for fear that it would interfere with Neurontin ( a drug I take to control nerve pain ).

Sorry so many more questions.

John

By the way, tomorrow is the anniversary of the repeal of prohibition in the United States. Happy Repeal Day to everyone! Prohibition was repealed December 5th, 1933.

[Bobbi]

#1063234

The thyroid doesn’t handle the metabolism of drugs. Thyroid hormone acts as a catalyst to the activities within the various organ and cell systems of the body and in that sense has an impact on metabolism. I.e. it influences how fast or slowly your body "runs." I’m not sure whether all drugs are metabolized in the liver, but a large portion of them are. And that use of the word "metabolism/metabolize" is slightly different than the use of the word to mean how fast your body runs. In the sense of the word when it comes to drug metabolization, what the liver does is take the drug (whether alcohol or aspirin) and break it down into a chemical form that the body can use….or not. When the body cannot use a by-product of the drug breakdown, the liver helps to eliminate the chemical from the body.

When you remove your thyroid, you are not "killing" your metabolism. You are removing the thyroid, yes, but you will be taking replacement hormone that is chemically identical to the body’s own T4, and you should expect normal levels of thyroid in your body, AND you should expect, over time, to regain feeling normal again as well. Those of us who have had our thyroid removed (me, Ski, Jake, Nancy, and millions more) live normal lives on the replacement hormone.

As we age, and sometimes with disease, the liver becomes less capable of ridding itself of the by-products of drug metabolization (if that’s a word??), and we can develop adverse side effects from taking the drugs, so whether or not your body handles alcohol/caffeine/drugX well in the future will have more to do with the good functioning of your liver than the fact that there is no thyroid. And, the liver also is a major area where T4 is converted to T3. T4 is converted to T3, naturally, in various other places throughout the body as well, but the liver is the dominant one. And that was true, even before you took out your thyroid.

Also, ablating the thyroid with RAI does not mean that you will have absolutely no thyroid cells left after the treatment. We can often be left with some thyroid cells still functioning, just not enough to make us hyperthyroid again (hopefully).

Recommendations on eating have nothing to do with conversion of T4 to T3 — it’s just that the body desperately needs good nutrition when it has been depeleted like ours have been when we’re hyperthyroid. And, of course, eating wisely keeps us healthier, and our bodies functioning better.

As to whether or not you can safely take a multivitamin, you need to talk with your doctor and/or a well-qualified pharmacist. Pharmacists are trained in interactions between drugs/chemicals/vitamins, etc. and that would be a possible source of good information for you.

Please know that about one week after your RAI, you will be MORE hyper than normal for a few days or a week. When the RAI destroys a thyroid cell, the cell releases it’s stored supply of thyroid hormone into the body, all at once. Its possible that your doctor warned you about this — we call it "dumping" here on the board — but sometimes they forget, and folks panic when they feel worse for a couple days while they are expecting to feel better.

I hope you are feeling much better soon.

[NormaRae]

#1063235

Hi,
I am new to the Graves Disease Arena. I am very grateful for this forum, as pointed out by K. D. I am forever in debt. I do not have a support group in the Hampton Roads area od Virginia. I am humbled and mortified of all the detachment of my hormons, the affects of the fall out, the emotional/physical affects, I mean. I am very pleased to read and absorb these posts and not go through this alone. I am grateful you all are here.

I have just recieved RAI treatment 03 Dec. I took a few days off and was allowed to continue Inderal. I am really not interested in going through "storm" twice. I am a very sensitive person, want to talk about feelings? Argh! I have had to force my way to an appointment with Endo and then no problem to see my PCM the next day.

I will address many questions and hopefully this time will get some answered.
I am learning a little more by reading here.

NormaRae

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