[Kimberly]

in reply to: Is it all due to graves? #1184768

Hello and welcome back! We are fellow patients here, not docs or nutritionists, but the 700 cal/day sounds like it would be *very* difficult for you to get enough nutrition to function on a daily basis!

That is good that you have an appointment with Mayo – hopefully, they will be able to shed some light on the issues you are experiencing.

TSH alone is fine for patients who are stable and feeling well, but with your symptoms, it would certainly make sense to take a look at Free T4 and T3.

Finally, if it was me, I would not include my e-mail in my signature. Although you have to be a member to post here, *anyone* can view the posts. I would hate for a spammer to get a hold of your e-mail! You can always change your signature to say “feel free to PM me.” You can send a private message to another user by clicking the PM option in the menu in the top right-hand corner of the screen or by clicking the PM option when you are looking at one of the person’s posts (located to the left of the post, below the screen name. When you send the private message, a notification will be sent to the person at the e-mail address they used to sign up for the forum. They will need to log in to the forum to view your message.

[Kimberly]

in reply to: New to Grave’s Disease/Please Help #1184759

Hello – A couple of notes…

Exposure to contrast dyes can increase the risk of developing hyperthyroidism. Here’s some info from the American Thyroid Association:

(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).

http://www.thyroid.org/patient-thyroid-information/ct-for-patients/vol-5-issue-7/vol-5-issue-7-p-7/

The upper threshold for antibody tests is set so that it will correctly diagnose as many actual cases of Graves’ as possible, while giving the fewest number of false diagnoses. So there is some gray area right around the actual cutoff. If your antibody levels were zero, though, that would certainly point to other causes.

Itching can be a side effect of methimazole, but it can also come from hyperthyroidism itself. Ask your doc about taking an antihistamine in conjunction with the meds.

Talk to your doctor about the Wellbutrin. Does he/she thing you still need it with the hyperthyroidism diagnosis? (The symptoms can sometimes overlap). Is anxiety a common side effect? And if so, is there another available med that could give you some relief?

You are the customer, so don’t worry about being the squeaky wheel if you aren’t feeling well! Your pharmacist can also be an excellent resource for info on side effects.

[Kimberly]

in reply to: New to Grave’s Disease/Please Help #1184755

Hello and welcome – Yes, things *do* get better. Antithyroid drugs (like methimazole) start working right away to block the production of *new* thyroid hormone, but the body still has to burn off its existing stores of excess thyroid hormone, which can take a few weeks before you really start to see relief.

Hopefully, you will be back to enjoying your little ones soon, but keep in mind that your body need some time to heal from being in a hyperthyroid state. Any non-essential tasks or responsibilities for the near future that you can “dump or delegate” will be helpful in reducing stress levels.

Most patients do well on antithyroid meds, but if for some reason, you need to pursue surgery or RAI, we have regular posters here who have had success with both options.

Take care – and keep us posted!

[Kimberly]

in reply to: 25 weeks pregnant – flu shot??? #1184753

Hello – That is a good question…you might see if you can find a high risk OB/GYN in your area who could provide some additional info.

As emmtee said, I’ve seen warnings against getting a live vaccine for patients on methimazole, but aside from that, the docs I’ve spoken with do advocate getting a flu shot.

[Kimberly]

in reply to: Pregnancy with Graves #1184735

Hello – This will vary by lab, so it’s possible that the specific lab your doc uses doesn’t have trimester-specific ranges. You can read more in this document from the American Thyroid Association (pages 1086-88 of the original journal article):

http://online.liebertpub.com/doi/pdf/10.1089/thy.2011.0087

(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).

[Kimberly]

in reply to: Blood tests before or after taking medication? #1184747

Hello – My doc always stamps on the lab order “no thyroid meds prior to labs“. However, at a recent event hosted by the American Thyroid Association in Denver, most of the docs there did not feel that it made a significant difference. Our Founder, Nancy, suggests getting labs done at the same time of the day (i.e. always morning or always afternoon).

[Kimberly]

in reply to: (UPDATE: Presenters Announced, Registration Now Open!) GDATF Will Be at the ThyCa Conference in Los Angeles on Oct. 22nd! #1184696

Hi Shirley – Sorry we will miss you. There are a ton of moving parts with an event like this. I always announce as soon as we have confirmation of a date. Sometimes we have the luxury of a lot of lead time (like we did in San Diego last spring), and other times (like this one), the events come together much more quickly.

[Kimberly]

in reply to: (UPDATE: Presenters Announced, Registration Now Open!) GDATF Will Be at the ThyCa Conference in Los Angeles on Oct. 22nd! #1184694

UPDATE: Registration is now open for the GDATF’s free patient education event in Los Angeles on October 22nd from 12:30 – 5:30 p.m. at the Hilton Los Angeles Airport Hotel.

The program will feature Dr. Raymond Douglas, Dr. Ira Lesser, and Dr. Andrew Gianoukakis. If you attended our 2012 San Diego conference, you know that this program is not to be missed!

Please click the link below to register:

https://www.eventbrite.com/e/graves-disease-thyroid-eye-disease-free-los-angeles-patient-education-seminar-tickets-28240360679

[Kimberly]

in reply to: Hyperthroid with no symptoms #1184738

Hello and welcome! One issue to check is whether your T4 is falling within the normal range of your lab, as this range will vary slightly from facility to facility.

If you are within the “normal” range for T3 and T4, this is considered subclinical hyperthyroidism (SH). The American Thyroid Association just released some new guidelines on the treatment of hyperthyroidism, including subclinical hyperthyroidism. They now recommend treatment for SH for “all individuals ≥ 65 years of age; in patients with cardiac risk factors, heart disease or osteoporosis; in postmenopausal women who are not on estrogens or bisphosphonates; and in individuals with hyperthyroid symptoms.” There are a number of concerns with untreated subclinical hyperthyroidism, particularly related to osteoporosis and heart issues.

If you have SH and do not fall within this recommended treatment group and do not wish to pursue treatment, it is certainly reasonable to seek another opinion. If your T4 is out of range, though, it’s more likely that your doctor will continue to push for treatment due to the risks mentioned regarding SH as well as the risk of thyroid storm.

One other issue to keep in mind is that it’s possible to be symptomatic, but to attribute the symptoms to other issues — or to get so used to them that they kind of become a regular part of our lives! Prior to diagnosis, I had tremors, sweating, insomnia, and rapid heart rate, but I’d written all of those things off to stress!

[Kimberly]

in reply to: Pregnancy with Graves #1184732

Hello and welcome – hopefully, others will chime in here, but a few notes…

When you are logged in, you can use the “search posts” feature to search for keywords such as pregancy, pregnant, etc. to read posts from other forum members.

It’s actually common for TSH to be on the low side and free T4 on the high side early in pregnancy – so make sure that your lab is using trimester-specific ranges.

If you do end up needing an antithyroid medication, PTU is the preferred drug during the first trimester, as there is less of a risk of birth defects than with methimazole.

Finally, make sure your doctor is aware of the new guidelines for treating hyperthyroidism in pregnancy. Antibody testing is now recommended during the first trimester.

Wishing you all the best!

[Kimberly]

in reply to: Whether to have a thyroidectomy #1184713

Welcome to Suze and MsMamaKat!

Regarding replacement hormone, food can interfere with absorption. Therefore, the vast majority of doctors will recommend taking it first thing in the morning and then waiting an hour before breakfast and/or coffee. Some docs will reduce this to 30 minutes, especially if you are taking a gel capsule like Tirosint.

Also, some docs will recommend taking the meds at bedtime, but that probably isn’t the best option if you eat late.

I haven’t had surgery, but I went hypo after years of taking methimazole. I leave out the meds and a glass of water on my bathroom counter every night. I set my alarm for an hour early, but then if I wake up in the middle of the night (which happens the majority of the time), I go ahead and take my meds and reset my alarm. Then I have a much happier morning.

Of course, it’s more ideal if you take the meds at the exact same time each day. But since I already take a different dose (50 mcg instead of 25 mcg) one day per week, I figure that the variability in time isn’t going to make *that* much more of a difference in my levels.

[Kimberly]

in reply to: Cholesterol control post TT #1184730

Hello – I have not heard any complaints specifically related to thyroidectomy. However, hypothyroidism *is* associated with cholesterol issues, so it is important to make sure you are on the right dose of replacement hormone.

[Kimberly]

in reply to: Long term side effects of Synthroid #1184699

Hello and welcome – Some doctors will prescribe desiccated products like Armour or Nature-throid (which are made from pig thyroid glands and contain both T3 and T4), although this is somewhat controversial in the medical community. We hear from patients who have had success with this approach, and from others who felt that these products brought back a return of their hypER symptoms. You can read more here:

http://gdatf.org/forum/topic/44358/

Hopefully, you are getting levels checked and the dose adjusted at least annually. Bone loss can be an issue *if* the dose of Synthroid is too high.

If you have bone loss, talk to your doctor about calcium supplementation – although this is another area where not all doctors agree!

Rarely, patients can react to the fillers/dyes in color-coded replacement hormone tablets. If you are taking a color-coded version of Synthroid, you might at least ask your doctor about taking the non color-coded version (there is usually one) and adjusting the # of tabs taken daily to get you to the correct dose.

There is also a product called Tirosint that is a T4-only gel capsule and does not have the binders/fillers in traditional meds.

Another thought would be to get a complete physical *just* to rule out any other possible underlying causes for the joint pain that could benefit from separate treatment.

[Kimberly]

in reply to: TT and eye disease symptoms #1184598

klassey wrote:

Is there a way to get this disease to burn out faster?
Klassey

Hello – Unfortunately, TED runs its own course and there are no shortcuts that I am aware of. However, not smoking or being around second-hand smoke is important, and it’s also important to make sure that your thyroid levels are stable. Although TED can strike at any time (in some people even before their thyroid levels go out of range), there is an increased risk when we are hyper or hypo.

[Kimberly]

in reply to: On ATD two years-plus? #1183787

@Flora – Fingers crossed that you have settled on your “sweet spot”! I know that those on this thread will welcome your continued input!

@scanders – There are new guidelines that just came out on the treatment of hyperthyroidism, and there is more emphasis on testing antibodies prior to withdrawing ATDs. Regular testing of antibodies probably isn’t as helpful – and can be very expensive!

[Author]

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