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High TSH (hypothyroid) raises cholesterol levels. Increasing synthroid should help your cholesterol.
in reply to: Symptoms lag behind tsh and Free T4 #1185006During the six months I was on methimazole, I felt awful but after the TT, the first year on levothyroxine was much better; however, even though my levels were within normal range, I still had complaints of anxiety, headache, muscle aches, etc. In my case, and this is not true for everyone i am sure, my “Aha” moment came when I went back and looked at my thyroid levels from annual physical exams long before I had Graves and found that sometimes they were mid range, sometimes higher or lower. As these checkups were routine exams, mainly for PAP smears, with no physical complaints, it dawned on me that since I did not even notice these variations then, why were they affecting me now. I have always had some anxiety, get migraines, have aches and pains, long before Graves. So I got my TSH at the value suggested post TT level, between 1 and 2 ( approximately, can be a bit over or under) and keep it there. If I feel I am a bit more anxious or achey or more headaches, I think of thyroid levels as a last consideration, not first. I found my anxiety over my levels was working against me, definite mind body thing. That is just me, everyone is different, and should my resting pulse exceed 120 or my hair start falling out by the handful, I would for sure get interim labs, but other than that, I have given up on “fine tuning” my values. These levels are not obtained in a vacuum, they naturally vary a bit by lots of factors like stress, illness, weight, season, etc so for me, so if within range of .5 to 2.5, I leave it alone.
Pepcid does not seem to affect levothyroxine, it is an H2 inhibitor (antihistamine). Zantac is also not a PPI so either one if they work for you might be better than ppi.
Proton pump inhibitors interfere with absorption of levothyroxine no matter when they are taken as they decrease acidity in the stomach. You would require a higher dose of levothyroxine therefore if you are on long term PPIs. This can be maybe avoided by taking levothyroxine in a liquid form inside a gel cap (Tirosint) which is more expensive than plain generic levothyroxine.
in reply to: GD with TED #1184540Mojon, Washington Univ in St Louis is a good choice. My husband did his fellowship there. Wait awhile after the decompressions to let your vision stabilize. Even though I had lateral walls which are supposed to cause less diplopia, it took several months for my double vision to return to its presurgery status.
in reply to: GD with TED #1184536As TED is relatively rare, there are not going to be large volumes of TED patients with strabismus being seen in pediatric ophthalmologists’ offices in smaller cities. Muscles in Graves patients present some challenges. I live in Cincinnati, which is a medium sized city, but still traveled to a center at a University that specializes in Graves (Kellogg Eye Center) for strabismus surgery. If you look at the CV’s of the surgeons you are considering, you might find some have trained at centers where they would have seen lots of Graves patients, like Wilmer or Shiley or Kellogg. Sometimes on their websites, they will list an interest in Graves. My husband is an ophthalmologist and if he is not comfortable with a difficult case, he has no problem referring the patient on to a large volume national specialty center so you also have to trust the doc to know the limits of his expertise. If you are close to a major eye center or large city, that might be your best bet.
in reply to: Doublevision not covered by insurance #1184993TED causes double vision. It is due to swelling and stiffness of the eye muscles. There are no exercises to fix this. It should be covered under insurance as it is a direct result of thyroid orbitopathy. If you have one bulging eye, it probably needs orbital decompression surgery, also covered by insurance, before any strabismus ( double vision) surgery, which cannot be undertaken until your thyroid levels are stable and no changes in your eye disease. I have had bilateral decompression as well as strabismus surgery, which corrected my double vision. No exercises were required at any time. You need to see an oculoplastic surgeon and a strabismus surgeon (actually a pediatric surgeon as they do all double vision surgery). I used press on Fresnel prisms at a cost of about $40 until double vision stopped changing and I could have surgery. This was covered also under insurance. I have Medicare and a supplement and I had no out of pocket costs for any of the surgeries. You need new docs.
in reply to: Is it all due to graves? #1184772I get my Graves eye care at the University of Michigan in Ann Arbor as they specialize in Graves. The university also has a thyroid multidisciplinary clinic in their Endocrinology division. The phone number I found for that on their website is 734-647-8906. If you live in northern Illinois, Ann Arbor is not very far. Maybe they can help you out. Are you sure your thyroid is completely gone? Has anyone done an ultrasound looking for remnants?
in reply to: Amazing Xiidra #1184895Shirley, be sure to download the coupon for a free month supply if you have Medicare and take the printout to the pharmacy. If on private insurance, there is a coupon for $250. Get coupons on the Xiidra website. Hope it works as well for you as it has for me.
in reply to: New and confused #1184938I had total thyroidectomy for Graves and it was the best thing I ever did. No regrets, feel fine.
in reply to: TSH hike 18 years after RAI #1184921Weight gain? Started beta blockers (heart meds)? Take proton pump inhibitors (Prilosec, Nexium, etc)? Have irritable bowel? All those affect absorption or hormone requirement too.
in reply to: No weight loss after TT. #1184935In looking at the literature, it does seem weight gain during the first year post TT or RAI is not uncommon. Some studies indicate once normal hormone levels are reached in the first year, things stabilize and weight loss occurs. Other studies say no correlation between hormone levels and weight gain! I did see some mention of low T3 being associated with no weight gain and in my case, the few times FT3 has been tested (preop eye surgery) it is usually low normal. I worked for bariatric surgeons and the surgery is successful but does require lifetime follow-up and lots of diligence. Most patients were happy they did it, but there are some side effects as well as failures. Being overweight is a big health risk especially with a family history.
in reply to: No weight loss after TT. #1184933I had a thyroidectomy three years ago. I gained some weight, less than ten pounds, but it was due to the high doses of steroids I was on intermittently for the eye disease. I do keep my TSH around 1, which is the recommended value for those with no thyroid. Some doctors are not aware of this, as the recommendation has changed in the past few years. Any higher, even within “normal” lab range, and weird things happen, like body hair loss, even though I might feel good. I ignore FT4 as long as it is in normal range, and it always is. Wondering if you are not taking enough levothyroxine. I have never had my TSH above about 1.5 long enough to have gained weight, but I would think being on the hypo side would cause weight issues. On the other hand, if you are hyper, which I was was at diagnosis, I was so hungry all the time I ate constantly and put on a few pounds that were quickly lost with treatment.
in reply to: AFFECT OF METHYLPREDNISOLONE INJECTION ON TSH #1184928I was on high dose IV steroid infusions once weekly for 6 weeks prior to thyroidectomy while on methimazole and for six weeks post thyroidectomy. I was on high dose oral prednisone for several months surrounding orbital radiation. I was put on oral steroids again for six weeks this fall for inflammation following lid surgery. I noticed no effect on my thyroid labs. I did, however, gain a few pounds, not unusual with steroids.
I am three years post TT. I dose replacement hormone by TSH, which I keep around 1. It is pretty stable. FT4 varies slightly, usually in upper part of range. FT3 isnt tested, unless Anesthesia requests it before general anesthesia for eye surgeries. I have no idea why they require it. When it is tested, it can range anywhere from low normal to hi mid range, even as everything else stays stable, so it isnt of much value. I have no idea what my antibodies are. The eye disease burned out within 6 months post TT and my TSH went from nondetectable to normal range at first labs two weeks post TT. I feel normal, no different than I felt prior to Graves diagnosis.
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