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Do Dr's Always Treat Hyperactive Thyroids
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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Do Dr's Always Treat Hyperactive Thyroids

Just found out that I have a hyperactive thyroid. Only symptoms I'm experiencing are the panic attacks and possibly depression (is that a symptom?) Dr. told me that she would monitor in 6 months with another blood test. Told me to start taking calcium supplements to reduce the osteoporosis risk. I did ask her if there were any risks by not doing anything and she said it was just dealing with the symptoms.

Question - unless the symptoms are really bothersome, do most dr's put patients on meds and if so, are there any risks with the meds themselves? Are there any risks by not taking any meds? Doc did prescribe .25 mg. xanax as I told her that it takes the anxiety/panic attack feeling away. I really don't want to take meds daily if I don't have to as the symptoms aren't always there.

Thanks.

Laurie
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Avatar_n_tn
Hi bunkywoo, I keep being amazed at how many patients on here are having Dr.s tell them they have either hyperthyroidism or hyperthyroidism and to "come back in six months". Hyperthyroidism (too much thyroid hormone), also called Grave's Disease, can be dangerous because it can cause a "Thyroid Crisis", also called Thyroid Storm. Usually, Dr.s first treat hyperthyroidism with beta-adrenergic blockers (beta-blockers). They also treat with thyroid suppressing drugs (anti-thyroid drugs), like Tapazole.
Once they try these treatments (calcium also commonly prescribed) and it does not control the disease, they will give RAI (radio-active iodine) treatment to at least partially destroy thyroid tissue/cells, to slow down production of hormones.
The calcium only helps with possible bone loss (osteoporosis) but won't help with symptoms. My guess is you didn't hear any of the above from your Doc. Maybe yours was only "sub-clinical" at this point. Do you have your actual lab-ranges and results. If so, list them on here if you like, maybe yours is really mild but hard to believe it would be with panic attacks etc... Did your Doc order thyroid antibodies tests too?
Bets Regards, JimLow
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Sorry, I meant to list both disorders instead of "hyper" twice.
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53833_tn?1235000229
Thanks for your info Jim. My test results are TSH 0.35 (range is 0.47-4.53), T4 Free is 1.13 (range is 0.84-2.26).

I had my thyroid tested 2 years ago while under treatment for Hep C (Interferon & Ribavarin) and docs thought maybe was due to sides of those meds. Obviously not since I've been off those meds for 2 years now.

Now 2 years later results are similar (don't have results with 2 years with me right now). I have the panic attack symptoms, fatigue, muscle weakness and can cry at the drop of a hat sometimes along with other kinds of mood swings. I told Doc all of this in the office and she told me that she wanted to put me on Prozac (said it has a different name when they prescribe it to women for hormonal things).

I'm waiting for a call back from Doc now and have a list of questions - basically - why aren't you starting treatment - which I understand is for about 1 year and it can be resolved. Been living with these symptoms for about 3 years now and attributed it to pre-menopause (i'm 44). At this point don't even know if I want her treating me.

Thanks for any guidance you give.

Laurie
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Avatar_n_tn
bunkywoo, Depression is listed as a symptom of hyperthyroidism, as well as anxiety symptoms, on just about any medical website you might go to. Use "symptoms of Grave's Disease" in a search engine, like google.com or others and you'll see it!
From what I read, Dr.s even found your thyroid was off two years ago. Your TSH was flagged low according to the range at the lab that tested yours. Even with the new range 0.34 to 3.04, you would be at borderline-low (even 2.5 with new range is suspect for hypo) but yours is in the hyper-thyroid range. I've read peoples posts of having a normal Free T-4 but their other thyroid hormones were high, like the T-3 and FreeT-3, so looks like you didn't get real thorough thyroid testing done. They usually check for thyroid antibodies too, when they suspect Grave's Disease.
I hope your Dr. will work with you on testing you might request.
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53833_tn?1235000229
I've done the Google searches - doc never mentioned Grave's Disease and I don't believe I have that based on the symptoms listed - although it does say you may not have any symptoms but still have the disease. Is the anti-body test done to determine Grave's? I do believe when I was tested 2 years ago that the dr then ran the T3 tests.

Also, I was a little confused by what you wrote - do you think I am borderline with my results and that is why she wanted to retest in 6 months?

Gotta say that if I don't like her answers I'm going to an endocrinologist on my own. I wouldn't trust current doc to prescribe the right medicine.

Thanks again for your info.

Laurie
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Avatar_n_tn
bunkywoo, when I said "borderline" I only meant on the TSH reading you were. Borderline just means right on the edge of being abnormal. As far as the condition itself, only complete testing can reveal if it's full blown Grave's or just entering that phase of abnormal. You are right about antibodies being the test to see if the hyperthyroidism is autoimmune (Grave's) or not because there are secondary causes of hyperthyroidism, such as a pituitary gland that puts out too much TSH, due to a tumor (very rare) etc...however, your TSH is low, so that probably rules out the pituitary!
If you have elevated antibodies along with hyperthyroidism, that gives the cause right there, "Grave's Autoimmune Hyperthyroidism". Blood tests will reveal if it's autoimmune and there's also the possibility of either/both a goiter or nodules. Goiter is thyroid swelling and nodules are small growths, common in both hypo and hyper thyroid patients with autoimmune as the cause.
I'm a fellow patient and of course my opinions are only for consideration but I do hope this helps. Please ask as many questions as you like. There are others more knowlegable than I, that may jump in here!
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53833_tn?1235000229
Just got off the phone with dr. and she told me that since my T4 was normal, she wanted to wait and see what my TSH is in 6 months. She said she could barely feel the goiter that was found on the Thyroid scan done 2 years ago. She said I couldn't be put on meds for a hyper thyroid - she said they would have to "burn" part of it off and she didn't want to do that right now.

I think I'm going to make an appt. with a specialist tomorrow. When I mentioned that I found some info on the internet about the treatments she got a little agitated.

I'm not sure if what's she's telling me is accurate or not so I'm going to a specialist without her knowing.

Laurie

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Laurie, Sometimes it's good to get a sencond opinion. I did this back when I was struggling with Hashimoto's Disease, trying to get diagnosed and coincidentally, it was the thyroid antibodies test that actually finally told me what was causing my hypothyroidism. I too got second opinions and never told my regular Dr. because I felt it was none of his business unless I completely switched to a new one and needed med. records transfered.
Your current Doc seemed to think the only treatment was to burn-off part of the gland but that is usually done if medications don't control symptoms. Do you have high blood pressure or tachycardia (rapid heart beat)? If you do, it is strange that she isn't concerned about it.
Maybe your symptoms are so mild she doesn't want to consider these other meds but your mention of panic attacks made me think your vital signs might be operating too high. Xanax might calm down your nerves but not sure it would help with high BP and heart rate. If symptoms truely are mild, that may be the reason she is waiting. Were your last BP/Heart rate readings fairly normal?
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Avatar_f_tn
Hi,

Just my two cents here. I was diagnosed w/Graves almost six years ago. Unlike you, I did have a lot of symptoms: increased heart rate, headaches, etc. And yes, depression is a symptom for both hyper and hypo. My recommednation is to go to an endocrinologist, I've found that general Drs are limited on this sense (at least based on my experience). You should get tested for Graves antibodies but your labs are "within range". However, my endo always says that treating a patient w/borderline labs results will depend on how the patient feels. Maybe some medication will help. So go to an endo as hyper thyroid could also be due to thyroiditis (immflamation of the gland due to a virus).

In regards to treatment, I don't know why your Dr said you couldn't be put on meds for hyper. I've been on Tapazole for the last almost six years and has worked wonders. My endo sat down with me and evaluated all of my alternatives: 1) meds 2) RAI (radiation in which they burn part of your thyroid) or lastly 3) surgery to remove part of your thyroid. I decided to go with meds before considering anything else and I don't regret it as I've heard of so many people feeling awful after the radiation and surgery is always a major thing.
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53833_tn?1235000229
My blood pressure is always good 80/120. I think my heart rate is fine too because they've never said it was high. I don't think I get heart palpatations - but it's hard to distinguish sometimes because the panic attacks give you the sense your heart is beating too fast.

I am going to an endocrinologist on my own - thanks for concurring on what I was thinking Jim.

My dr. really irritated me yesterday when I told her I had read "this and that" on the internet. She made it seem like anything that I read on the internet was bogus. When I was being treated for Hep C, after treatment I told my dr. I wanted this Heptimax Test because it was an extremely sensitive test that measured viral load down to 5 units (std. tests only measure to 50). He was totally clueless until I faxed him some info on it - and then he wrote me a script for it. That whole treatment experience has taught me not to put blind trust in ANY doctor when it comes to my or my family's health.

Thanks for all of your comments. I'll let you know what happens after I see the specialist.

Have a great weekend!

Laurie
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