Grave's Disease and Heart problems

[ccarlton]

I am a 27 year old female with body mass index of 20-21.  I have just found out that I have Grave's Disease.  My TSH has been suppressed for over a year now.  I finally had a radioactive iodine uptake test which after 24 hours was 37%.  My thyroid itself was atleast twice the size it should be.  I had a bone density at the same time which showed osteopenia.
I have heart palps that are getting worse and I will have an echocardiogram tomorrow.  I am on thyroid meds for a week now and have red places on my skin and I itch everywhere.  I didn't notice my thyroid being enlarged before but now I can feel that it is.
How long does it take for this to level out?
What is thyroid storm?  I have a major surgery in December and was told thyroid has to be under control
Is the thyroid function affecting my heart functions?
Is a rash and itching all over normal?
Also, my sugar has been borderline for a year now as well around 130+.  Will that also go away when thyroid gets under control.

Thanks in advance for any advice

[loveblue]

Wow - your symptoms are so similiar to what I've experienced in the past, we could be twins.  

I was diagnosed with Graves Disease in March of '05.  Partly because I had alot of things going on in my life then, and partly because I still felt fine, I almost totally ignored my endo's diagnosis.  By the end of 2005, I was starting to feel very tired all of the time and was having alot of trouble sleeping, so I finally started on PTU for the Graves Disease.  Within weeks, I developed a mealy, intensely itchy rash on over 80% of my body.  At one point, I thought I would lose my mind over the itching alone.  My endo changed my prescription to Methimizole, but the itching was relentless.  

After three months on the thyroid medication, everything came crashing down.  My resting heartbeat was close to 140 beats per minute.  My heart also beat very, very hard, which scared me to death.  I had great difficulty concentrating and it just seemed like the entire world was on fast forward, with me trying to keep up.  I had been dealing with the itching for about seven months when, on one particularly horrible day of itching, I had a very calm suicidal thought.  That was all it took.  

I decided to find a new endo, who was horrified by the results of my blood tests, my sharing of the symptoms I was experiencing and the exam to determine the size of my thyroid gland.  For the next three weeks, I was on pre-op medication to bring my thyroid levels (which were four times what they should be) down to a safe level for a total thyroidectomy.  Both my endo and my surgeon explained that if my thyroid levels were not at a safe level, during surgery I could have a thyroid storm, which is similiar to having a stroke.  I was also advised by my surgeon that if I hadn't had the surgery, I would have most likely eventually gone into heart failure.    

The surgery itself (in late August of '06) went very well.  I'm not tired anymore, I sleep like a baby and my heart beats normally now.  Getting the right prescription and dose for the thyroid levels has been tricky, but we're slowly getting there.  I still have problems with the itchy rash, but nowhere near the levels I did prior to the surgery.  I also have my concentration back and feel much, much more on top of things.  

I hope this helps you.  I never thought I would have to have something a drastic as the thyroidectomy, but the medication for the Graves just didn't help me, which I admit I hindered by not taking the medication as soon as I was diagnosed.  

I wish you well with your treatment.  Problems with thyroid disease can affect so many of the body functions.  One thing I learned with the Graves - don't be afraid to stand up to your doctor, which can include firing your doctor if need be.

[Mark Lupo, M.D.]

The rash is likely due to the med (tapazole I presume).  Tell your doc about that.  THyroid storm is cardiac decompensation (usually requring ICU admission) due to hyperthyroidism -- this is rare.  You should be on a beta blocker for your heart (ie, propanolol or atenolol) while you are hyperthyroid.  The sugar is sometimes high in hyperthyroid - likely will get better.

You may do best with RAI (I-131) treatment.  If you smoke, stop now -- this worsens treatment response and increases risk of thyroid eye disease.