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Help--hyperthyroid question related to labs
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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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Help--hyperthyroid question related to labs

I called my MD and told him that all seemed to be getting worse (starting with shakiness, warm, up at the crack of dawn and a busybody) and it was not my imagination--had my labs done and on Sept 12,2012  my TT4 was 11.7   It was then that I increased my PTU to 75mg daily--I know that is not much of an increase but my doctor agreed to try that small increase to see if it would make a difference.   On Oct 9, 2012 he checked my FT4  it was 1.9 (0.76-1.46)  --not sure why he did just the FT4 and not also the TT4 for comparison.  I had had my labwork done at 6pm at night and he called me the next morning at 7:30 am concerned--I agreed to up my PTU to 50 mg three times a day and have been on that since Oct 9, 2012.  On Oct 22, 2012 he had me repeat labs: FT3 5.5   ( 2.0-3.5) , TT4 10.4 (5.3-12.3)--he kept me on the PTU 50 mg three times a day.  On Nov 19,2012  labs:  FT3 4.9 (2.0-3.5)  and TT4 7.5 (5.3-12.3) TSH undetectable.  I am feeling better with only a rare palpitation.  However, I am slightly constipated, I feel the need to wear heavier clothing even indoors, I am gaining weight, etc.  My doctor said he will recheck in 3 weeks.  I am a bit concerned since there was such a drastic drop from 10.4 to 7.5 (TT4) in 4 weeks .  Any suggestions?
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These are not very unusual changes as we titrate medications like PTU.  You may want to ask about methimazole instead of PTU, methimazole can be taken once a day.  It does sound like your physician is checking frequently enough, usually if we check more frequently than every 4 weeks and we don't get a very good sense of a true trend.
8 Comments
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Avatar_f_tn
Thank you for your response. I had been on Methimazole in the past but developed the hives and had to go back on PTU.  I still feel ok but have been gaining weight which makes me think I am getting too low on my total t4.  My labs are due on Dec 10th or sooner --so my md said.  I will wait till the 10th since I "feel" ok.  Last time I was this low on Total t4 I was very down and depressed and felt like the life had been sucked right out of me--I was ferful to return to that state--to me it was worse than being hyperthyroid.   Time will tell.  Thanks once again :)
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Avatar_f_tn
hi yankee-

i just read up on your post and it looks like things took a turn for you after we first stated emailing on this site.  I'm also in a downward spiral...my tsh went from .0004 to 7.7 and my FT4 is on the low end.  i agree that being hypo is much worse than being hyper.  i've been having the same symptoms as you.  and a head cold to add to the mix with some intense anxiety attacks.

how have you being doing since this early dec post?
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Avatar_f_tn
i dont agree that hypothyroid is worse than hyperthyroid, both of diseases are
equally as bad, i have had grave Disease for 20yrs and now i am hypthyroid which is a terrible feeling,  i have had  3 rai and it destroyed my thyroid and i am having worse symsptoms, i wouldnt wish this disease on anyone, i am hypoglecimic with high cholesteral with low blood pressure and fibromyalgia with ear ringing, i currently being tested for hashimoto disease, this disease screws up everything and it has casued me to have hypo and hyper symptoms and i lost 20 pounds a and weigh 115 pound, and they do not even
lnow why i am losing weight , this is scary
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Avatar_f_tn
I had just typed a rather lengthy piece but it disappeared so now you get the very shortened version:)  I feel good--my labs are stabilizing now.  I agree with cyndi78 that hypo and hyper both have their own major downfalls.  For me however the hypo made me feel the least hopeful and extremely depressed.  To go from hyper to hypo so quick felt like I had been on the edge of a cliff and someone yanked the carpet right out form underneath me.  I couldn't get any lower in mind state than I felt--I thought I might be just depressed so I tried to do things to force myself to feel better--I use to get up every morning and make myself smile in front of the mirror --hearing that even forcing a smile can fool the brain to think happy thoughts or something like that--I have never seen such a sad smile on me before.. The hyper was it's own hell with the rapid heart rate (160-170) , chest pressure, shortness of breath, panic /anxiety attacks, full body shakiness, feeling like I was in an oven and sweating profusely , etc  For some reason I still felt I had hope with the hyper but the hypo I was at rock bottom.  I know there are different extremes to both states--it all depends on how bad things are.  
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Avatar_f_tn
How are you doing?
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Avatar_f_tn
Has anyone checked out your adrenals?  The hypoglycemia  and low bp makes me think that.  None of this stuff is fun--I do find I have an appreciation for when I do feel good.  I also feel that I feel much more empathetic to my patients who have thyroid issues and other chronic diseases.  I know that I didn't ask for these problems and I always tried to take care of myself but VOILA I got this thyroid issue.. Believe me when friends and family found out they thought "Why you--you take care of yourself?"  It is what it is.
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Avatar_f_tn
No they have not, i found on national graves and hpothyroid foundatioon there are blood test for female weight loss panel which includes cmp,lipid profile,cbc, dheas-s(adrenal) free testosterone, estradiol, progesterone, c-reactive proteinm insulin resistance,tsh, t4 and t3,shbg, vitamin d,cortisol
thyrogolobulin,,ferritun,leptin,t3 hormone, i am getting scared i have never had hypoglecemia or fibromyalgia, my my muscle ache and i hurt and my fingers  are swollen, i  eat 5 meals a day and still get sugar attacks, i want to know how many calories do i need to  gain weight, i know something is not right and i feel miserable, i have had graves and hypothyroid and feel like a mack truck
rolled over my body, i get very weak and  i am frustrated, both of these diseases are not fun, i had a good doctor in chicago, i am trying to find a
good one in florida, i feel like going to mayo clinic in florida, i hate this desease nobody realizes that your thyroid effects everything, i know when
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