[scanders]

#1060675

I met with my endo today. My labs are pretty much mid-range again (I’d been a smidge hyper the last few months.) She said that people without thyroid disease have labs below mid-range, and that’s what she usually shoots for. We’ve already figured out over these past few years with titrating MMI that I seem to need to be at least mid-range to have any type of cognitive function, so she’ll accept my mid-range numbers, but doesn’t really want them higher than that. I think that during my little bout with slightly higher numbers I actually felt better than I do now, not that I feel horrible. I just felt better, somehow. (I think I don’t like feeling so chilly again, especially going into winter.)

I thought I’d read somewhere that Graves patients should strive for thyroid hormone levels in the upper third of the reference range, but I can’t find an actual reference for this, just commentary on various other forums. I know everyone has their own optimal place they feel well, but is there any logic that we need higher FT levels than “normal” people? Any actual references anyone is aware of? Thanks!

[Kimberly]

#1184067

Hello – I’ve actually seen one or two studies that showed a *negative* effect for patients who are at the upper end of normal for T3/T4. I don’t recall if those were specific to Graves’ or just for the general population. I am working a conference and have spotty internet access at the moment, but will look them up next week.

[Kimberly]

#1184068

Hello – Here are the links I promised. These studies looked at the general population, not Graves’. If you find a study from a credible journal (Thyroid, Journal of Clinical Endocrinology & Metabolism, European Journal of Endocrinology, etc..) that is specific to Graves’, feel free to share here.

Keep in mind that the studies below simply indicate an increased risk. It doesn’t mean that any of these issues *will* occur for someone with high normal Free T4 levels. In fact, in the first link, the increased risk is very small – 4% over 10 years.

However, if you really don’t feel well at mid-range and accept the risks of maintaining high-normal levels, this is definitely a discussion to have with your doctor. Would you accept these future risks in exchange for a better quality of life now? Only you can make that decision.

(Note on links: if you click directly on the following link, you will need to use your browser’s “back” button to return to the boards after viewing, or you will have to log back in to the forum. As an alternative, you can right-click the link and open it in a new tab or new window).

Sudden cardiac death:
http://www.clinicalendocrinologynews.com/specialty-focus/pituitary-thyroid-adrenal-disorders/single-article-page/high-free-thyroxine-may-increase-risk-of-sudden-cardiac-death/bbc2e822916c967be80131d259a2af0e.html

Dementia:
http://www.medscape.com/viewarticle/853079

Pregnancy Issues:
http://www.endocrineweb.com/professional/hyperthyroidism/hyperthyroidism-high-normal-free-t4-levels-linked-hypertensive-disorder

[scanders]

#1184069

Thank you, Kimberly! Very helpful. I appreciate your perspective. (I think what would really help is if I could remember what my “normal” felt like, but I have no idea…)

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