Adjusting Methimazole Dosage

[Germangirl]

I was diagnosed with hyperthyroid on 4/25. I've since been taking 40mg/day of Methimazole. Ultrasound showed slightly enlarged thryroid. After about 3 weeks on the medication, I felt like a whole new person. I was surprised when my endo told me to only come back in August. This doctor has since quit the clinic I have to use and at this time they have no endo on staff. I went to a family doctor and asked him to send me for another test. He agreed but said he would not know what the results mean.He never called me with the results so I requested a copy of my last two blood test. I was amazed to see, that my numbers have come down a lot. Below are the before my results from when I first was diagnosed and from the test 6 weeks later. My question is: should I lower my medication? I'm feeling somewhat exhausted.Also, the last test showed that my always normal cholesterol went up from 140 to 220(I'm eating the same.Could this be related to my illness or the medication?
4/25/07 : TSH 0.005          6/07/07 : 0.012
          T4  24.0                     7.7  
    T3 Uptake 42.2                     24.5
         FT4  5.32                     0.92
Free T4 Index 10.1                     1.9
     T3 Total 381                      106

[Mark Lupo, M.D.]

Yes, would lower the medication -- the TSH slow increase is expected, there has been a dramatic decrease in t4 and t3 to the lower end of normal.  40mg of methimazole is a high dose, so a decrease (? to 20mg) and recheck in 4-5 weeks is what I would typically do in this situation.  

Also need to confrim this is Graves disease - TSH-receptor Ab (aka TSI&TBII) would help.  Could also look back at the ultrasound to see if they mentioned increased blood flow which is seen in Graves as opposed to nearly absent flow seen in thyroiditis.