Where to go next?

[chelytoad]

I went into my doctor's office about a month ago with heart palpitations and other symptoms that were similar to "hot flashes". I had a partial hysterectomy last summer so it made sense. My doctor ran some blood work which included TSH. We were surprised when it came back at 0 but that would explain my sky high blood pressure and pulse rate. I was given a beta blocker to help with those symptoms and just completed a RIAU. It came back normal. ??? At this point, we are going to run blood work again (TSH, T3 and T4). According to the nurse, if this comes back normal this time we are "done". I am still concerned regarding my symptoms especially since my paternal grandmother, father, and uncle all have thyroid disease. Just wondering if this seems reasonable?

[Mark Lupo, M.D.]

This is likely graves disease.  The uptake is normal or high in graves.  You have a strong family history as well.  The blood tests are the reflection of hyper vs hypo -- not the uptake values -- the uptake values tell us why someone is hyper (not if they are hyper)....ie low uptake is thyroiditis (transient) - normal or high is graves or toxic nodule(s).

[chelytoad]

Thanks for the reply. My follow up work is of course still showing my TSH level as abnormal...only this time it was .01 rather than 0. I was told by the nurse that it was NOT Grave's disease. ??? I have made an appointment with another office for a second opinion.

Thanks!

[Mark Lupo, M.D.]

looks like graves still based on the information you provided.

[chelytoad]

I am making an appointment with another doctor's office tomorrow. Needless to say I have NOT been feeling well at all and it has been nearly a month since my TSH came back at 0. Can't wait until I see another doctor and get some meds that will actually help me with the underlying issues.

Thanks!

[GravesGirl]

Hi! I would ask for a TSI test to be run on you. It will confirm Graves, if you have the antibodies for it. (thyroid stimulating immunoglobulins)

[anneseno]

Good day! Thanks for your advices re Graves disease.

[chelytoad]

Update:
Well, when the nurse told me my radio scan was "normal" all she meant was that I had no nodules, etc. It did show extremely low uptake however.

I was advised to wait a month and come back in for more blood work which I just did. This time my TSH came back at 39. AT this point, it has been suggested that my initial symptoms can occur with  Hashimoto's before the hypothyroidism symptoms begin. I have an appointment on Monday & am assuming I will now join the other members of my family taking Synthroid.

Thanks for all the input.

[Mark Lupo, M.D.]

Looks like the "normal" report on the scan was misleading to us.
The scan should not have read "normal" in thyroiditis as the uptake is too low to produce a diagnostic image....

anyway, looks like thyroiditis, currently hypo phase -- this may be permanent but in many cases is transient.  So consider the levothyroxine (synthroid) for now, but it may be possible to discontinue in the future.